Concussion and Occupational Therapy

Written by Erica Friesen, Student OT. Edited by Stefani Koulovasilopoulos, Student OT, and Jenni Diamond, OT Reg. (Ont.)

Male with concussion holding head

What is Concussion

The human brain is a complicated organ. It contains billions of cells and blood vessels which share information and keep the brain healthy1. It is surrounded by liquid and covered by hard outer layers which include the skull1. Your brain is the control center for your body1. It is responsible for organizing movement, controlling emotions, making decisions, and processing your senses such as vision, hearing, and touch1.

A concussion is a form of mild traumatic brain injury that can impact how our “control centre” operates.2,3. A concussion can happen when an individual hits their head or body hard enough to cause their brain to move around in the surrounding liquid and hit the hard inner layers of their skull2,3. This can hurt the cells and blood vessels of the brain and temporarily change how they work2,3. The result of this movement can change the way the individual thinks, acts, moves or feels2,3. Below are common symptoms of concussion3:

Early (minutes to hours later):

  • Headache
  • Dizziness
  • Lack of awareness of surroundings
  • Nausea or vomiting
  • Light or noise sensitivity
  • Balance problems
  • Vision changes
  • Confusion
  • Forgetfulness

Late (days to weeks later):

  • Continuous headache or head pressure
  • Light-headedness or dizziness
  • Getting tired easily
  • Sensitivity to light or loud noises
  • Balance problems
  • Eye strain with reading
  • Poor attention and concentration
  • Memory and thinking problems
  • Feeling irritable or easily frustrated
  • Anxiety and/or depressed mood
  • Sleep changes

What are Persisting Symptoms after Concussion?

Most concussions heal in the first few weeks after injury, but about 15% of people have symptoms that last for several weeks, months, or years4. When symptoms last beyond 4 weeks they are called persisting symptoms after concussion (or PSaC)5. These symptoms can include emotional or mood issues (e.g. anxiety, irritability), physical problems (e.g. headache, fatigue, dizziness, sensitivity to light and noise), thinking problems (e.g. concentration, memory, learning, and decision making) and sleep disturbances4,6.

Research shows that people who have a history of a prior concussion are more likely to experience persisting symptoms4. Other things that can increase one’s risk for persisting symptoms include being female sex, older age, prior concussions, having mental health challenges, history of headaches, or a history of sleep disturbance4,7. Understanding a person’s medical history is important and can help healthcare providers figure out who might be more likely to have lasting symptoms after a brain injury and how to best manage their symptoms4.

How can Occupational Therapists Support Concussion Recovery?

Occupational Therapists (OTs) are trained healthcare providers who help people get back to doing the activities they want, need, or have to do. They can support people after a concussion, whether it’s right after the injury or if symptoms last longer.

Because every concussion is different, it’s important to have a recovery plan that fits your personal needs and goals. OTs will work with you to create this plan and help you set goals that matter to you. For example, they can help you make a step-by-step plan to return to school, work, or sports and help you find practical solutions to the challenges you are experiencing, getting you back to your regular activities.

The following are ways that an OT can support you with achieving your goals:

  • Manage daily activities (e.g. cooking, cleaning, driving, managing finances, self-care tasks)
  • Improve function at work or in the classroom
  • Increase energy levels
  • Manage headaches/head pressure
  • Improve quality of sleep
  • Relaxation and stress reduction
  • Cognitive strategies (e.g. memory, planning, organization, problem solving, word finding, focus)
  • Ergonomics
  • Concussion education

Occupational therapists help individuals after concussion to manage symptoms and adapt activities, ultimately improving their ability to participate in daily activities as fully as possible. Concussion recovery can take time, and OTs are here to help guide you through it.

References

  1. Krebs, C., Weinberg, J., Dilli, E., & Akesson, E. J. (2018). Lippincott illustrated reviews: Neuroscience (Second edition.). Wolters Kluwer.
  2. Mullally, W. J. (2017). Concussion. The American Journal of Medicine, 130(8), 885–892. https://doi.org/10.1016/j.amjmed.2017.04.016
  3. Master, C. L., Mayer, A. R., Quinn, D., & Grady, M. F. (2018). Concussion. Annals of Internal Medicine, 169(1), ITC1–ITC16. https://doi.org/10.7326/AITC201807030
  4. Permenter CM, Fernández-de Thomas RJ, Sherman AL. Postconcussive Syndrome. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK534786/#
  5. Patricios, J. S., Schneider, K. J., Dvorak, J., Ahmed, O. H., Blauwet, C., Cantu, R. C., Davis, G. A., Echemendia, R. J., Makdissi, M., McNamee, M., Broglio, S., Emery, C. A., Feddermann-Demont, N., Fuller, G. W., Giza, C. C., Guskiewicz, K. M., Hainline, B., Iverson, G. L., Kutcher, J. S., … Meeuwisse, W. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022. British Journal of Sports Medicine57(11), 695–711. https://doi.org/10.1136/bjsports-2023-106898
  6. Jaber, A. F., Hartwell, J., & Radel, J. D. (2019). Interventions to address the needs of adults with post-concussion syndrome: A systematic review. American Journal of Occupational Therapy, 73(1), 1–12. https://doi.org/10.5014/ajot.2019.028993
  7. Living Concussion Guidelines. (2024, August). Pre-Injury or Acute Predictors of Prolonged Concussion Symptoms (> 1 Month PostInjury) Based on Good Quality Studies. https://concussionsontario.org/sites/default/files/2024-08/Pre-Injury%20or%20Acute%20Predictors%20of%20Prolonged%20Concussion%20Symptoms%20Based%20on%20Good%20Quality%20Studies.pdf

 

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