An Introduction to Concussion Recovery:

Please note that I am not a medical professional. My goal is to help spread awareness about concussion recovery and aid in facilitating conversations between concussion & traumatic brain injury survivors and their healthcare providers.

A Basic Outline of Concussion Types & Potential Treatment Providers

According to this article from the National Library of Medicine, The 7 Clinical Phenotypes of Concussions** that warrant the need for evaluation and potential treatment can be described by this acronym: COACH CV (outlined below). I’ve included notes with suggested treatment providers I’ve discovered on my journey with help from resources posted by TBI Survivor Molly Parker, PT, DPT.

C: Cognitive Function

Common symptoms: memory problems, decreased attention, difficulty concentrating, slowed mental processing speed. Emotional function should also be assessed by your doctor.

Treatment Providers: Speech Therapist, Occupational Therapist, or Neuropsychologist.

O: Oculomotor Manifestations (Visual)

Common symptoms: problems with visual pursuit, convergence, screen viewing, and light sensitivity. It may be necessary to get a referral to an eye doctor an optometric assessment.

Treatment Providers: Neuro-Optometrist, Occupational Therapist, or Physical Therapist with training in vision.

A: Affective Disturbances (Depression)

Common symptoms: increase in depressed mood and anxious thoughts. There is a big overlap between symptoms of depression and concussion - it is important to consider your history with depression, anxiety, and mood disorders and check in with your doctor about your mood and emotional developments during your recovery. 

Treatment Providers: Psychologist, Naturopath for hormones & diet, Counselors/Therapists who specialize in depression, anxiety, trauma, even EMDR. 

C: Cervical

Common symptoms: neck pain, headaches, dizziness, balance difficulties. There is also a big overlap of whiplash and concussion symptoms, so it is important to have a physical assessment of the cervical spine and neck range of motion after concussion.

Treatment Providers: Physical Therapist, Chiropractor, Osteopath.

H: Headaches

This is the most common symptom reported after concussion! There are multiple types of headaches and treatments outlined below. This is not an exhaustive resource.

• Post-concussive 
  • pressure/pain increases typically front or both sides of head as you exceed your brain’s capacity
  • Addressed by implementing planning and pacing (such as the spoon theory) for your cognitive tasks typically with an occupational therapist or speech therapist
• Cervicogenic 
  • pain originating from neck muscles or joints
  • Can be treated by a physician, physical therapist or chiropractor
• Occipital neuralgia 
  • pain originates from the occipital nerve at the base of your skull/back of neck
  • Often associated with cluster headaches
  • Can be treated by physician, physical therapist, chiropractor
• Inflammatory 
  • dull, aching head pain that can be similar to migraine 
  • chronic inflammation issues can be addressed with anti-inflammatory diet
  • Can be treated by physician, naturopath
• Sinus/Allergy/Ocular 
  • pressure/pain around eyes and/or front of face, may be confused with migraine
  • Can be treated by physician, physical therapist, optometrist, chiropractor
• Migraine 
  • light & sound sensitivity, can last for days, may or may not have an aura
  • Causes may be genetic, hormonal, neurological, inflammatory, musculoskeletal
  • Can be treated by physician, physical therapist, chiropractor 
• Tension 
  • pressure, tight band around head
  • Causes can be postural, stress, poor sleep
  • A common diagnosis that blends with other headache types listed above
  • Can be treated by a physician, physical therapist, psychologist

C: Cardiovascular

Common symptoms: Exercise intolerance, heart rate problems, fatigue, autonomic system anomalies (dysautonomia), and POTS (postural orthostatic tachycardia syndrome).

Treatment Providers: Medical Doctor, Physical Therapist, Chiropractor.

V: Vestibular

Common symptoms: dizziness, vertigo, balance problems. Often paired with visual symptoms associated with the oculomotor manifestations.

Treatment Providers: Vestibular Therapist, or an Occupational or Physical Therapist who have training in vestibular therapy.

**The 7 Clinical Phenotypes of Concussions article was written in 2017 and our knowledge about concussion and brain injury recovery continues to evolve and improve. Find the PDF here.