The 5 Stages of Progression of Concussion Recovery

The 5 Stages of Progression of Concussion Recovery

Concussion is a brain injury caused by a sudden jolt to the head. This can occur with either a direct impact to the head or when the head is suddenly jolted and the brain moves rapidly inside the head, causing it to bounce against the skull. Either occurrence can cause brain damage or chemical imbalance.

In 85% of cases, concussion recovery takes approximately ten days; but up to 15% of patients remain symptomatic past the ten-day mark, manifesting some aspect of post concussion syndrome.

The recovery stages for concussion can be broken down into the following steps:

  • Neurological and Cognitive Examination
  • Rest Periods from physical and mental exertion
  • Resuming Physical Activity
  • Resuming Cognitive Activity
  • Resuming Regular Functioning

1. Neurological and Cognitive Examinations

Neurological and Cognitive Examinations

Upon experiencing trauma to the head, the patient can be subjected to a wide range of medical screenings or testing to detect any impairment as a result of the injury.

The tests can include brain scans such as CT and MRI to detect structural damage, along with cognitive, balance and vision tests to assess the degree to which damage has impaired neurological functioning.

2. Rest Periods

Depending upon the severity of the injury that the patient has experienced, physicians may recommend periods of rest both from physical and cognitive exertion.

Specifically, patients are requested to abstain from any exercise that provokes symptoms such as headaches, nausea or dizziness.  Higher intensity exercise that might raise heart rates and blood pressure is more likely to cause these symptoms.  Even during this phase, however, patients are still encouraged to stay mobile.  Walking, for instance, or low intensity cycling, is definitely ok to try, and even encouraged, as newer thinking in this area supports the idea of stimulating some blood flow to the brain to aid in healing.  This is a balancing act, but complete rest is gradually falling out of favour.

After this initial period, the remaining stages are differentiated based on the amount of activity that the patient may indulge in. The degree to which exercise may be allowed is based on the severity of the symptoms that maybe provoked with the exercise in question.


3. Resuming full physical Activity

Resuming full physical Activity

As treatment progresses, it is advised that the patient gradually indulge in more strenuous exercise. The intensity increases based on the sensitivity to exercise induced symptoms at each stage. Patients are prohibited from directly engaging in exercise that provokes symptoms to an unmanageable level.

The progression starts from light anaerobic exercise that increases in intensity, often accompanied by physiotherapy.

4. Resuming Cognitive Activity

Resuming Cognitive Activity

Immediately after experiencing a concussion, patients may experience memory loss and impaired cognitive functioning. During the initial phases, it might also be recommended that patients  abstain from going to school or work  and  engaging in otherwise cognitively strenuous activity.   It is important to avoid environments that are noisy, cognitively stimulating or demanding so as to not provoke symptoms. It is also recommended to limit all screen time.  When recovering, patients gradually increase the cognitive load that they can take on while remaining under observation.

5. Going back to Regular levels of Activity

Going back to Regular levels of Activity

After a thorough examination of the patient and having been put through escalating levels of cognitive and physical strain, if symptoms have subsided, patients may go back to resuming normal activity to take on the same strains as before.


Sports & Exercise Medicine Institute clinics are greater Toronto area based sports medicine, physiotherapy, chiropractic and massage therapy clinics that offer a wide range of services such as sports medicine physicians, multidisciplinary rehabilitation staff, pelvic health, brace fitting and regenerative medicine, among others.


To learn more about them, get in touch with us by calling at 1-844-223-7364. Our services are offered in the greater Toronto area at Sheppard, St. Clair and Thornhill.

About the author



I’m Nancy and no, I didn’t always look like I do in that picture on the right. My foray into health and fitness began as a brace-faced, 16 year-old who was too afraid to wear a two-piece at the beach because I felt my body paled in comparison to my much more toned friends.

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