Neurology
Concussion Care: Beyond “Sit in a Dark Room”
Guidelines have shifted: strict cocooning is rarely the whole answer. Here is the nuance I use with patients and families.
By Dr. Elena Vance, DPT, CSCS, OCS, FAAOMPT
What changed in concussion management
Within the first 24–48 hours relative physical and cognitive rest still matters—but prolonged isolation in a dark room for weeks can worsen mood, sleep, and deconditioning.
Modern care emphasizes sub-symptom threshold activity: light walking, gradual return to school or work with accommodations, and vestibular or visual exercises when indicated.
Red flags still come first
Any worsening headache, repeated vomiting, seizure activity, weakness, or confusion warrants urgent medical evaluation—not a blog post. After clearance, graded rehab can begin.
Common misconceptions
Myth
Screens are forbidden forever after concussion.
Reality
We titrate screen time and breaks based on symptom response, often with a structured return-to-learn or work plan.
Myth
If you feel fine, you can jump straight back to contact sport.
Reality
Return-to-play should follow objective criteria and often medical clearance—not how you feel on day three.
Concussion recovery is a team sport between you, your physician, and rehab. My role is to pace vestibular and exertional progress so you rebuild capacity without boom-bust cycles.
Educational content only—not individualized medical advice. Stock photos are illustrative and do not depict a specific patient.