A concussion can affect much more than memory, concentration, or headaches.
For some people, the biggest problems after a concussion are feeling dizzy, unsteady, visually overwhelmed, or simply “not quite right” when moving. Walking may feel different. Turning the head may create dizziness. Busy environments may become difficult to tolerate. Even simple movements can suddenly require more concentration.
Why does this happen?
One important reason is that the brain has to process information from several sensory systems at the same time. Your eyes provide visual information, your inner ears provide vestibular information, and your muscles and joints provide proprioceptive information about where your body is in space.
These systems are constantly communicating with the brain to help you maintain balance, coordinate movement, and understand where you are in your environment.
After a concussion, that communication can become less efficient.
Your Brain Uses Three Major Sources of Information
Think about standing on one foot.
Your eyes are looking at the environment around you. Your inner ears are detecting changes in head position and movement. At the same time, receptors throughout your muscles and joints are providing information about the position of your ankle, knee, hip, spine, and the rest of your body.
Your brain combines all of this information to produce a complicated, coordinated response.
This is called sensory integration.
The problem is that a concussion can disrupt the way the brain processes or integrates these signals. The individual systems may still be functioning, but the brain may have difficulty efficiently putting the information together.
That can contribute to symptoms such as dizziness, balance problems, motion sensitivity, visual discomfort, headaches, and difficulty coordinating movements.
Why We Don’t Always Want to Train These Systems Separately
Traditional rehabilitation may focus on individual components of movement.
But eventually, the brain has to put everything back together.
You don’t walk through the world using your eyes alone. You don’t maintain balance using your inner ears alone. And you don’t move your body using proprioception alone.
You use all three.
That’s why concussion rehabilitation can progress toward exercises that challenge multiple sensory systems simultaneously.
For example, a patient might perform a controlled visual task while standing on an unstable surface. The visual system is being challenged while the proprioceptive system has to provide information about body position. At the same time, the vestibular system is responding to head and body movement.
The goal isn’t simply to make an exercise difficult.
The goal is to challenge the brain’s ability to integrate information from multiple sensory systems and produce an appropriate motor response.
Training the Eyes After a Concussion
Vision plays a major role in balance and movement.
The brain uses information from the eyes to determine where the body is relative to the surrounding environment. Eye movements also have to coordinate with head movements and body movements.
Following a concussion, some people experience difficulty with visual tracking, saccades, focusing, visual motion, or maintaining visual stability during movement.
Rehabilitation may therefore incorporate controlled eye movements, visual tracking, target identification, or other visually guided activities.
The important point is that these exercises should be appropriately selected and progressed based on the individual’s symptoms and functional limitations.
Training the Vestibular System
The vestibular system is located in the inner ear and provides the brain with information about head movement, acceleration, and orientation relative to gravity.
It works closely with the eyes and the body’s proprioceptive system.
This is particularly important when you’re moving your head while walking, turning, changing direction, or navigating an environment.
After concussion, vestibular dysfunction can contribute to dizziness, imbalance, motion sensitivity, and difficulty tolerating movement.
Vestibular rehabilitation can be used to gradually challenge the brain’s ability to process this information and coordinate an appropriate response.
Training Proprioception
Proprioception is sometimes described as your body’s internal sense of position.
Receptors in muscles, tendons, joints, and other tissues continuously provide information to the nervous system about where different parts of your body are and how they are moving.
You don’t have to look at your foot to know that it is moving.
Your nervous system is constantly receiving information from your body.
After an injury or concussion, however, the brain may benefit from exercises that deliberately challenge proprioceptive processing.
Balance pads, changing surfaces, coordinated limb movements, and controlled changes in body position can all provide additional sensory information for the nervous system to process.
What Happens When We Combine Them?
This is where concussion rehabilitation becomes especially interesting.
Instead of asking the brain to process one type of information at a time, rehabilitation can gradually introduce exercises that require the brain to process visual, vestibular, and proprioceptive information simultaneously.
Imagine standing on a balance surface while visually tracking a target and moving the head.
Now the brain has to answer several questions at once:
Where is my body? Where is my head? What is my visual environment doing?
How am I moving? Am I losing my balance? What motor response should I produce?
That is a very different challenge than simply standing on a stable floor.
The objective is to progressively challenge the nervous system while keeping the exercise controlled and appropriate for the individual.
The Goal Is Better Integration, Not Simply More Difficult Exercises
Concussion rehabilitation isn’t about seeing how difficult an exercise can become.
More difficult doesn’t automatically mean better.
The goal is to identify where the patient’s nervous system is struggling and then provide an appropriate stimulus that challenges that system without unnecessarily provoking symptoms.
As the patient’s tolerance improves, the exercise can become more complex.
A simple visual task may eventually become a visual task combined with head movement. A stable standing position may progress to a less stable surface. A simple movement may progress to a coordinated movement involving the arms, legs, eyes, and head.
The nervous system is continually being asked to process more information and coordinate a more complex response.
Why This Matters in Chiropractic Rehabilitation
At BeWell Chiropractic, our approach to concussion rehabilitation looks beyond simply treating the neck or the location of pain.
The musculoskeletal system and nervous system are closely connected. Movement, balance, coordination, vision, vestibular function, and proprioception all contribute to how a person interacts with their environment.
A neurology-based, functional approach allows rehabilitation to address these systems together when appropriate.
That may include specific movement patterns, balance challenges, visual exercises, proprioceptive activities, vestibular stimulation, and other forms of sensory-motor rehabilitation.
The treatment is individualized because every concussion is different.
Concussion Recovery Is About Getting the Systems Working Together Again
Your eyes, ears, and body are constantly sending information to your brain.
Your brain then has to organize that information and turn it into an appropriate response.
After a concussion, that process may not be working as efficiently as it did before the injury.
That’s why rehabilitation shouldn’t always focus on one system in isolation.
The ultimate goal is to help the nervous system process information from the eyes, ears, and body and use that information to produce better movement, balance, and coordination.
If you’re still experiencing dizziness, balance problems, motion sensitivity, visual difficulties, or coordination problems after a concussion, a functional evaluation can help identify which systems may need additional attention.
Concussion Rehabilitation in Tigard, Oregon
At BeWell Chiropractic in Tigard, OR, we use a neurology-based, functional approach to help patients work toward improved movement, balance, coordination, and function following concussion and other injuries.
Recovery doesn’t mean simply waiting for symptoms to disappear.
Sometimes the nervous system needs the right input and the right challenge to help it perform better.
