Specialized Treatment Areas

Specialized Treatment Areas

Early on rest is an appropriate treatment for sport concussion. Rest from exercise and sport is recommended until evaluated by an appropriate medical professional trained in concussion management for a formal assessment. It may also be beneficial to limit TV, cell phone, computer and video game use. Active treatment strategies may be helpful in the management of concussion and return to sport participation. Specialized treatment at TRIA include:

Vestibular Physical Therapy

Symptoms such as dizziness, motion sickness and fogginess are common complaints when the vestibular system is affected. These symptoms are due to the brain not being able to correctly integrate sensory inputs from visual, inner ear and somato-sensory systems. Examples of activities that may reproduce these symptoms include walking in a supermarket isle or in busy crowds. The vestibular system also plays an important role in stabilizing your gaze while the head is in motion. This function is crucial for all athletes and becomes important in being able to perform activities such as following a ball while running or watching a puck while skating. Physical therapists specially trained in vestibular rehabilitation work with patients to correct these symptoms.

Cervical Spine Management

Patients may experience dizziness and persistent headaches due to cervical spine dysfunction after a concussion has occurred. TRIA’s physical therapy concussion team evaluates and treats cervical spine pathology that can exacerbate symptoms of dizziness and headaches.

Medication Management

Patients may deal with poor cognitive performance, sleep disturbance, anxiety or post-traumatic migraines after a concussion. When symptoms do not improve with cognitive and physical rest, or behavioral modifications, then medications may be beneficial. Physicians at TRIA who manage concussions are well versed in appropriate use of these medications.

Sports Psychology*

It is not unusual for athletes to experience behavior or mood changes related to depression and anxiety after a concussion has occurred. These symptoms arise from neuro-chemical changes within the brain as well as the stressful effects of being out of academic, exercise and sports routines. Behavioral sports psychologists will help with depression or mood disorders triggered or aggravated by a concussion.

*Services offered at off-site location.

 Return-to-Exercise Progression

Once concussion symptoms resolve or have stabilized the athlete may tolerate starting an exercise program. Physical therapists and athletic trainers guide an athlete in graded exercise to improve symptom recovery.

Sport Specific Return-to-Play Protocol

An athlete should not return to sports while concussion symptoms are present. Once an athlete is determined to be “symptom free,” the concussion team will design a step wise, sport specific return-to-play program.


Neuropsychology is the field of medicine that assesses cognitive abilities and how well the brain is functioning. At TRIA, neuropsychologists with experience in sport concussion management will evaluate for deficits in attention, speed of processing, and memory that are commonly seen after a concussion. Based on the test results, the neuropsychologist will formulate a plan for return to cognitive-based activities and help determine the need for academic accommodations during recovery.

Computerized Neuropsychological Assessment (ImPACT):

A traditional neuropsychological evaluation may take up to eight hours. ImPACT used at TRIA provides an abbreviated form of neuropsychological assessment that is easy to administer in a clinic or athletic training room setting and that may be used repeatedly to monitor cognitive progress. ImPACT objectively evaluates memory, processing speed and reaction time. Testing time usually takes about thirty minutes with data readily available for interpretation.


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