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Palmetto Health Children's Hospital

7 Richland Medical Park Dr.
Columbia, SC 29203

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Post-Concussion Program

What is post-concussion syndrome?

A concussion is a mild traumatic brain injury that usually occurs after a hit to the head. A hit to the head does not always include loss of consciousness.

After a concussion, individuals may experience one or more of the following symptoms:

  • Dizziness
  • Poor attention and concentration
  • Headaches
  • Sensitivity to light and noise
  • Increased agitation and changes in mood
  • Difficulty with speech
  • Difficulty with reading and writing
  • Changes in sleep patterns, memory loss or slowed reaction times

These symptoms usually go away within 10 days for adults and within 21 days for children and adolescents. Post-concussion syndrome (PCS) is a disorder in which these symptoms persist beyond the typical 10–21 day recovery time. PCS affects two out of 10 people who sustain a concussion. PCS especially is concerning for children and adolescents because the brain still is developing new skills daily.

View our post-concussion brochure (PDF)

Post-concussion treatment

Successful treatment and management of post-concussion syndrome requires a multidisciplinary team which includes the patient, the patient’s family, various school personnel and the patient’s medical team. The medical team should include a physician, physical therapist, occupational therapist, speech therapist, psychologist and others. Your physician or therapist will refer you to the most appropriate care after an initial assessment. Important team members at school include athletic trainers, school nurses, coaches and teachers. Each member of the team offers a unique perspective that is essential in maximizing recovery.

Physical therapy

In post-concussion physical therapy, we assess the following areas:

  • Musculoskeletal integrity of the cervical (neck) and thoracic (back) spine
  • Vestibulo-occular functioning
  • Balance
  • School, home, work and sport activity tolerance
  • Return to sport

After assessment, a physical therapist will provide treatment and management to reduce symptoms of headache and neck/back pain, dizziness, imbalance and blurry vision by improving vestibular function. Strategies to address fatigue and decreased activity tolerance is also provided. Additionally, the physical therapist will develop a plan of care for safe transition back to school, work and play.

Occupational therapy

In post-concussion occupational therapy, we assess the following areas:

  • Balance
  • Cognition and memory
  • Attention to task
  • Eye-hand coordination
  • Return to sports
  • Visual problems
  • Reaction times
  • Executive skills

After assessment, an occupational therapist will providestrategies to manage symptoms such as dizziness, headache, sensitivity to light and noise. In addition, the therapist will develop treatment plans to improve function within daily activities and assist in the transition/return back to work, sports or play.

Speech therapy

In post-concussion speech therapy, we assess:

  • Speech and language skills
  • Reading and writing skills
  • Reduced attention/concentration
  • Memory
  • Organizational and executive skills that negatively affect communication-cognition, work re-entry and going back to school

After assessment, a speech therapist will provide treatment for aphasia – the difficulty to speak, read, write and understand language – as well as treat poor attention/concentration, memory, organizational and executive skills.

Psychological therapy

In our post-concussion program, we refer to a psychologist who assesses emotional and cognitive symptoms plus functioning. The psychologist can help patients and families manage emotional symptoms like anxiety, frustration irritability, sadness, anger, depression, lack of motivation and personality changes. The therapist will work closely with schools to develop an integrated plan for a patient’s return to learning and the classroom. Psychological therapy is available on a referral basis only.


When to refer to the Post-Concussion Program

  • Symptoms present beyond 10 days (adults) and 21 days (children and adolescents)
  • Migraines or persistent headaches after concussion
  • Multiple concussions
  • Difficulty with memory, concentration, problem solving
  • Balance problems or dizziness
  • Visual problems (double or blurry vision)
  • Lack of eye hand coordination
  • Difficulty with speaking (language) or reading
  • Difficulty completing schoolwork or employment duties compared to before injury
  • History of anxiety, depression, learning disabilities, sleep disorder and other emotional symptoms

A physician referral is needed for therapy.

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