Oculomotor function is critical in brain function, with about half of the brain’s pathways devoted to vision. These are particularly vulnerable to concussion. Visual symptoms can include blurred vision, difficulty with tracking and focusing on a target, even moving eyes side to side or up and down can cause symptoms. Eyes usually work in synchrony and this can be disrupted in concussion, triggering dizziness, nausea, screen and reading intolerance, headaches and fatigue. Cognitive or thinking problems such as impaired attention is associated with oculomotor dysfunction. Oculomotor symptoms can cause profound impairment in daily life since we rely on our eyes and task them with visual coordination and function from the moment we open our eyes in the morning. Vestibular [Balance]

The vestibular system controls your ability to balance and navigate space. It is housed in your inner ear and is commonly affected in concussion. Vestibular dysfunction can cause balance issues which can make it hard to stand, walk, or tolerate movement. Symptoms you might feel with vestibular dysfunction includes dizziness, nausea, headache, fatigue and more. Driving or being in moving vehicles or on the water can be especially difficult to tolerate with vestibular dysfunction. Cervical [Neck Specific]

A bit more about Cervical functionality. Autonomic/Physiological [Physical]

Autonomic or physiologic dysfunction is a hallmark of concussion, arising from a mismatch between the brain and its ability to manage the energy demands of the body. Autonomic dysfunction presents as exercise or exertion intolerance which may be associated with alterations in cerebral blood flow. Initiating exercise within 48 hours of injury has been shown to expedite recovery and improve outcomes, avoiding the typical concussion related deconditioning and its adverse effects on mood, sleep, and overall function. Resuming activity following concussion can be challenging for many, with what feel like unpredictable symptom spikes, and barriers to adjusting back to sport-specific demands. Experienced therapists can support, streamline, and expedite autonomic recovery with an individualized assessment and precision rehabilitation program. Cognitive [Thinking]

Cognitive or thinking symptoms are common complaints after concussion, disrupting a person’s ability to work, attend school, or even manage daily home or family responsibilities. These symptoms can come from or worsen with pain or headache, with symptoms like dizziness or nausea, with low mood or anxiety, or other physical or emotional symptoms. Attention and memory rely on visual functioning, and can be profoundly affected by oculomotor impairment. Treatment of underlying systems is critical, and cognitive symptoms are expected to resolve with resolution of the other symptom areas. Careful monitoring and management of cognitive symptoms by a neuropsychologist is a critical component of recovery from concussion. Emotional [Mood]

Emotional symptoms such as anxiety or depressive feelings are symptoms of concussion, but also common reactions to the stress and distress that is associated with concussion injuries. Prolonged periods of inactivity can compound anxious and low moods and deprive patients of a physical outlet that would otherwise help them manage their stress. Anxiety can also be triggered by oculo-vestibular dysfunction. Counseling and therapy can help to support healthy coping and adjustment to concussion, as well as support engagement in the rehabilitation needed to support recovery. It is critical to address system impairments which may be the cause of mood symptoms, or those symptoms that interfere with daily function and self-concept, rather than mood alone. Counselors or psychologists with expertise in concussion can uniquely highlight and support more common emotional and adjustment challenges.