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.