Concussion Care

What concussion is — and what it isn’t

A concussion is a brain injury caused by a sudden force — a hit to the head, a fall, or a whiplash-style movement that shakes the brain inside the skull. Most uncomplicated concussions resolve over the course of one to four weeks with appropriate rest and a thoughtful return to activity. But for a meaningful minority, symptoms persist beyond that window — and that’s where the picture gets more complicated.

Persistent symptoms after a concussion (sometimes called post-concussion syndrome) aren’t always about ongoing brain injury itself. By the time someone is two or three months out from the original event, the symptoms that linger — headaches, neck pain, dizziness, fogginess, light sensitivity, fatigue — often have musculoskeletal, vestibular, or visual components layered on top of any residual neurological effect.

The useful news is that those layered components are often very treatable, even when “the concussion” itself has technically resolved.

What we work on

Bluebird is a primary diagnosis-and-management service for concussion. You don’t need a referral, and you don’t need to see your family doctor first — for non-emergency presentations, we can be your first call. Whether you’ve just been injured, you’re a few weeks in with symptoms that aren’t settling, or you’re an athlete working through return-to-play, we work across the full picture:

• Diagnosis and clinical assessment. A structured concussion exam — history, neurological screen, cervical exam, vestibular and visual screening — to identify what’s driving symptoms and what stage of recovery you’re in.
• Cervical spine dysfunction. The same forces that cause a concussion almost always strain the neck. Cervicogenic headaches, suboccipital tightness, and upper-cervical joint dysfunction are well-documented contributors to persistent post-concussion symptoms.
• Vestibular and visual integration. When the inner ear and visual system aren’t communicating well, the result can be ongoing dizziness, motion sensitivity, and difficulty in busy visual environments. We screen for and treat these contributors directly, and bring in a vestibular specialist when the case calls for it.
• Soft-tissue restrictions in the neck, upper back, and jaw that can drive headaches and tension.
• Rehabilitative exercise and heart-rate-based training. Current evidence supports gentle, sub-symptom-threshold aerobic activity relatively early in recovery, progressed thoughtfully as symptoms allow — not open-ended rest. We use heart-rate-guided protocols where appropriate.
• Return-to-sport and return-to-life. A graded progression — from cognitive rest, to light aerobic work, to sport-specific drills, to full contact or full work demand — at the pace your symptoms allow.
• Coordination with the rest of your care team. When your family doctor or another specialist needs to be in the loop, we make that happen.

When to go to the ER first

A concussion clinic is not the right first stop if you have signs of a more serious head or brain injury. If you’ve recently been hit on the head and you have any of the following, go to the emergency department or call 911:

• Loss of consciousness, even briefly
• Worsening headache or repeated vomiting
• Confusion, slurred speech, or difficulty staying awake
• Seizure
• Numbness, weakness, or coordination changes
• Unequal pupils or vision changes
• Fluid or bleeding from the nose or ears

If you have a recent concussion without those red flags, you can come straight to us — we’ll do a full assessment and put a plan in place from there.

What a treatment plan looks like

Whether you’re seeing us in the first week after injury or three months in with symptoms that haven’t budged, the structure is similar:

1. Assessment. A focused history, neurological screen, cervical exam, and vestibular/visual screening to identify which contributors are driving the symptoms.
2. Targeted treatment. Hands-on care for cervical dysfunction, soft-tissue work on the neck and upper back, and specific exercises for any vestibular or visual deficits identified.
3. Graded loading and return-to-activity. A progression that respects your current symptom threshold while moving you forward — gentle aerobic work, heart-rate-based training where appropriate, and a sport-specific or work-specific return plan. Not a rest-only approach, which the current research has largely moved away from past the first 24–48 hours.
4. Honest reassessment. If we’re not seeing the right response within a reasonable window, we re-look at the whole picture and bring in another specialist if appropriate.

A note on expectations

Concussion recovery is highly individual. Most uncomplicated concussions resolve within a few weeks with appropriate rest and graded activity. A smaller group has symptoms that linger longer — and within that group, the response to different interventions varies.

Our job is to give you a clear diagnosis, a structured plan, and a realistic timeline — and to manage the recovery alongside you. If we hit a point where the case needs another specialist’s eyes, we say so and make the referral. The goal is the same either way: get you back to sport, back to work, and back to feeling like yourself.

If you’ve had a concussion — recent or lingering — a single assessment visit is the right starting point. We’ll work out what’s driving symptoms today and what the plan looks like from here.