13 Concussion Therapy Exercises You Can Do at Home

13 Concussion Therapy Exercises You Can Do at Home

If you’ve suffered a concussion, there’s a chance you’ve been told to rest until your symptoms go away. But sitting in a dark room doing nothing for days won’t help you recover any faster; in fact, it might even shorten your recovery time. 

Instead, we highly recommend finding a treatment provider who can get you in therapy as soon as possible after your injury. Therapies that may be useful after you’ve had a mild traumatic brain injury (mTBI) include physical therapy, cognitive therapy, vision therapy, and vestibular therapy.

In this post, we’ve put together some common therapy exercises used in concussion management in each category (with physical therapy split into physical exercise and neuromuscular massage).

While these exercises are no replacement for a medical assessment and a supervised concussion treatment plan, they can help you if…

  • You are unable to visit a therapist or otherwise receive active treatment of your concussion.
  • You would like (with your therapist’s permission) to supplement your therapy at home.
  • You want to learn more about what therapy can involve.

Every head injury is different and so are the potential problems it may cause. There are many types of vision dysfunction, for example. If you’re having vision problems, completing an eye saccades exercise will help your eyes move more accurately from one target to another, but if you’re mainly struggling with divergence and convergence, it won’t help at all.

That’s why it’s important to find knowledgeable treatment providers — like the staff at Neural Effects — who can determine in what way the concussion has affected your body’s systems. They can then put together a tailored treatment plan to help you recover more quickly.

With that said, it’s almost always better to do some therapy than none at all. Even doing a few simple exercises at home is better than leaving your symptoms unchecked. The exercises we cover in this article are a great place to start working your brain as it heals. We cover: 

If you live in Provo, Salt Lake City, or anywhere else in the Utah valley area, we can help you recover from your concussion and reduce your chance of long-term symptoms. We are in network for most types of medical insurance. Schedule your evaluation today.

How to Get the Most Out of Concussion Therapy Exercises at Home

A woman writing down notes in her notepad.

First, make sure to get a thorough concussion evaluation after a head injury. Following a 48-hour period of rest (even from movies and video games), you can start therapy exercises to help your brain and body recover from your concussion.

Set up a regular schedule to incorporate these exercises into your daily activities and stick to it.

For each session you do, start with some aerobic exercise (examples below), followed by a few therapy exercises for the specific areas that you need. Then take a period of rest.

This is known as the prepare/activate/recover cycle.

This cycle helps you take advantage of the cognitive boost triggered by exercise while you’re doing different therapies. Then, rest and relaxation give your brain a much needed break before moving on to your next activity.

If you want to do concussion exercises at home, you must learn how to monitor your concussion symptoms. If you’re not sure how to do this, you can follow these guidelines:

  • Stop if you’ve noticed that three symptoms are getting worse when you do an exercise. For example, if you have a growing headache, dizziness, and nausea, move into the rest phase and let your symptoms settle for a while.
  • Stop if one symptom is worsening quickly and severely. For example, if in the past few minutes your headache has gone from what you usually rate as a 1 (mild) to a 4 (medium) on a 1 – 10 point scale, then it’s time to stop.
  • You don’t have to stop every time you notice a symptom. If you’re just feeling a small increase in the symptom, it’s safe to continue. In fact, stirring up your symptoms to a small degree is an indication that the therapy is doing something helpful.

Don’t try to do too much too soon. Start your concussion recovery slowly, and gradually increase duration and frequency of the exercises. We recommend that you start with once or twice daily and increase as you feel better.

Finally, don’t give up. The exercises may make your symptoms worse at first, but your symptoms should steadily improve with time and consistent work.

Note: While the following exercises deal with many of the physical issues you might experience after a concussion, head injuries can affect your mental health as well. If you experience symptoms such as depression, anxiety, or mood swings, know that you are not alone. Neuropsychological symptoms are common after a concussion. Please let your medical provider know as soon as possible so they can help you through a treatment plan.

Physical Exercise as Therapy

An example of some of the treatment exercises at Neural Effects and Cognitive FX.

In the past, most medical providers recommended weeks or months of rest in a dark room with limited brain stimulation until symptoms subsided. However, recent research has shown that this approach — called cocooning — can actually do more harm than good.

Regular exercise as soon as possible after a concussion is not only safe, but it also improves symptoms and speeds up recovery. According to this recovery method, patients can start exercising after a 48-hour rest period following the concussion.

Despite the benefits, many concussed patients shy away from physical activity when it increases symptoms such as dizziness, headaches, and extreme fatigue. Often, this is simply because they don’t know how to exercise safely after a concussion.

If this is the case for you, here are some tips to help overcome exercise intolerance:

Start where you are. Whether you were a super fit, elite athlete or not really active before the concussion, you must take it slow when you start exercising. You cannot return to your pre-injury exercise levels straightaway. Start slow and pay attention to how your body responds to that level of effort. If and when your body tolerates it well, you can gradually increase the duration and intensity of training. 

Don’t avoid symptoms altogether: After a traumatic brain injury (TBI), exercise may make you feel worse at first. Follow the symptom-monitoring technique we explained in the previous section, and push through mild symptom increases.

Understand when your symptoms get worse: An easy way to achieve this is by using a heart rate monitor. As soon as you feel symptoms increasing, take note of your heart rate. Many patients find that their symptoms increase rapidly when their heart rate reaches a specific value.

Exercise at your sub-symptom threshold:  Once you’ve identified your exercise threshold, train just below that point. This is the best level to promote healing without making your symptoms significantly worse.

Exercise #1: Stationary Bike or Treadmill

A second option for low impact exercise includes stationary bikes or treadmills. This is actually what we use at Neural Effects for our aerobic exercise sessions. Most models have variable programs that allow you to adjust speed, resistance, and incline. Do short bursts of cardio followed by controlled breathing and rest. For example, you might do a 30 second cardio burst followed by two to three minutes of breathing before repeating the cycle.

Exercise #2: Walking

If you don’t want to invest in any equipment, the best option is to go for a walk. Even walking a short distance every day works wonders for your healing process. Once you start feeling better, look for difficult terrain, or add intervals of jogging to make it more challenging and effective.

Neuromuscular Therapy

There are many concussion therapy exercises you can try at home, including self-massage of the neck, shoulders, and face.

Neuromuscular therapy is a special type of massage where physical therapists apply pressure and friction using the fingers, knuckles, or elbows to release trigger points in the muscles.

Trigger points are small areas in the muscle which remain heavily contracted and feel like a nodule, colloquially referred to as a knot. These areas can be extremely painful to touch and cause weakness in the muscle.

Trigger points often cause neck and shoulder pain for concussed patients. They might form when muscles subconsciously contract to try to provide some protection to the head and brain when you realize an impact is imminent (during a car accident, for example).

If the muscles stay in this protective mode after your head injury, you’ll suffer from pain and tension. This condition limits mobility, puts pressure on the spine and head, and creates strain in the neck muscles.

The aim of neuromuscular massage (a type of manual therapy) is to help these muscles relax and return to their primary function of supporting the head. You can watch a video made by our sister clinic, Cognitive FX, explaining these techniques in more detail: 

Exercise #3: Self-Massage of the Shoulders

The main muscle in your shoulders is called the trapezius muscle, which starts at the base of the neck, covers your shoulders, and extends to the middle of your back.

This muscle is important because it helps you move your head, neck, arms, and shoulders while also stabilizing your spine. Muscle strain and trigger points caused by a concussion can cause pain and decreased mobility in the trapezius muscle.

To relieve tension in the trapezius, try this self massage:

  • Sit comfortably and relax your shoulders. Maintain a steady breathing rhythm throughout the massage.
  • Bring your left hand over your right shoulder.
  • Search for any tender or sore spots.
  • Once you find a tender spot, move your hand in a gentle circular motion or backwards and forwards while applying some pressure with your fingertips to stimulate blood flow.
  • Move your head to the left and right, and keep massaging your shoulder with your hand.
  • Move your head as fast as you can cope and keep a consistent rhythm.
  • Stop your head in one position (such as at a 45 degree angle) and continue with the massage.
  • When you’re finished, repeat with your left shoulder.
  • If you feel pain or discomfort, you can stop for a few minutes or until your symptoms subside.

Exercise #4: Self-Massage of the Back of the Neck

The next target involves a group of muscles called the suboccipital muscles. These are a group of four muscles located on each side of your spine, just below the base of the skull.

These muscles not only play a crucial role supporting the neck, but also control head movements. They are closely linked to vestibular and balance functions (see below for more information on vestibular therapy).

Concussed patients often describe a stiff neck and headaches on the side of the head, extending from the back of the head to the eye. These headaches happen when the suboccipital muscles tighten. This also interferes with messages sent to the brain, which explains why these patients sometimes suffer sensory symptoms, including dizziness and visual disturbances.

To relieve tension in the suboccipital muscles, try this self massage:

  • Sit comfortably and relax your muscles.
  • With your fingertips, find the middle line at the base of your skull, then gently move your hands to the left or right to find the suboccipital region. 
  • Gently massage that area by moving your fingers in a gentle circular motion or back and forth. Start with your head remaining still, and then move your head to the right and left.  
  • In concussed patients, this area can be very sensitive — only apply as much pressure as you can handle.
  • Repeat on the other side.

Exercise #5: Self-Massage of the Face

A third area which can be affected in patients by a head trauma is the temporomandibular joint. This region includes the chewing muscles and the temporalis muscle, which is a thin, fan-shaped muscle situated behind your ears.

Patients often experience pain and discomfort in their jaw, ears, shoulders, neck, and skull. They may also get headaches and migraines related to tension in this region.

To relieve tension in the jaw and face, try this self massage:

  • Sit comfortably and relax.
  • Place both hands on your cheekbones.
  • Slowly massage up towards the ear and then down just below the jaw bone.
  • While massaging this area, clench your teeth to feel the muscles contract. Then, open your mouth slightly to relax the muscles.
  • Massage up towards your ears to cover the temporalis muscle.
  • Only use as much pressure as you can handle.

If you live in Provo, Salt Lake City, or anywhere else in the Utah valley area, we can help you recover from your concussion and reduce your chance of long-term symptoms. We are in network for most types of medical insurance. Schedule your evaluation today.

Cognitive Therapy

An example of some of the treatment exercises at Neural Effects and Cognitive FX.

In simple terms, cognition refers to our ability to think, process information, and solve problems. Cognition involves components such as attention, concentration, memory, planning, and others. We use these brain functions on a daily basis.

Not surprisingly, concussions can cause cognitive impairments. Some symptoms include:

  • Getting distracted more easily.
  • Problems with memory.
  • Difficulty switching attention from one task to another.
  • Difficulty learning and remembering new information.
  • Difficulty problem solving.
  • Reacting slowly to changes or warning signs in the surroundings.
  • Taking longer to carry out physical tasks, including routine activities, such as getting dressed or cooking.
  • Difficulty thinking of the right word.
  • Trouble starting conversations, following them, or understanding what others say.
  • Difficulty expressing thoughts in an organized manner.
  • Having problems reading nonverbal communication and social cues that indicate others’ thoughts and feelings.
  • Misunderstanding jokes or sarcasm.

Fortunately, the brain can be very resilient. Cognitive rehabilitation exercises are a great way to improve cognitive function after a concussion.

Here are two exercises you can try at home. For more ideas, read our sister clinic’s list of 17 at-home cognitive exercises.

Exercise #6: Card Sorting

This is a good game for attention and memory.  

  • From a 50-card deck, find the ace from each suit and set them aside.
  • Shuffle the other cards.
  • Place each ace in a specific order that you choose (for example, hearts, clubs, diamonds, spades).
  • Give yourself a few seconds to memorize the order, then turn the cards upside down.
  • From the deck of cards, draw one card at a time and sort it according to where you think the matching suit is. Place the card upside down on the pile. Your goal is to have all the clubs in a pile for clubs, all the diamonds with other diamonds, and so forth.
  • For an extra challenge, ask a friend to give you small cognitive tasks at the same time. For example, say the name of an animal for each letter of the alphabet, or think of a word that is opposite to what your friend used. For example, if your friend says “hot,” you need to say, “cold.”
  • At the end, turn over the card piles and count how many you placed in the wrong pile.

Exercise #7: Guess the Word

The four letter word game is a verbal game you can play anytime. All you need is a friend to play with you. This game improves language and executive function skills.

  • Ask your friend to think of a word that is four letters long. Your goal is to guess that word by suggesting a series of four letter words.
  • For each word you suggest, your friend will tell you whether any of the four letters in your word are also in their word and, if so, whether they are in the right position.
  • For example, say your friend thinks of the word “blue” and your first suggestion is “burn.” Your friend should respond, “Two correct, one in the right position.” That’s because both b and u are in the word “blue;” ‘b’ is in the starting position for both, so it’s in the correct spot. But ‘u’ is in the second position for “burn” and the third position for “blue,” so it is in the incorrect position.
  • Use the information provided by your friend to help come up with other four letter words. For example, if your next word is “bark,” and your friend replies that there is one letter in the correct position, then you know the first letter is likely a “b.” You could confirm this guess by pitching “dark,” to which the response would be, “No letters correct.”
  • For an added challenge, play the game while doing something physical, like walking on uneven terrain or tossing tennis balls back and forth.
  • There are also several apps available to play this game on your phone.

Vision Therapy

An example of some of the treatment exercises at Neural Effects and Cognitive FX.

Vision problems are an extremely common symptom following a concussion, with over ⅔ of patients complaining of some form of visual issues, including eye strain and double or blurred vision.

Typically, concussions do not affect your visual acuity — if you have 20/20 vision, you are not going to lose it. But concussion may cause problems with eye teaming (which allows both eyes to work together), focusing, and tracking.

As a consequence, concussions may cause some of these symptoms:

  • Double vision
  • Dizziness
  • Nausea
  • Blurred vision
  • Eye strain
  • Fatigue when reading
  • Headaches that intensify with visual activity
  • Balance and depth perception issues
  • Difficulty tracking moving objects or losing your place when reading
  • Headaches in forehead or temple
  • Feeling overwhelmed in visually stimulating environments
  • Problems with coordination (tripping or stumbling and poor eye-hand coordination)

It’s been proven that vision therapy, even when done at home, can successfully improve many of those symptoms. Some examples of vision therapy include:

Exercise #8: The Brock String

One of the most important pieces of equipment used during vision therapy is the Brock string. It’s easy to use and offers you instant feedback regarding how your eyes are working together to focus on objects at different distances. 

It consists of a white string, up to 6 feet in length, with three colored beads that can be moved along the string. You can easily make one at home or purchase it online.

The aim of the Brock string is to teach the patient how to see clearly with both eyes at the same time. Here’s how to do the exercise:

  • Securely affix one end of the string to a doorknob or cabinet drawer.
  • Position the near bead about six inches from your face. If you can’t see it as a single bead, move it out to 10 – 12 inches from your face. If you still can’t see the bead clearly at 12 inches, get a referral to a neuro optometrist.
  • Position the middle bead six inches further than the first bead.
  • Position the far bead near the end of the string closer to the doorknob.
  • Stand in front of the door and hold the string under your nose. Make sure the string is stretched taut.
  • Focus on the near bead. If you see double, this suggests an eye teaming problem. If this happens, move the bead further away until you see it as a single image, and then gradually get closer as the task becomes easier.
  • As you look at the bead, you should also see two strings.
  • If your focus on the bead is accurate, the two strings should appear to meet exactly at the bead forming an “X”. As the bead is moved closer, the two strings should eventually meet exactly at the bead forming a “V.”
  • Slowly move your gaze from the first bead to the second and then the third bead, following the string. Your goal should be to “push” the X formed by the string toward each bead.
  • Once you’ve moved your vision from the closest to the furthest bead, return down the string, being careful to maintain the “X” of the string along the way.

Exercise #9: Tracking Exercises

Eye-tracking is defined as the ability to move your eyes from left to right (or up and down) while still being able to focus on an object. This is a vital skill for reading, writing, driving, and many other daily activities.

Under normal circumstances, eye-tracking happens without us even realizing it. However, after a concussion, quick eye movements that don’t match between the left and right eye can cause eye-tracking problems.

In this case, the aim is to force the eyes to build on their tracking skills:

  • Complete word finds or hidden pictures puzzles to visually scan and find objects on a page.
  • Solve mazes and follow the line’s puzzles. Don’t use your finger or move your head; do the whole puzzle visually.
  • A Tangram Puzzle has many different shapes. Copying from a diagram is a great way to practice visual tracking as well as cognitive skills.

Exercise #10: Eye Saccades Exercises

Saccades refer to the eye’s ability to accurately move from one target to another. Like eye tracking, this is a critical skill in reading and writing.

For example, when you’re reading a book, your eyes must move left to right along a straight line without getting confused with the lines above or below. In addition, when you reach the end of a line, your eyes must complete a movement back to the beginning of the next line. It’s common for concussed patients to struggle and lose their place when reading.

This exercise was designed to improve the precision and speed of saccadic eye movements after a concussion:

  • Get a piece of standard printer paper (8.5” x 11”). Either print or write two columns of the alphabet about six inches apart from each other.
  • Tape the paper to the wall at eye level.
  • Stand two to three feet away from the wall.
  • Focus your gaze on the top left of the first column (letter ‘A)’, then quickly switch to the bottom right of the second column (letter ‘Z’).
  • Proceed to the letter ‘B’ on the first column, then jump to the letter ‘Y’ in the second column.
  • Continue in this pattern until you’ve completed both columns. Remember to move only your eyes and not your head.
  • For added difficulty, you can increase the distance between yourself and the paper. If that’s too easy, try slowly walking heel-to-toe towards the posters and then walking away while completing the exercise.

Vestibular Therapy

An example of some of the treatment exercises at Neural Effects and Cognitive FX.

The vestibular system relies on the vestibular organ, which is located in the inner ear. This includes but is not limited to three tubes filled with fluid and lined with tiny hairs to monitor movements of the head. When you move your head, the fluid sloshes around and touches the hairs, which allows your brain to detect motion.

Concussions can disrupt this system, which means the brain struggles to determine the position of your head in relation to your body. When this happens, the brain must rely on visual input to stabilize the head. This is less efficient and leads to fatigue and tension headaches. If you feel dizzy, you’re also more likely to avoid moving your head, which may cause neck stiffness and headaches.

Typical vestibular dysfunction symptoms include:

  • Dizziness
  • Vertigo
  • Nausea
  • Headaches
  • Loss of balance
  • Fatigue
  • Eye strain
  • Blurred vision
  • Poor sleep

As its name suggests, vestibular rehabilitation therapy targets the vestibular system to restore your balance and spatial orientation. It is one of the most effective and evidence-based methods for treating balance issues caused by a concussion.

Exercise #11: Gaze Stabilization Exercises

Under normal circumstances, a reflex called the vestibular ocular reflex coordinates eye movement with head movement in order to provide clear vision while you’re walking. However, this can be affected after a concussion and, as a result, patients complain of balance problems, like dizziness and vertigo, when moving.

The aim of gaze stabilization exercises is to improve the vestibular ocular reflex, improve focus during eye-head movements, and reduce symptoms:

  • Draw the letter ‘A’ on a sticky note and place it on a wall at eye level.
  • Stand at arms’ length from the wall.
  • While focusing on the letter, move your head left and right as quickly as you can tolerate without losing focus on the letter or causing neck pain. Keep the movement small — it’s like nodding ‘No.’
  • Continue for 30 seconds. If you get too dizzy, slow down.
  • Take a one minute break (or however long you need to let your symptoms settle).
  • Repeat the exercise, this time nodding up and down as if to say, “Yes.” Remember that you can keep the motion small; a large, exaggerated head swing will not make the exercise more effective and may put strain on your neck.
  • To add difficulty, stand with one foot in front of the other. When that is easy, try standing on one foot (as long as you have someone to spot you in case you fall). You can also place the letter against a busy background to practice focus.
  • Over time, you can build up to one minute.
  • Do this exercise two or three times per day.

Exercise #12: Habituation Exercises

For patients with severe dizziness, habituation exercises are the best option. These balance exercises help reduce this symptom by gradually increasing exposure to the movements that trigger it, such as quick head movements, or bending over to pick up something.

These exercises can also help patients who feel dizzy watching fast action TV or in busy environments, like bustling shops.

Exercises should be challenging but manageable. Some examples of habituation exercises include:

  • Moving from a sitting position to laying flat on your back.
  • Standing up and sitting back down.
  • While sitting up, bending forward until your head is between your knees, then sitting back up.

Like gaze stabilization exercises, the more you practice, the faster you will improve. Since vestibular exercises can often be unpleasant, don’t complete them more than two or three times per day.

Exercise #13: VR games

Some virtual reality (VR) games may be able to help you improve hand-eye and full body coordination, which are often affected in concussed patients.

Our favorite example is a VR game called Beat Saber. It requires the use of both right and left hands, arms, and legs for a well-rounded workout. In the game, players have to cut approaching cubes in the correct direction using a pair of glowing sabers.

It’s important to note that not all VR games are suitable for concussed patients and some may make your concussion symptoms worse. Play them only as tolerated.

What can you expect from doing these exercises at home?

Every concussion is different, so not every therapy exercise will be equally effective. For example, even if you notice problems with your vestibular system, there are different helpful exercises depending on whether you have problems with motion or balance.

While doing these exercises at home is better than nothing, we strongly recommend getting medical help from a healthcare provider, such as a concussion clinic like Neural Effects.

We believe the best treatment for a concussion involves a combination of aerobic exercise and a range of therapies to address different symptoms. Therapy sessions at our clinic include some of the exercises described in this article, as well as a few more that cannot be attempted at home.  

Treatment at Neural Effects

An example of some of the treatment exercises at Neural Effects and Cognitive FX.

Treatment at Neural Effects starts with a thorough assessment, including a review of your medical history, as well a series of physical exams to assess vision and balance issues, among others. With the results of these tests, our cognitive and physical therapists can design a treatment plan to suit your needs.

Typically, treatment comprises three one-hour sessions for two weeks, but this can be adjusted for each patient. Each day may include:

  • Cardio exercises, typically on a stationary bike or treadmill
  • Vision therapy
  • Vestibular therapy
  • Neuromuscular therapy
  • Cognitive therapy

At the end of each session, you will meet with your therapist to review how your session went and receive a list of exercises tailored to your injury that you can do at home to maximize your chances of recovery.

As a final note, if you try these exercises at home for a while and see little or no improvements after a few weeks, you may be experiencing post-concussion syndrome (PCS). This occurs when post-concussion symptoms last longer than expected. In this case, we strongly advise you to seek medical care from therapists specialized in dealing with these persistent symptoms, like the ones at our sister company, Cognitive FX.  

If you live in Provo, Salt Lake City, or anywhere else in the Utah valley area, we can help you recover from your concussion and reduce your chance of long-term symptoms. We are in network for most types of medical insurance. Schedule your evaluation today.