Short answer
Current guidelines recommend relative rest for about the first 24 to 48 hours after a concussion, then a gradual return to light activity, rather than days in a dark room1. Strict, prolonged rest can prolong symptoms2. When dizziness, headaches, visual problems or neck pain persist, active rehabilitation that targets the vestibular, eye movement, neck and exertion systems helps recovery3.
Answered by Dr. Manan Patel, PT, DPT, TPS, Certified Vestibular Specialist and Therapeutic Pain Specialist. Updated October 18, 2026.
Why can too much rest slow concussion recovery?
In a randomized trial, young patients prescribed five days of strict rest reported more symptoms than those given one to two days of rest followed by a gradual return to activity2. Prolonged inactivity can also lead to deconditioning, poor sleep, isolation and anxiety, which all make symptoms worse.
What does active concussion rehab include?
- Exertion: sub-symptom aerobic exercise, guided by graded treadmill or bike testing based on Buffalo Concussion Treadmill principles4
- Vestibular and eye movement: gaze stabilization, convergence, pursuits and saccades
- Neck: manual therapy and exercise for the whiplash-type injury that often comes with concussion
- Balance: progressive challenges measured on BioSway
A randomized trial showed early sub-symptom aerobic exercise helped adolescents recover from sport-related concussion5.
When does a concussion need urgent medical care?
Go to the emergency department for a worsening headache, repeated vomiting, seizures, increasing confusion or drowsiness, slurred speech, weakness or numbness, or unequal pupils. Return to school, work and sport should follow a stepwise plan agreed with your physician1.
Where can I get concussion rehabilitation in Alpharetta or Cumming?
We treat lingering post-concussion symptoms at our Cumming and Alpharetta clinics for patients from Johns Creek, Milton, Roswell, Suwanee and Forsyth County, working alongside your physician and, for athletes, coaches and athletic trainers.
Where can I get help in Alpharetta, Cumming and nearby?
Dr. Manan Patel, PT, DPT, TPS and our team of physical therapists see patients from Alpharetta, Johns Creek, Milton, Roswell, Cumming, Suwanee, Sugar Hill, Buford, Duluth and Forsyth County at two North Atlanta clinics. Every visit is 60 minutes, one-on-one, and urgent appointments are available within 48 hours. We are in-network with Traditional Medicare, BCBS / Anthem and Tricare, and offer a $129 rate per visit for self-pay and out-of-network plans. Not sure where to start? Take the free symptom self-check, or visit our Alpharetta clinic or Cumming clinic page.
Cumming clinic
Off GA-400 Exit 13 on Peachtree Parkway
Cumming, GA 30041
Alpharetta clinic
Inside Georgia Brain & Spine Physical Therapy
Alpharetta, GA 30022
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References
- Patricios JS, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam 2022. British Journal of Sports Medicine. 2023.
- Thomas DG, et al. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatrics. 2015.
- Quatman-Yates CC, et al. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury: Clinical Practice Guidelines. Journal of Orthopaedic & Sports Physical Therapy. 2020.
- Leddy JJ, Willer B. Use of graded exercise testing in concussion and return-to-activity management. Current Sports Medicine Reports. 2013.
- Leddy JJ, et al. Early subthreshold aerobic exercise for sport-related concussion: a randomized clinical trial. JAMA Pediatrics. 2019.
This answer is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor. Call 911 for sudden severe dizziness with trouble speaking, weakness, numbness, double vision or a severe headache.
