Concussions

A concussion is a type of brain injury caused by a bump, blow or jolt to the head that can change the way your brain normally works.

Concussions can occur in any athletic activity, as well as a motor vehicle crash or fall. Most concussions occur without a loss of consciousness. A healthcare provider with expertise in concussion management should evaluate all concussions. The primary risks of not receiving a medical evaluation may include:

  • Increased risk for severe brain injury or death (Second Impact Syndrome)
  • Prolonged symptoms
  • Difficulties with schoolwork and other activities
  • Delayed return to sport

During recovery, exercising or activities that involve a lot of concentration (such as studying, working on the computer or playing video games) may cause concussion symptoms to reappear or get worse.

Concussion Signs & Symptoms

  • Appears dazed or stunned
  • Answers questions slowly
  • Loses consciousness (even briefly)
  • Exhibits moody behavior or personality changes
  • Can't recall events prior to hit or fall
  • Has a headache or "pressure" in head
  • Exhibits nausea or vomiting
  • Has balance problems or dizziness
  • Experiences double or blurry vision
  • Has sensitivity to light or noise
  • Feels sluggish or foggy
  • Has concentration or memory problems
  • Does not feel right or is feeling down

Concussions and TBI

A traumatic brain injury (TBI) is a blow, jolt or bump to the head or a penetrating brain injury (from blunt trauma, vehicle crashes, falls, and sports) that disrupts the normal function of the brain. More than 1.5 million people suffer from these types of brain injuries. Adolescents, young adults, and older adults are the majority of patients who suffer from mild TBI.

While some patients receive emergency care and even an appropriate diagnosis of mild TBI, many do not. Despite the persistence of symptoms— headache, confusion, pain, cognitive and/or memory problems, fatigue, changes in sleep patterns and mood, dizziness/vertigo—people who suffer from concussions often do not get the necessary evaluation, testing or treatment by brain injury specialists.

Concussion Clinic

The Concussion Clinic is a unique outpatient service of the MedStar National Rehabilitation Network that offers highly specialized services for people suffering from the lingering—and often life altering—results of mild traumatic brain injury (TBI). Our staff provides the correct treatment those who need help with long-term cognitive impairment but do not require hospitalization.

The MedStar NRH Network Concussion Program includes an assessment by a physician and/or neuropsychologist. At some sites, evaluations may be conducted by other trained healthcare professionals.

Evaluation includes:

  • Neurologic examination 

  • Balance testing 

  • Review of medications 

  • Neuropsychological assessment 

  • For athletes, if previous screening was done with ImPACT, testing may be repeated 


The physician and neuropsychologist consult after the evaluation to make a treatment plan, which may include referrals for rehabilitation treatments or further medical consultations, such as:

  • Physical therapy for concussion rehab and vestibular therapy.
  • OT and SLP, as indicated.

The Role of Physical Therapy in the Treatment of Concussion


Concussion services include physical therapy to address persisting symptoms of fatigue, vestibular/balance issues, as well as head and neck pain. The NRH Rehabilitation Network has trained physical therapists to assess individual symptoms and limitations. The physical therapist designs a treatment plan specific to the individual’s needs which can include vestibular, manual and cardiovascular therapy.

Vestibular Therapy — the vestibular system, the inner ear and its connections with the brain, is responsible for balance. The physical therapist provides specific exercises and training to reduce/stop dizziness and improve overall balance and stability.

Manual Physical Therapy — is used to decrease Cranio-cervical dysfunction in the head and neck area to restore normal mobility. This includes cranial release, muscle energy techniques, and myofascial release.

Aerobic/Cardiovascular Therapy — improving and restoring normal cardiovascular activity is a key component to recovery. The physical therapist helps to establish guidelines to resume physical activity gradually. In addition, the therapist works closely with athletic trainers, personal trainers, coaches and parents to design a return to play program that will assist with providing the greatest amount of recovery in a safe and realistic time frame.

Common Causes:

  • Blunt trauma or acceleration or deceleration from motor vehicle crashes, falls firearm use, sport, and recreation

Common Patient Population:

  • Adolescents and young adults (ages 15 to 24)
  • Older adults (age 65 and older)


If you suspect a concussion, seek medical attention right away.

Call our MedStar Sports Medicine specialist Christian C. Glaser, DO, at (301) 290-5300 to make an appointment.

Related Information

Local Outpatient Therapy Locations

St. Mary’s County

Charles County

Prince George’s County

Washington, D.C.