Persistent Concussion Symptoms / Mild Traumatic Brain Injury
What is mTBI and PCS?
Mild traumatic brain injury (mTBI) is very common. It is usually caused by an impact or blow to the head or from rapid forces of acceleration and deceleration. These injuries can be caused by a variety of incidents including road traffic accidents, sporting injuries and falls. A concussion is a mTBI and is sometimes the term that is used especially in sports.
A head injury can set off a series of events in the brain that can disrupt the normal balance of brain cells. It is thought that this ‘neurochemical cascade’ is a major reason why people experience the different signs and symptoms following a head injury.
The majority of people with a mTBI do not have measurable changes to their brain that show up on a routine scan such as computed tomography (CT). This can make it very difficult for the person because the changes they are experiencing in their physical functioning, cognition or emotions can be very challenging and yet the injury remains ‘invisible’.
What are the common symptoms of mTBI and PCS
After a mTBI people may report a broad range of symptoms, which are often temporary and can resolve within 1-3 months. However, around 20% of people will experience persistent concussion symptoms (PCS) which is a collection of symptoms that happen after a mTBI including headache, dizziness, fatigue, irritability, reduced concentration, sleep disturbance, memory problems, anxiety, sensitivity to noise and light, blurred vision and low mood.
Sometimes, people find it difficult to access the support they need because the symptoms can seem non-specific and may be found in other health conditions. Therefore, it can be difficult for clinicians to determine their cause. It is generally accepted that PCS involves a complex interaction between biological, psychological and social factors and can be affected by a person’s prior health, stressful life events and worry.
What is our service?
The Hobbs mTBI/PCS service focusses on dealing with the range of difficulties caused by mTBI. We aim to support people to understand and cope with the effects of their mTBI and develop a rehabilitation plan specific to their impairments and goals. This aims to help people manage any physical changes, cognitive difficulties and psychological distress that they may be experiencing. We offer a multidisciplinary rehabilitation approach and provide comprehensive assessment and therapy to promote greater quality of life including reconnecting with previously valued activities relating to work, education, family and social life.
All Hobbs Physiotherapists have extensive post-graduate training and experience in brain injury and additional training and experience in vestibular rehabilitation including physiotherapy intervention for persistent concussion symptoms.
Physiotherapy assessment will incorporate a full subjective history and bed-side assessment of oculo-motor, vestibular function and balance. The assessment is very holistic and will take into consideration pre-existing issues such as musculoskeletal injuries or neurological conditions, as these can all impact on balance and movement.
Physiotherapy intervention will be prescribed based on the assessment findings and your personal goals. This could include specific repositioning manoeuvres to treat BPPV, balance and gait re-education, multi-sensory training, treatment of musculoskeletal issues and a customised exercise programme to target specific issues identified in your assessment. Guidance will be given to support a graded return to every-day activities which may have become challenging such shopping, using public transport, returning to sport, education or work.
Education is a key component of PCS rehabilitation. We aim to empower our patients to understand their symptoms, their triggers, and how to manage them, working towards their individual goals.
Clinical Neuropsychology is a branch of clinical psychology specialising in brain-behaviour relationships. At Hobbs, we are a team of Clinical Psychologists who specialise in working with individuals affected by a range of neurological conditions including mTBI/PCS and have expertise in helping people understand and cope with the effects of their neurological condition. This includes exploring changes to memory and thinking skills (cognition) and also emotional wellbeing.
Research into mTBI and PCS recommends that Neuropsychological assessment and intervention is an important part of the wider clinical management of the condition. This may include:
- Education about mTBI.
- The opportunity to make sense of difficulties people are experiencing so that they feel understood and reassured
- Formal neurocognitive assessment to identify the nature of cognitive changes and inform strategies to help with graded return to work or social activities. It is important to note that Clinical Neuropsychologists have extensive training both at doctoral and post-doctoral level to administer and interpret these psychometric tests.
- Advice and guidance about managing sleep disturbances.
- Psychological therapy to help people manage changes to their mood, anxiety, relationship difficulties or adjustment. This may take the form of Cognitive Behaviour Therapy (CBT) and Acceptance and Commitment Therapy (ACT).
How to refer:
If you would like to receive more information about our service or wish to self-refer, please email with the following information:
Brief summary of your injury and ongoing problems:
Details of any investigations or other professionals involved in your care:
Telephone : 01730 890072