Youth Sports Concussion Protocols in New York: What Every Parent and Coach Needs to Know
As the leading independent concussion clinic in New York City and part of the Trusted Rehabilitation Network at Mount Sinai, we use evidence-based methods to support safe, complete recovery.
Concussions and Screen Time: How to Safely Use Phones, TV, and Computers During Recovery
As the leading independent concussion clinic in New York City and part of the Trusted Rehabilitation Network at Mount Sinai, we use evidence-based methods to support safe, complete recovery.
Understanding Concussions: Symptoms, Modern Recovery, and When to See a Specialist
As the leading independent concussion clinic in New York City and part of the Trusted Rehabilitation Network at Mount Sinai, we use evidence-based methods to support safe, complete recovery.
Neuro Training for Concussion Recovery in New York City
As the leading independent concussion clinic in New York City and part of the Trusted Rehabilitation Network at Mount Sinai, we use evidence-based methods to support safe, complete recovery.
Specialized Care Matters
Specialized Care Matters Free Phone Consultation A concussion is a brain injury and should be evaluated by a specialist with focused training in concussion care. A concussion specialist has experience diagnosing and managing concussions and post-concussion symptoms, including how they affect cognition, balance, vision, mood, and daily function over time. This level of specialization helps guide appropriate evaluation, treatment planning, and recovery decisions. Concussion Management of New York is proud to be the first independent concussion specialty practice in New York City, built on evidence-based evaluation and individualized, patient-centered care. Our team works closely with leading medical institutions, including Mount Sinai, to ensure patients receive coordinated, research-informed care throughout recovery. When it comes to concussion recovery, understanding who you see for care matters.
Multiple Prior Concussion in High School Athletes
Multiple Prior Concussion in High School Athletes Free Phone Consultation High school athletes with a history of multiple concussions present a complex clinical challenge. Because adolescent brains are still developing, understanding how repeated head injuries affect baseline symptoms, neurocognitive performance, and recovery timelines is vital for athletic trainers, parents, and healthcare providers. A large-scale retrospective study evaluated thousands of student-athletes to determine whether a history of multiple concussions correlates with elevated baseline symptom reporting or impaired cognitive function. Key Findings from the Study The study evaluated 6,075 high school athletes (57% male, 43% female) across 49 high schools using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®) system. Prevalence of Prior Concussions: The majority of student-athletes (85.3%) reported no prior history of concussion, while 4.6% reported sustaining two or more prior concussions. Increased Baseline Symptom Burden: On multivariate analysis, a history of multiple concussions was significantly associated with a higher baseline symptom score (P < 0.001). Athletes with prior head injuries reported more persistent baseline complaints such as headaches, fatigue, and brain fog, even when symptom-free from recent acute injuries. Cognitive Composite Scores: While initial simple regression showed a link between concussion history and lower verbal memory scores, multivariate modeling demonstrated that multiple concussions did not permanently impair baseline computerized neurocognitive performance when controlling for other variables. Confounding Clinical Factors: Mental health history (depression/anxiety), pre-existing migraine history, gender, and learning or developmental disorders had a greater overall impact on baseline symptom reporting than concussion history alone. Cumulative Risks & Recovery Challenges Despite stable baseline cognitive scores, athletes with multiple concussions face unique physiological risks that necessitate extra caution: Lower Threshold for Re-Injury: Secondary concussions often occur from lighter physical impacts or force levels that previously would not have caused an injury. Prolonged Recovery Windows: Student-athletes with a history of repeated head impacts routinely take longer to return to baseline cognitive and physical function compared to first-time concussed peers. Risk of Post-Concussion Syndrome (PCS): Multi-concussed athletes have a substantially higher likelihood of persistent symptoms lasting beyond 4–6 weeks. Second Impact Syndrome (SIS): A rare but severe condition where a second concussion occurs before the brain has fully healed from a prior injury, causing rapid, dangerous cerebral swelling. Clinical Management & Protocol Adjustments Managing high school athletes with a history of multiple concussions requires a conservative, tailored approach rather than a standard timeline: Comprehensive Neurocognitive Baseline Testing: Establishing accurate pre-season ImPACT® baselines to contextualize future post-injury testing. Targeted Vestibular-Ocular Screening: Assessing visual tracking, convergence, and balance metrics to uncover subtle neurological deficits that symptom checklists might miss. Prioritized Return-to-Learn (R2L): Implementing structured academic accommodations (reduced screen time, rest breaks, deferred testing) before beginning physical exertion. Conservative Return-to-Play (R2P): Requiring athletes to be 100% symptom-free off all medication before starting a gradual, multi-stage exertional protocol. See full study. Get Expert Concussion Management in New York City If your student-athlete has a history of head injuries or is experiencing persistent concussion symptoms, specialized care can help ensure a safe return to the classroom and the field. Contact Concussion Management of New York at (212) 717-8331 or visit our Manhattan clinic at 109 W. 38th Street, 4th Floor, New York, NY 10018 to schedule a comprehensive evaluation.
Concussion Rehab Focusing on the Inner Ear and Cervical Spine
Concussion rehab focusing on the inner ear and cervical spine Free Phone Consultation Persistent dizziness, neck pain, and headaches are among the most common and challenging symptoms following a sports-related concussion or mild traumatic brain injury (mTBI). Because the mechanical forces involved in head trauma require as little as 4.5g to injure cervical spine tissues—far lower than the 70g–120g force typically needed to cause a concussion—brain injuries almost always co-occur with cervical spine strain. Disruptions to both the inner ear (vestibular system) and the cervical spine (neck) create overlapping symptoms, making targeted, dual-focus physical therapy critical for full recovery. The Overlap: Inner Ear vs. Cervical Spine Involvement Disentangling whether dizziness and balance issues stem from the inner ear, the neck, or both is essential for effective treatment planning: Vestibular System (Inner Ear): Responsible for sensing head position, linear motion, and rotational movement. Concussion-induced vestibular dysfunction often leads to room-spinning vertigo, gaze instability during head movements, motion sensitivity, and postural imbalance. Cervical Spine (Neck): High concentrations of proprioceptive nerve receptors in the upper cervical spine send continuous feedback to the brain regarding head-on-neck positioning. Mechanical strain to upper neck joints and muscles causes cervicogenic dizziness, stiffness, occipital headaches, and impaired spatial orientation. Sensory Mismatch: When the inner ear and cervical spine send conflicting signals to the brain, patients experience persistent disorientation, lightheadedness, and motion sickness. Key Research Findings on Combined Rehabilitation Landmark clinical trials evaluating post-concussion physical therapy demonstrate that treating either system in isolation is far less effective than addressing both simultaneously: Significantly Higher Clearance Rates: Patients with persistent post-concussion dizziness and neck pain who received combined cervicovestibular physical therapy were nearly 4 times more likely to be medically cleared for return-to-play within 8 weeks compared to those receiving standard rest and gradual exertion protocols alone. Accelerated Time to Recovery: Integrating cervical spine manual therapy with vestibular exercises dramatically shortened the duration of persistent symptoms. Reduced Post-Concussion Syndrome (PCS) Risk: Early intervention targeting upper neck joints and inner ear reflexes prevents chronic compensation patterns and reduces long-term disability. Essential Components of Cervicovestibular Therapy A targeted rehabilitation program focuses on restoring normal joint mechanics, visual tracking, and sensory integration: Cervical Spine Manual Therapy: Gentle joint mobilization, soft-tissue release, and deep cervical flexor retraining to reduce neck pain, restore range of motion, and alleviate cervicogenic headaches. Vestibulo-Ocular Reflex (VOR) Retraining: Gaze stabilization exercises that re-train the eyes to stay focused on a target while the head is in motion. Cervico-Ocular Reflex & Proprioceptive Exercises: Joint position error (JPE) testing and laser-guided target tracking to restore accurate head-on-neck spatial awareness. Habituation & Balance Training: Controlled exposure to symptom-provoking environments and dynamic standing balance tasks to reduce visual motion sensitivity. See full study. Get Specialized Concussion Rehabilitation in New York City If you or your athlete are struggling with lingering dizziness, neck tightness, or headaches after a head injury, specialized cervicovestibular physical therapy can help. Contact Concussion Management of New York at (212) 717-8331 or visit our Manhattan clinic at 109 W. 38th Street, 4th Floor, New York, NY 10018 to schedule a comprehensive evaluation.