What is post-concussion dizziness?
A concussion is a mild traumatic brain injury caused by a blow, bump, or jolt to the head — or by a hit to the body that causes the head to move rapidly. While most concussion symptoms resolve within two to four weeks, dizziness and balance problems are among the most persistent complaints, affecting up to 50–80% of people in the early stages and lingering for months or even years in some cases.
Post-concussion dizziness is not a single condition. It is an umbrella term for several overlapping vestibular and neurological problems that can follow a head injury. The impact of a concussion can disrupt communication between the inner ear, the eyes, and the brain — the three systems responsible for keeping you balanced and oriented in space. When any part of this network is impaired, the result is dizziness, imbalance, or difficulty tolerating motion and busy environments.
Understanding exactly which systems are affected is the key to effective treatment, and that is where a thorough vestibular assessment becomes essential.
Common symptoms
- Dizziness or lightheadedness that worsens with head movement or position changes
- Difficulty with balance — feeling unsteady when walking, turning, or standing on uneven surfaces
- Motion sensitivity — increased symptoms in busy visual environments such as shopping centres, scrolling screens, or traffic
- Visual disturbance — blurred vision, difficulty tracking moving objects, or trouble focusing after head movements
- Nausea triggered by movement, reading, or screen use
- Fogginess or difficulty concentrating that intensifies alongside dizziness
- Fatigue from the extra effort your brain expends to maintain balance
These symptoms often overlap with visual vertigo and motion sensitivity, and in some cases a secondary BPPV may develop as a direct result of the head trauma.
How we assess post-concussion dizziness
At Burlington Vestibular Therapy, your initial assessment typically takes 60 minutes and is designed to identify the specific vestibular and neurological contributors to your symptoms. Your physiotherapist will evaluate:
- Oculomotor function — smooth pursuit, saccades, and convergence to determine how well your eyes are working with your brain
- Vestibulo-ocular reflex (VOR) — the reflex that stabilises your vision during head movement; impairment here is one of the most common findings after concussion
- Positional testing — the Dix-Hallpike and roll tests to rule out or confirm BPPV, which occurs in up to 25% of post-concussion patients
- Balance and gait assessment — static and dynamic balance tasks, including conditions that challenge your visual and proprioceptive systems
- Motion sensitivity screening — a standardised questionnaire and functional movements to quantify how much motion and visual complexity provoke your symptoms
- Cervical spine screen — neck dysfunction after concussion can independently contribute to dizziness and headaches
The findings from this assessment guide a personalised treatment programme tailored to the exact problems identified.
How post-concussion dizziness is treated
Vestibular rehabilitation is an evidence-based, exercise-driven approach that retrains the brain's ability to process balance and spatial information. At Burlington Vestibular Therapy, your treatment programme may include several of the following components depending on your assessment findings.
Vestibulo-ocular reflex (VOR) training
VOR exercises involve coordinated head and eye movements designed to improve gaze stability. These exercises progressively challenge the reflex so your brain can recalibrate how it stabilises your vision during everyday head movements — reducing dizziness and visual blurring.
Habituation exercises
If motion sensitivity is a significant part of your presentation, habituation exercises involve repeated, controlled exposure to the specific movements and visual environments that provoke your symptoms. Over time, your nervous system learns to reduce its overreaction to these stimuli, gradually expanding the activities you can tolerate without discomfort.
Balance and gait retraining
Progressive balance exercises challenge your visual, vestibular, and proprioceptive systems in a structured way — beginning with simple standing tasks and advancing to dynamic activities such as walking with head turns, navigating uneven terrain, or dual-tasking. The goal is to restore the confidence and stability you need for daily life.
Canalith repositioning (if BPPV is present)
If positional testing reveals a concurrent BPPV, your therapist will perform the appropriate repositioning manoeuvre — such as the Epley or Semont — to resolve it. Treating BPPV early often produces an immediate and noticeable improvement in overall dizziness. Learn more about BPPV and how it is treated.
Graded return-to-activity guidance
Your therapist will work with you to establish a safe, stepwise return to physical activity, work, and screen use. This includes guidance on pacing, symptom monitoring, and when to progress to the next level of demand — ensuring your recovery moves forward without repeated setbacks.
Recovery timeline
Recovery from post-concussion dizziness varies depending on the severity of the injury, the specific systems involved, and how long symptoms have been present before treatment begins. As a general guide:
- Mild cases with primarily VOR impairment or isolated BPPV often improve significantly within 4–6 weeks of targeted vestibular therapy.
- Moderate cases involving motion sensitivity and balance deficits typically require 8–12 weeks of consistent rehabilitation.
- Persistent cases — where symptoms have lasted several months or longer — may require a more extended programme, but meaningful improvement is still expected with the right approach.
Research consistently shows that early, active vestibular rehabilitation leads to better outcomes than rest alone. Even patients who are months or years post-injury can make significant gains when the underlying vestibular contributors are properly identified and treated.
When to seek treatment
If you are experiencing dizziness, balance problems, or motion sensitivity after a concussion — whether the injury occurred days, weeks, or months ago — vestibular rehabilitation can help. You do not need a referral from a doctor to see a vestibular physiotherapist in Ontario.
Seek assessment sooner rather than later if:
- Dizziness is preventing you from returning to work, school, or sport
- Your symptoms have not improved with rest
- You feel unsteady or fearful of falling
- Busy environments or screens consistently trigger discomfort
- You were told to "wait it out" but symptoms persist beyond four weeks
Book your vestibular assessment at Burlington Vestibular Therapy. We will identify the specific causes of your dizziness and build a rehabilitation programme to get you back to the activities that matter to you.
This content is for informational purposes only and does not replace professional medical advice. If you have experienced a head injury with loss of consciousness, worsening headaches, repeated vomiting, seizures, or changes in vision or speech, seek emergency medical attention immediately.
Learn more about vestibular therapy and the full range of conditions we treat.