November 18, 2020

Post Concussion Challenges

Post Concussion Challenges  
Did you know that more than 1 in 10 people that have POTS reported that their symptoms started within 3 months of a concussion? 

POTS has been traditionally associated following viral infections, surgeries or pregnancy, and traumatic brain injuries like concussions.
Postural Orthostatic Tachycardia Syndrome or POTS for short, is part of a larger family of conditions called dysautonomia. Dysautonomia is the dysfunction of the autonomic nervous system, the system responsible for fight/flight and rest/digest. If the autonomic nervous system is not working well, you can have troubles with blood flow, lightheadedness, digestion, headaches, light sensitivity, and syncope sometimes called fainting or “blacking out.” For people with POTS, lightheadedness or even fainting after standing up can be common. This happens because the heart starts racing, scientifically called tachycardia. When the heart beats too fast, it does not have time to fill up with blood all the way between pumps which can deprive good blood circulation to different parts of your brain and body. 

The POTS Concussion Connection
Having POTS after a concussion makes sense, since the part of the brain that controls the autonomic nervous system is the brainstem, a small structure that connects our brain to our spinal cord. This area is vulnerable in acceleration/deceleration injuries like a concussion, especially if there is torsion or twisting involved. Unfortunately, if part of your condition causes decreased or inappropriate blood flow to the area you are trying to heal, like the brain, healing can be slowed down. 
There is a specific subtype of post-concussion syndrome that may be more likely to occur with POTS, physiological post-concussive disorder. Like most post-concussion syndromes, active rehabilitation is recommended to improve brain function. This can include neurological rehabilitation and physical exercise. Neurological rehabilitation may be needed before physical exercise can be prescribed. To learn more about neurological rehabilitation and how it can help you, contact us at


Ellis, M. J., Leddy, J. J., & Willer, B. (2015). Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment. Brain Inj, 29(2), 238-248. 

Miranda, N. A., Boris, J. R., Kouvel, K. M., & Stiles, L. (2018, Jul). Activity and Exercise Intolerance After Concussion: Identification and Management of Postural Orthostatic Tachycardia Syndrome. J Neurol Phys Ther, 42(3), 163-171. 

Plasticity Centers ©