Picture this. It is three weeks after the Saturday rugby match, or the bumper bash on the N14, and everyone assumes you are fine. The scan was clear. Yet the headache arrives by ten in the morning, the laptop screen feels far too bright, and you snapped at the children over nothing. You rested in a dark room as you were told, and you still do not feel like yourself.
What a concussion actually does
A concussion is a mild traumatic brain injury. The brain is soft, and when the head stops or turns suddenly, the brain moves inside the skull. The long, thin fibres that connect brain cells, called axons, are thought to be stretched and strained in the process. When this is severe, doctors call it axonal shearing.
The result is thought to be less like a bruise and more like a temporary energy crisis, in which brain cells have to work harder to restore their normal balance. This may be why a normal CT or MRI scan is so common after a concussion. Those scans look at structure, and the problem is thought to be mostly one of function.
Most people recover within a few weeks. For some, symptoms carry on for months. When that happens, doctors may speak of post-concussion syndrome, or persistent post-concussion symptoms.
Why rest in a dark room is not the whole answer
A short period of rest in the first day or two is still sensible. Concussion guidance has, however, moved away from long stretches of lying in a darkened room. Too much rest and isolation can leave you unfit, low in mood and anxious about every twinge. A gradual, guided return to normal activity tends to serve people better.
Lingering symptoms usually arrive in clusters:
- Headaches, dizziness and sensitivity to light or noise
- Fog, slow thinking and trouble finding the right word
- Tiredness that is out of proportion to what you actually did
- Poor sleep, whether too little or far too much
- Irritability, tearfulness, anxiety or a flat, low mood
The mood changes deserve a special mention. Feeling depressed after a concussion is not a weakness of character. The injury itself, the broken sleep and the loss of your normal routine all play a part. If your mood is low, please tell your doctor.
See a doctor first, and know the red flags
A doctor's diagnosis always comes first. Any suspected concussion should be medically assessed, and children and teenagers should not return to sport until a doctor has cleared them.
Go to an emergency unit straight away if, after a head injury, you notice any of the following:
- A headache that is severe, sudden or steadily getting worse
- Repeated vomiting
- A seizure, fainting or increasing drowsiness
- Growing confusion, unusual behaviour or slurred speech
- Weakness, numbness or loss of coordination in an arm or leg
- Double vision, or clear fluid from the nose or ears
If your symptoms are simply not lifting after a few weeks, go back to your GP. You may be referred to a neurologist, a sports physician, a physiotherapist who works with balance and neck problems, an occupational therapist or a psychologist. Neurofeedback does not replace any of them. It is a complementary approach that sits alongside medical treatment and rehabilitation.
Where neurofeedback may fit in
Neurofeedback is a non-invasive form of brain training. Small sensors on the scalp read the brain's electrical activity. Nothing is sent into the brain. A computer then gives you feedback, usually through sound or a picture on a screen, each time your brain shifts towards a steadier pattern. The idea is that, over many repetitions, the brain learns what is being rewarded, much as you once learnt to ride a bicycle.
It is important to be honest about what training can and cannot do. Neurofeedback does not repair stretched axons or heal brain tissue. Time, rest, good medical care and the body's own recovery do that work. What training aims to do is help the nervous system regulate itself more steadily, which may ease how fog, poor sleep and a short fuse are experienced day to day. Evidence for neurofeedback after concussion is still limited. Results vary from person to person.
A clear scan tells you the structure is intact. It does not tell you how hard your brain is working to get through an ordinary day.
What training looks like in our Krugersdorp practice
Every client begins with a 19-channel brain map, which takes about an hour and a half. Sessions after that last 45 to 60 minutes and start with a short check-in on how you are feeling. You can read more about each step on our what to expect page.
Parents of young players may also find our article on rugby concussion and returning to match focus helpful. If the injury was more severe, our piece on stroke and traumatic brain injury rehabilitation explains how brain training can sit beside a formal rehabilitation programme.
Common questions
Can neurofeedback cure post-concussion syndrome?
No, and nobody should promise that. Neurofeedback does not repair brain tissue or guarantee a result. It is a complementary form of brain training that may help the nervous system regulate more steadily, which may ease fog, poor sleep and irritability. It works alongside your doctor's care and rehabilitation, never in place of them.
Can neurofeedback clear my child to play sport again?
No. The decision to return to rugby, hockey or any contact sport belongs to a doctor, following a graded return-to-play process. Neurofeedback cannot clear a player and should never be used to speed that decision up. Training may support focus and steadiness while your child follows the medical plan.
Do I need to stop my headache or mood medication?
No. Please carry on taking any medication exactly as prescribed. Neurofeedback can be done alongside it. If you feel that a medicine is no longer needed or is causing side effects, discuss that with the doctor who prescribed it. Never stop or change a dose on your own.
A concussion that drags on can be lonely, particularly when you look perfectly well from the outside. You do not have to wait it out in the dark. If your doctor has assessed you and you would like to talk through whether brain training might help, you are welcome to get in touch with Irine and ask your questions.
- concussion
- post concussion syndrome
- tbi
- brain fog
- headache
