The Activcore Blog

What Is Happening Inside My Head During and After A Concussion?

Posted by Dr. Nick Passe, Physical Therapist at Activcore on January 15, 2020 at 1:21 PM

Concussion illustration

Most people think that a concussion occurs when the brain comes in contact with the skull. However, this simply is not the case.

Our brains are floating in cerebrospinal fluid (CSF). This fluid keeps the brain in constant motion during all of the activities throughout our lives. When we are impacted, for example, in a car accident or hit on the athletic field, the brain tissue is sheared in multiple directions. When the neurons within the brain are sheared, they become more permeable for fluid and nutrients to flow within the cells. They are then taking in more energy than is available in the surrounding fluid, leaving little energy remaining for future use.

Because of this, a concussion is an issue of energy use and availability rather than just an issue due to direct impact. This depletion of available energy is what causes both the fatigue and the inability to tolerate basic activities (e.g., reading, television, academics) for extended periods of time. Until the neurons are healed, you might continue to have these hallmark signs and symptoms of concussion.

  1. Headache
  2. Dizziness/ appearing dazed
  3. Nausea/vomiting
  4. Fatigue/ mental fatigue (cloudiness)
  5. Difficulty with activities of daily living
  6. Slurred speech/ inability to comprehend words (written or verbal)

Does every physical contact cause this amount of stress on our brain cells? No. In fact, it takes a force of about 70-120 times greater than the amount of force of gravity (most occurring around the 98g threshold), or a high velocity of rotational force (9,500 rads/second) to cause this amount of damage. The majority of contacts in daily life produce far less impact than this amount of force.

How can we most effectively heal the neurons and stabilize the energy flow within the cerebrospinal fluid? When a concussion does occur, the approach to healing should be multifaceted. A treatment plan that incorporates a diet high in the proper nutrients, graded exposure to aerobic conditioning, and neural exercises that don’t exacerbate any symptoms has been proven to be most effective.

The video below shows one example of an exercise that I do with some of my clients. This movement combines neuromuscular activation training with an integration of multiple senses like visual, vestibular and cerebellar.

In future posts, we will explain the effects of multiple concussive impacts on the brain and how a neurological and diet-based approach to treatment can change the outcomes of these impacts. We will also discuss the very popular and often controversial topic of Chronic Traumatic Encephalopathy (CTE).


Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Learn more about how a physical therapist and performance specialist can help you by clicking here to find an Activcore location near you.

Also check out our Telehealth offerings to get help from the comfort of your home.



Broglio, S.P., et. al (2010).The Biomechanical Properties of Concussions in High School Football. Medicine & Science in Sports & Exercise; 42(11); 2064-2071.



Nick Passe. Bio

Nick Passe is a Doctor of Physical Therapy (DPT) who specializes in contact sports like football, basketball, lacrosse and ice hockey. He works at Activcore in Princeton, New Jersey, located just 2 miles from Princeton University.

As a former football player and college cheerleader, Nick knows what it takes to succeed in competitive sports and to overcome injuries. He holds a Bachelors degree in Psychology and Natural Sciences from Pittsburgh University, as well as a Doctorate degree in Physical Therapy from the University of Medicine and Dentistry of New Jersey (now part of Rutgers University), ranked among the top 50 PT schools in the country. He also has advanced post-graduate training in movement assessment and treatment of athletes, including concussion management and prevention.

Nick goes beyond the symptoms and looks at the whole body to help his athletes recover from pain and injury, and safely return to a fulfilling life of sport, activity and wellness. He is among just a handful of physical therapists nationwide to have earned the prestigious designation as a Certified Neurac Provider (CNP), making him exceptionally equipped to evaluate and treat each athlete from head to toe.

Applying the principles of Neurac (Neuromuscular Activation), Nick utilizes the Redcord suspension system to optimize how the mind and muscles work together as one. This is an evidence-based method that a few high-level sports teams are using to keep their athletes healthy and free from pain and injury. In fact, Nick has the pleasure every few months to teach these principles to both the Washington Capitals NHL team and the Washington Nationals MLB team. [READ MORE]



Related Topics: Pain Relief, Performance, Physical Therapy, Headaches, Athlete, Concussions, Sports Injuries