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Level Up Physical Therapy

Returning to Work after Concussion


Returning to work after concussion

Returning to work after Concussion


Many people find that switching from being at home to being full time at work is a difficult transition.


At home, you can adjust the lighting, the sound environment, the type of activity you’re engaged in, and the timing and length of breaks you take through the day.


Jumping into work full time at regular duties can be quite provoking for some people. This may provoke headaches, fatigue, or dizziness. You may realize there’s a limit to the time you can concentrate on a task and be productive.


Ideally, a graduated return to work program can be arranged.


You should be gradually increasing your thinking activities and physical activities at home as you recover from your concussion.


If you’re able to tolerate 3 – 4 hours of activity with some occasional short breaks, a gradual return to work can be initiated.


A graduated return to work would ideally be working part time hours from home on non-urgent tasks so you can incorporate breaks throughout the day and still complete the tasks.


You should also trial the commute to work to determine its effects on symptoms.



It’s important to understand two points:

  1. You do not need to be symptom free before returning to work after a concussion.

  2. It’s normal to experience increased symptoms when attempting new activities like returning to work.


Scheduling regular breaks and being able to take breaks when symptoms are increasing is important.

An example of a simple rule is that if a symptom increases by 2 out of 10 points in severity, then you should take a break. This break could be simply changing to a new unrelated activity, or it might be 10 to 20 minutes in a quiet room. You can then return to the original provoking activity but being cautious about how much time you spend doing that activity so your symptoms don’t flare up again.


If symptoms are not settling after a 20 minute break, it may be time to stop the work day, but recognizing the specifics of the provoking task so you can set a timer the next day to keep the duration of that activity within a non-provoking zone.



With a return to your regular work environment, here are some items that should be considered after concussion:

  • Flexible work hours

  • Reduced workload

  • Start your return to work with less demanding tasks

  • Extra time for completion of tasks

  • Access to a quiet and distraction free environment for breaks.

  • Have a plan to leave work if a 20 minute break is not enough to settle aggravated symptoms.


After the initial return to work for 3 – 4 hours, a gradual process of increasing the hours and increasing the demands of the work are implemented. This process is often a trial and error type of learning process. For example, you may not know you’re sensitive to a group meeting with a large bright screen until you’re in that particular situation.



Important concerns with returning to work after concussion:

Some types of employment can have risks to one’s self or risk to others and need special considerations and clearance from a physician.

Examples: Driver, heavy equipment operator, working from heights, and health care situations like nursing or physicians.



Summary of concepts for return to work after concussion:

  • You don’t need to be symptom free before returning to work.

  • You may need an initial plan for reduced hours, increased availability to breaks, and reduced workload.

  • Gradually increasing your hours and workload is often a bumpy road.

  • The graduated return to work should be viewed as a learning process to develop a strategy that fits you and your specific employment and work environment.



If you're recovering from a concussion, consider booking an assessment or just giving us a call.

Here's the link to the concussion page of our website:

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