Optimize Sports Chiropractic

24/06/2026

🧠 Persisting Symptoms Post Concussion: More Than Just Symptoms

A concussion is often described as a “temporary brain injury,” but emerging research suggests that for some individuals, the biological effects can persist long after the initial impact.

When recovery is incomplete—or when multiple concussions occur—the brain can become trapped in a cycle of:

🔥 Chronic Neuroinflammation
⚡ Mitochondrial Dysfunction
🧬 Oxidative Stress
🧠 Neuronal Dysfunction
📉 Persisting Symptoms

What happens?

Following concussion, microglia (the brain’s immune cells) become activated to help repair damage. However, when this activation persists, they can continue releasing inflammatory cytokines such as IL-1β, TNF-α, and IL-6.

Over time, this chronic inflammatory environment can:

• Increase oxidative stress
• Damage mitochondrial DNA
• Impair the electron transport chain
• Reduce ATP (cellular energy) production
• Disrupt neuronal communication and neuroplasticity

The result can be persistent symptoms including:

✅ Headaches and migraines
✅ Brain fog and cognitive fatigue
✅ Dizziness and autonomic dysfunction
✅ Mood disturbances and irritability
✅ Exercise intolerance
✅ Sleep disturbances

The Vicious Cycle

1️⃣ Concussion and other physiological stressors trigger inflammation
⬇️
2️⃣ Microglia remain chronically activated
⬇️
3️⃣ Oxidative stress damages mitochondria
⬇️
4️⃣ Neurons struggle to meet energy demands
⬇️
5️⃣ Symptoms persist and recovery stalls

Breaking the Cycle

Evidence-based approaches may target:

✔️ Neuroinflammation reduction
✔️ Mitochondrial support and metabolic recovery
✔️ Oxidative stress management
✔️ Sleep optimization
✔️ Cervicovestibular and visual rehabilitation
✔️ Progressive aerobic exercise
✔️ Individualized concussion management

The key takeaway:

Persisting concussion symptoms are not simply psychological or “all in your head.” They are often linked to measurable physiological changes involving inflammation, energy metabolism, and brain network function.

Understanding the biology behind persisting symptoms post concussion helps move beyond symptom management and toward targeted rehabilitation strategies.

23/06/2026

🧠 When the brain can’t stop burning — neuroinflammation and persistent post-concussion symptoms.

Most concussions resolve in 7–14 days. But for up to 30% of patients, symptoms persist for months or years. One of the most important — and underappreciated — reasons why? The brain’s immune system gets stuck ‘on.’

After a concussion, microglia (the brain’s resident immune cells) activate to clear debris and initiate repair. In most people, this resolves. In others, this inflammatory response becomes self-perpetuating — driving brain fog, sleep disruption, mood dysregulation, and exertion intolerance long after the initial injury.

CSF biomarker studies now confirm elevated inflammatory cytokines (TNF-α, IL-2, IL-15, VEGF) in athletes with PPCS months to years post-injury. This isn’t subjective — it’s measurable biology.

One emerging intervention that maps directly onto these mechanisms: transcranial photobiomodulation (tPBM). Red light penetrates the scalp and skull, absorbs into mitochondrial cytochrome c oxidase, and — critically — shifts microglia from a pro-inflammatory (M1) to a repair-promoting (M2) phenotype. It also enhances meningeal lymphatic flow, complementing glymphatic clearance strategies.

The clinical evidence is still developing. This is a space worth watching — and an area where the mechanistic rationale is well ahead of standardised clinical protocols.

22/06/2026

🧠 When the brain can’t stop burning — neuroinflammation and persistent post-concussion symptoms.

Most concussion symptoms resolve in 7–14 days. But for up to 30% of patients, symptoms persist for months or years. One of the most important — and underappreciated — reasons why? The brain’s immune system gets stuck ‘on.’

After a concussion, microglia (the brain’s resident immune cells) activate to clear debris and initiate repair. In most people, this resolves. In others, this inflammatory response becomes self-perpetuating — driving brain fog, sleep disruption, mood dysregulation, and exertion intolerance long after the initial injury.

CSF biomarker studies now confirm elevated inflammatory cytokines (TNF-α, IL-2, IL-15, VEGF) in athletes with PPCS months to years post-injury. This isn’t subjective — it’s measurable biology.

One emerging intervention that maps directly onto these mechanisms: transcranial photobiomodulation (tPBM). Red light penetrates the scalp and skull, absorbs into mitochondrial cytochrome c oxidase, and — critically — shifts microglia from a pro-inflammatory (M1) to a repair-promoting (M2) phenotype. It also enhances meningeal lymphatic flow, complementing glymphatic clearance strategies.

The clinical evidence is continuing to develop. This is a space worth watching — and an area where the mechanistic rationale is well ahead of standardised clinical protocols.

Swipe through for the full breakdown 👆

20/06/2026

Concussions are often treated as short-term injuries, but what if the real issue is how the brain recovers afterward?

In this episode, Dr. Rob Silverman sits down with Dr. Brett Jarosz, an ACA endorsed Fellow Sports & Exercise Chiropractor, to explore the evolving science of concussion recovery and brain health. Together, they challenge outdated approaches that rely on complete rest and discuss why modern rehabilitation focuses on restoring function through targeted movement, individualized therapy, and metabolic support.

Dr. Jarosz explains why a concussion is more than just a structural injury, how persistent symptoms can stem from dysfunction across multiple systems, and why factors such as autonomic regulation, inflammation, and brain energy production play critical roles in recovery. The conversation also dives into emerging therapies like photobiomodulation, the science behind red light therapy, and why personalized rehabilitation may be the future of concussion care.

Whether you’re a clinician, athlete, coach, or someone recovering from a brain injury, this episode offers practical insights into helping the brain heal and perform at its best.

Key takeaways:
•Concussion is an energy crisis in the brain, affecting metabolism, blood flow, and neurological function.

•New models of concussion treatment emphasize controlled exercise and targeted rehabilitation over complete rest.

•Photobiomodulation, especially low-level laser therapy, shows promising results in improving brain recovery post-concussion.

•Persistent post-concussion symptoms could be multi-faceted, involving neuroinflammation, metabolic dysfunction, and autonomic nervous systems.

•Female athletes experience different concussion recovery processes due to biological and structural differences.

YouTube: https://youtu.be/EDaPG8-nowM?si=rX4eVToajaXrcCrZ

19/06/2026

https://youtu.be/EDaPG8-nowM?si=L_zpaRYbjJsiITwx

Concussions are often treated as short-term injuries, but what if t...

15/06/2026

The vestibulo-ocular motor screening (VOMS) has become one of the most widely used concussion assessment tools.

But if you’ve looked closely at the Sport Concussion Office Assessment Tool 6 (SCOAT6), you may have noticed something interesting…

Several VOMS components were removed.

Does that mean those tests are no longer important?

Not at all.

The modified VOMS (mVOMS) was developed because research showed that certain components provided overlapping information, allowing clinicians to maintain diagnostic accuracy (of symptom provocation) while reducing assessment time.

Importantly, this was a decision about screening efficiency—not about the clinical importance of vestibular or oculomotor dysfunction.

For athletes with persistent symptoms, a comprehensive assessment needs to still include:

• Near Point of Convergence (NPC), Accommodation & Vergence assessment
• Vertical eye movement assessment
• Gaze fixation
• Advanced vestibular testing (eg videooculography and eye tracking)
• Exercise tolerance testing
• Autonomic assessment
• Force Plate Balance assessment
• Motor coordination assessment
• Cervical sensorimotor evaluation

A screening tool is designed to identify potential problems.

A comprehensive assessment is designed to understand them.

Understanding the difference is critical when managing concussion recovery.

08/06/2026

Many concussion assessments rely heavily on symptom reporting.

“Does this make you dizzy?”
“Does your headache increase?”
“Do you feel more foggy?”

These questions are important—but they don’t necessarily tell us why the symptoms are occurring.

Two people can have identical VOMS scores but completely different underlying problems:
• Vestibular dysfunction
• Oculomotor dysfunction
• Cervicogenic dizziness
• Autonomic dysfunction (including POTS)

This is why objective and quantitative assessment is becoming increasingly important in modern concussion rehabilitation.

Technologies and assessments such as:
👁️ Video oculography (VOG)
👁️ Eye tracking
👁️ Dynamic visual acuity
👁️ Convergence & accommodation testing
❤️ Exercise tolerance testing
❤️ Autonomic assessment
🦴 Cervical sensorimotor evaluation
⚖️ Force Plate Balance Assessment
can help identify the specific physiological systems involved and guide a more individualized rehabilitation plan.

The goal isn’t simply to ask:
“How do you feel?”

It’s to understand:
“How is your nervous system functioning?”

The future of concussion management is moving toward precision rehabilitation—matching the right treatment to the right underlying dysfunction.

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02/06/2026

🚨 Concussion Recovery Has Changed 🚨

The old advice:
❌ “Rest until all symptoms are gone”

The current evidence:
✅ EARLY, TARGETED rehabilitation can help speed recovery.

Research now shows that appropriately prescribed:
👁️ Vision therapy
🌀 Vestibular rehabilitation
🧠 Cervical rehabilitation
🏃 Subthreshold aerobic exercise
…can improve recovery times and outcomes after concussion.

Why?
Because the brain enters a period of heightened neuroplasticity after injury — meaning it may be MORE responsive to the right type of rehabilitation in the early stages.

01/06/2026

Concussion Recovery Has Changed 🚨

The old advice:
❌ “Rest until all symptoms are gone”

The current evidence:
✅ EARLY, TARGETED rehabilitation can help speed recovery.

Research now shows that appropriately prescribed:
👁️ Vision therapy
🌀 Vestibular rehabilitation
🧠 Cervical rehabilitation
🏃 Subthreshold aerobic exercise
…can improve recovery times and outcomes after concussion.

Why?
Because the brain enters a period of heightened neuroplasticity after injury — meaning it may be MORE responsive to the right type of rehabilitation in the early stages.

26/05/2026

Concussion recovery is increasingly understood through the lens of mitochondrial dysfunction and cerebral hypometabolism.

Transcranial photobiomodulation (tPBM/tLLLT) aims to directly target these mechanisms through electron transport chain complex I-IV activation, improved oxidative phosphorylation, ATP production, and neurovascular effects.

The research continues to evolve, and the mechanistic rationale is overwhelmingly compelling.