Michael Collins, a leading American concussion specialist, identifies six different types of concussion. Each of these is characterised by different types of symptoms and should be treated in a distinct way. They are not mutually exclusive, so you might have more than one of these, or even the full house:
- cognitive fatigue (including concentration problems, brain fog, distractability)
- vestibular (problems with balance, co-ordinating head and eye movements, motion sensitivity)
- ocular (problems with eyes working together rather than poor vision per se, so ocular-motor really)
- migraine (headache with nausea, light or noise sensitivity)
- anxiety (excessive worry, rumination, low mood)
- neck (due to damage to neck or spinal cord, less common)
Six types of concussion and how to treat them (short article)
Six types of concussion – Infographic pdf
Michael Collins – short video summary (3 and a half minutes)
Michael Collins – detailed interview (over one hour) – “there are highly effective treatments for this injury”
The long interview gives more information about the treatment approaches for the different types. For example, vestibular concussions require activities to challenge the vestibular pathways in the brain, while having high anxiety (caused by excessive sympathetic nervous system arousal – being too much in ‘fight or flight’ mode) can be helped by physical exercises to stimulate the parasympathetic nervous system to relax you.
(Canadian filmmaker Sarah Polley suffered from post-concussion symptoms for years after a fire extinguisher fell on her head and eventually saw Michael Collins who diagnosed her with a vestibular concussion and instructed her to stop avoiding triggering her symptoms and instead to do all the things that bring them on. She did this, initially finding it excruciatingly difficult, but after about two weeks realised she was able to cope with much more, and after six weeks felt basically to normal and has been fine every since.)
Michael Collins also notes that problems with one system, such as the vestibular system, can have numerous knock-on effects on other systems, which is why specialist diagnosis is important to figure out the root problem(s) and treat them effectively.
Specialist diagnosis is not always available, especially in the UK with its failing NHS, and up-to-date research can take 15-20 years to become incorporated into general medical practice (according to concussion specialists). If you can’t find or afford a concussion specialist, it’s worth taking a look at the Concussion Fix programme.
This is an online programme run by three concussion-focused specialists (a chiropractic doctor, a naturopath, and a clinical psychologist) which goes over all the possible underlying causes of your persistent concussion symptoms – including all those outlined above – and shows you ways to resolve them.
I’m doing this programme now and it’s already making a difference (summer 2025). I’ll report back when I’ve completed it…