Concussion recovery is complex and deeply individual, often shaped by a combination of physical, cognitive, and emotional symptoms. One question that frequently arises—especially among athletes, students, and individuals engaged in regular music use—is whether listening to music after a concussion is safe or potentially harmful.
Given the central role of the auditory system in brain processing, this concern is valid. But emerging research reveals that music, when applied thoughtfully, may actually support rather than hinder recovery in many cases. The key lies in timing, type of music, and symptom monitoring.
Understanding the Auditory System’s Role in Concussion Recovery
Concussions disrupt neural communication, particularly within networks responsible for attention, executive function, and sensory processing. The auditory cortex, housed in the temporal lobe, works in coordination with multiple brain regions—meaning that auditory stimulation like music can have widespread neurological effects.
In the acute phase of recovery (the first 24–72 hours post-injury), most guidelines recommend a period of cognitive and sensory rest. This includes minimizing screen time, avoiding loud environments, and limiting intense auditory input.
However, sensory rest does not equate to total deprivation.
According to the 6th International Conference on Concussion in Sport (Amsterdam, 2022), a graduated return to normal activity is encouraged after the brief rest phase. This includes reintroduction of light physical and cognitive tasks, based on tolerance and symptom monitoring. Music, as a form of controlled auditory input, can fit into this phase—if used with clinical discretion and with an individualized approach.
When Is Music Helpful, and When Is It Not?
The appropriateness of music during concussion recovery depends on several key factors:
Timing within recovery: During the initial rest period, music—especially if loud or emotionally intense—may exacerbate symptoms. In later stages, however, structured and familiar music can help stimulate cognitive processes in a non-threatening way.
Symptom presentation: Patients experiencing phonophobia (sensitivity to sound), headaches, or vestibular dysfunction may need to avoid or significantly limit auditory input initially.
Cognitive load and emotional state: Music with lyrics, rapid tempo changes, or strong emotional associations may increase mental fatigue or trigger mood swings in some individuals.
Clinical judgment is essential. One patient's soothing background music could be another’s overwhelming sensory input.
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Evidence Supporting Therapeutic Use of Music After TBI
A growing body of literature supports the use of music-based therapy in traumatic brain injury (TBI), including concussions. While most studies have focused on moderate to severe TBI, the mechanisms explored—neuroplasticity, white matter regeneration, emotional regulation—are highly relevant to mild traumatic brain injury recovery.
One randomized controlled trial published in the Journal of Clinical Medicine found that neurological music therapy (NMT) promoted white matter recovery and improved executive functioning in TBI patients by engaging rhythm and melodic structures (Link). Participants experienced measurable gains in attention and set-shifting abilities after structured, repetitive music sessions.
In another case study on multimodal stimulation after TBI, researchers observed improvements in consciousness and responsiveness with the use of music therapy combined with tactile and visual input (Link). The sensory engagement provided by music may help reactivate cognitive pathways that are otherwise dormant during passive rest.
Even more compelling, a Cochrane Review on music therapy in acquired brain injuries concluded that music therapy could meaningfully improve mood, cognition, movement, and communication when integrated into standard rehabilitation care (Link).
Clinical Applications: How Music Can Be Used Safely Post-Concussion
1. Passive Listening in Controlled Environments
In later stages of recovery, low-volume instrumental music in a quiet setting can reduce stress and support cognitive re-engagement. It’s important that the environment is free from competing auditory stimuli and that the individual is not multitasking during listening sessions.
2. Familiar and Predictable Music
Case studies suggest that familiar childhood songs or previously enjoyed music can improve attention and reduce cognitive fatigue by leveraging memory networks without introducing novelty stress. One study using familiar auditory sensory training in chronic TBI found noticeable gains in attention regulation and fatigue management (Link).
3. Rhythmic Auditory Cueing for Vestibular and Gait Rehabilitation
For patients with balance issues following concussion, rhythmic auditory stimulation has demonstrated benefits in coordination and movement. A pilot study showed improvements in gait patterns when rhythmic music was paired with motor training (Link).
This aligns with common vestibular rehabilitation strategies where external rhythmic cues help reinforce balance and movement sequencing.
4. Structured Cognitive Remediation Through Music Training
Music-based cognitive remediation is a more active and goal-directed use of music, involving tasks like piano playing or rhythm imitation to target executive function and working memory. Structured sessions have been shown to improve attention span and cognitive flexibility in individuals with TBI (Link).
For athletic trainers and physical therapists, this approach offers a non-pharmacologic method to engage recovering athletes in meaningful cognitive tasks that parallel sport-related demands.
Red Flags: When to Avoid or Delay Music Exposure
Listening to music should not be rushed into without considering clinical signs. Avoid music use if the individual reports:
Increased headaches, dizziness, or nausea during or after music exposure
Heightened irritability or emotional distress linked to specific songs
Difficulty concentrating or following simple conversations following auditory stimulation
Known vestibular dysfunction or auditory sensitivity post-injury
In such cases, auditory therapy may still be appropriate—but should be guided by a licensed vestibular or neurological therapist experienced in concussion care.
Real-World Scenario: Music Tolerance in a High School Athlete
A high school soccer player sustains a concussion during a late-season match. After 48 hours of rest, he returns to school on a modified schedule but complains of headaches and fatigue after loud hallway noise. During a treatment session, his athletic trainer considers reintroducing music.
The strategy: Start with 10–15 minutes of soft, instrumental music during a post-treatment rest period. The volume is kept low, and the environment controlled. The athlete is monitored for symptom escalation. Over time, this becomes a calming ritual that helps him tolerate other cognitive tasks like homework and class participation.
This approach respects the timing of recovery, the athlete’s symptom profile, and integrates music as a rehabilitative tool—not a passive entertainment source.
Music after a concussion is not inherently dangerous—but neither is it automatically beneficial. Like any therapeutic tool, it requires thoughtful implementation. When used in coordination with professional judgment and individualized approaches, music can support cognitive recovery, emotional regulation, and even motor function.
Concussion care is moving away from outdated “cocooning” strategies and toward individualized, evidence-guided activity resumption. Music—when appropriately timed and applied—can play a helpful role in that process.
Clinicians, athletic trainers, and sports medicine professionals should consider music not simply as a background element, but as a potential asset in multidisciplinary recovery strategies.
If you're managing concussion recovery and have questions about reintegrating music or other sensory inputs, consult with a licensed physical therapist, vestibular specialist, or your concussion management team. Recovery doesn’t mean isolation—it means strategic engagement.
