Holistic Concussion Treatment: A Comprehensive Approach for Athletic Trainers

Most athletes recover from concussions within a typical timeframe, but a substantial subset experience prolonged symptoms that interfere with daily function and return-to-play readiness. Athletic trainers are at the front lines of concussion management, and a growing body of research now supports a holistic, interdisciplinary approach to care that extends far beyond rest and reassurance.

This comprehensive model integrates physical, cognitive, psychological, nutritional, and environmental interventions—each playing a role in restoring athlete function and accelerating safe recovery. For athletic trainers balancing demanding schedules, this treatment philosophy provides a framework that is not only evidence-based but also adaptable to real-world challenges.

Why a Holistic Model Matters

Historically, concussion treatment emphasized physical and cognitive rest. However, emerging research shows that a multi-modal, active recovery plan improves outcomes and helps prevent the development of persistent concussion symptoms.

For example, the GAIN (Get going After concussion) study published in eClinicalMedicine demonstrated that an interdisciplinary, eight-week intervention involving physical therapy, psychological counseling, and education significantly reduced symptom severity compared to usual care (source). These findings align with current best practices, as outlined in the 6th International Conference on Concussion in Sport (Amsterdam, 2022), which advocates for symptom-targeted, progressive treatment approaches.

Physical Therapy and Vestibular Rehabilitation

Vestibular dysfunction and cervicogenic symptoms are common post-concussion and contribute to dizziness, imbalance, and visual instability. Evidence strongly supports vestibular and cervical physical therapy as core components of concussion rehabilitation. Multimodal physical therapy has demonstrated effectiveness in systematic reviews, emphasizing vestibular training, cervical mobilization, aerobic exercise, and neuromotor control interventions (source).

Physical Therapy

Athletic trainers can initiate early assessment of balance and vestibular symptoms using portable tools and collaborate with physical therapists to tailor referral timing and treatment protocols. This integration helps reduce symptom chronicity and supports a faster, safer return to activity.

Neuro Rehab and Emerging Neuromodulation Techniques

Photobiomodulation (red and near-infrared light therapy) is being studied for its potential to increase cerebral blood flow and reduce neuroinflammation. Preliminary data from case series highlight its promise, especially in patients with prolonged cognitive symptoms (source).

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Mind-Body Interventions for Anxiety and Dysregulation

An often-overlooked component of concussion recovery is psychological well-being. Many athletes develop anxiety, mood fluctuations, or somatic concerns post-injury, which can prolong symptoms. Mind-body therapies have shown potential to reduce these psychological barriers to recovery.

In the TOR-C pilot study, a four-session, video-based mind-body program including breath work, mindfulness, and cognitive strategies showed feasibility and symptom reduction in anxious young adults with recent concussions (source). Athletic trainers working closely with athletes can identify emotional dysregulation early and recommend or facilitate access to supportive psychological care.

Osteopathic and Manual Therapy Approaches

Manual therapies such as osteopathic manipulative treatment (OMT) are increasingly recognized for their benefit in addressing somatic dysfunction post-concussion. A 2025 literature review noted statistically significant symptom reductions in patients receiving OMT compared to those receiving conventional treatment alone (source).

Techniques targeting the cervical spine, craniosacral system, and myofascial restrictions may relieve associated symptoms like headache and neck pain, contributing to a smoother recovery trajectory. For athletic trainers skilled in manual therapy or working within a multidisciplinary team, incorporating such modalities may enhance outcomes.

Nature-Based and Ecological Therapies

Two pilot studies have investigated nature-based therapy in individuals with persistent concussion symptoms. These interventions, conducted in forest therapy gardens, combined physical movement, sensory integration, and relaxation exercises. Both studies reported reductions in mental fatigue and improved subjective well-being that persisted weeks after the program ended (2024 pilot; 2019 study).

Ecological Therapies

While not widely adopted in athletic settings, these findings invite creative thinking around environmental and sensory strategies—such as outdoor walks, mindfulness breaks in green spaces, and structured downtime—that can be adapted for athletic populations.

Hyperbaric Oxygen Therapy (HBOT)

Low-pressure hyperbaric oxygen therapy has shown promise in improving cognitive symptoms and brain structure in persistent concussion cases. A 2023 double-blind, sham-controlled pilot trial revealed statistically significant improvements compared to placebo (source).

While HBOT remains resource-intensive and less accessible in most high school settings, awareness of its efficacy can inform referrals for complex cases and long-haul athletes, especially those treated in specialty centers. There is still significant research to be done in this area and already lots of conflicting evidence. 

Bringing It All Together in the Athletic Setting

Holistic concussion care requires coordination across disciplines—but athletic trainers are uniquely positioned to orchestrate this effort. They maintain daily contact with athletes, monitor subtle shifts in symptom presentation, and can quickly triage to appropriate specialists.

Incorporating holistic strategies doesn’t mean abandoning standard protocols. It means enhancing them with tools and therapies that are specific to the individual patient and athlete’s needs. Whether that’s integrating balance assessments with mindfulness coaching, supporting dietary adjustments alongside rehabilitation exercises, or advocating for psychological referrals, the athletic trainer plays a pivotal role in comprehensive care.

Athletic trainers are more than first responders—they are long-term advocates for athlete health. Embracing a holistic model of concussion treatment not only improves outcomes but also reflects a deeper understanding of the athlete as a whole person. As research evolves, so should our strategies—ensuring that every step of concussion recovery is purposeful, informed, and person-centered.

Continued collaboration with physical therapists, neurologists, psychologists, and other professionals will be key in delivering this standard of care. And as evidence continues to support integrative approaches, athletic trainers remain vital to translating research into recovery, one athlete at a time.

Reviewed by Kim Wyand, PT, DPT

Director of Customer Experience, Sway Medical

Dr. Kim Wyand is a licensed physical therapist and concussion education specialist with more than a decade of experience in outpatient orthopedic and neurological rehabilitation. On top of leading the customer experience team, Kim works closely with Sway's research team, ensuring the platform remains grounded in research and consistently aligned with evidence-based best practices. She leads the development of tools and resources that support over 13,000 clinicians and athletic programs in delivering high-quality concussion care.