How Long Does Dizziness Last After a Concussion? Clues from the Latest Research

Factors That Prolong Dizziness

Multiple variables can influence the duration of dizziness after a concussion:

• Undiagnosed Vestibular Dysfunction: Many athletes are not initially screened for vestibular impairments, leading to missed rehabilitation opportunities.
  
  
• Visual System Disruption: Oculomotor issues can worsen balance and coordination, contributing to persistent dizziness. A case-based article from Presbyopia Physician highlights how integrated neuro-optometric and vestibular care is essential when visual symptoms accompany dizziness (source).
  
  
• Coexisting Headache Disorders: Vestibular migraine and other headache syndromes can overlap with post-concussive symptoms, further muddying the clinical picture. A recent case study in BMJ Open SEM described a patient with vertigo and dizziness weeks after a concussion who showed improvement with the migraine medication atogepant, pointing to overlapping neurochemical pathways (source).
  
  
• Inactivity and Avoidance: Fear of movement and prolonged rest can delay vestibular compensation, prolonging symptoms.

Clinical Scenarios and Real-World Implications

Consider a collegiate soccer player who continues to experience lightheadedness and balance issues three months post-concussion. Her initial rest period was extended, but vestibular therapy was not initiated. By the time she begins rehabilitation, her symptoms have become entrenched, affecting her gait and confidence on the field.

In another example, a high school athlete recovering from a car accident presents with visual tracking difficulties and dizziness. Collaborative treatment between a vestibular therapist and a neuro-optometrist results in symptom resolution within eight weeks—an outcome that may not have been possible without an integrated approach.

Clinical Takeaways for Athletic Trainers and Physical Therapists

• Early Screening is Critical: Vestibular and visual screening within the first week post-injury can identify treatable impairments early.
  
  
• Multidisciplinary Care Yields Results: Collaboration with vestibular-trained physical therapists, neuro-optometrists, neurologists, and headache specialists improves outcomes, especially in complex cases.
  
  
• Rehabilitation Should Be Progressive: Begin with symptom-tolerant activities and progress to dynamic balance and visual tasks. Individualized care plans are key.
  
  
• Educate Athletes and Families: Persistent dizziness can be frustrating and frightening. Providing reassurance, setting realistic expectations, and outlining a clear rehabilitation plan can improve adherence.

Objective Balance Testing: Enhancing Clinical Decision-Making

Assessing postural stability is a core component of concussion management, especially when dizziness is present. One valuable tool in this process is mobile-based balance testing, which offers objective, accessible, and real-time feedback without the need for specialized equipment. Platforms like Sway use the motion sensors already embedded in mobile devices to capture subtle postural shifts during balance stances. These movements are quantified into a 100-point scale, providing clear data on an athlete's stability.

This approach supports clinical decision-making at multiple stages—from sideline assessments immediately after injury to progress monitoring during recovery. Standardized protocols such as the mBESS and mCTSIB are integrated into the testing process, allowing athletic trainers and clinicians to track recovery with confidence. When paired with other vestibular or neurocognitive evaluations, mobile balance testing helps identify lingering impairments that may not be visible through symptom reporting alone, improving return-to-play safety and patient outcomes.

Dizziness following a concussion is not just a symptom—it can be a signal of deeper vestibular or visual system disruption. While many athletes recover within weeks, a significant number continue to experience symptoms for months or even years. The good news is that with timely screening, targeted therapy, and coordinated care, recovery is possible.

The latest research affirms what clinicians have long suspected: post-concussive dizziness deserves careful attention, not only for symptom relief but also for optimizing long-term athletic performance and quality of life.

If you're working with an athlete struggling with persistent dizziness, consider a referral for vestibular evaluation. Early intervention can make all the difference.