Concussions are complex injuries that affect the brain's structure and function, often leaving patients with persistent symptoms that disrupt daily life and athletic performance. Despite advances in concussion management, many individuals—particularly athletes and military personnel—continue to experience lingering issues such as fatigue, brain fog, emotional instability, and memory problems weeks or even months after injury.
These persistent concussion symptoms call for innovative, evidence-based interventions. One promising emerging therapy is red light therapy, also known as photobiomodulation (PBM).
Transcranial red and near-infrared (NIR) light therapy is gaining traction among clinicians, particularly those working in neurorehabilitation and sports medicine. With growing clinical data supporting its ability to modulate brain metabolism, reduce inflammation, and promote neuroplasticity, red light therapy may offer new hope for individuals recovering from concussions.
What Is Red Light Therapy?
Red light therapy involves the application of low-level red and near-infrared light to the body using LEDs or lasers. In transcranial applications, this light penetrates the scalp and skull to reach brain tissue. The primary mechanism is mitochondrial stimulation: red and NIR wavelengths are absorbed by cytochrome c oxidase, a key enzyme in cellular respiration. This enhances adenosine triphosphate (ATP) production, reduces oxidative stress, and triggers cellular repair processes.
These mechanisms are particularly relevant to brain injuries, where mitochondrial dysfunction and neuroinflammation are known contributors to prolonged symptoms. By targeting these underlying physiological issues, red light therapy aims to support the brain’s recovery process at a cellular level.
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The Science Behind Red Light Therapy and Concussion Recovery
Several studies have explored the use of red/NIR light therapy in patients with mild traumatic brain injury (mTBI), including those with persistent symptoms post-concussion. While the research is still evolving, early results are promising and support clinical curiosity.
One of the most widely cited pilot studies is the ImPACTR trial, which assessed photobiomodulation in individuals experiencing persistent symptoms after a concussion. Participants reported meaningful improvements in cognitive clarity, mood regulation, and sleep after regular PBM sessions. The study noted improved mitochondrial function and regional cerebral blood flow as key physiological outcomes of treatment.
Another significant contribution comes from Naeser et al., who documented measurable gains in executive function, working memory, and verbal learning in patients with chronic TBI following a structured regimen of transcranial LED therapy. This case series also highlighted the therapy’s safety profile and its potential to enhance quality of life without the side effects commonly associated with pharmaceuticals.
Importantly, this therapeutic modality isn't limited to clinical settings. A case report involving a professional hockey player demonstrated substantial improvements in cognitive performance and structural brain integrity after consistent home-based red light therapy. Functional MRI scans showed restored activity in brain regions previously impaired by concussion, suggesting that PBM may not only ease symptoms but also support true neuroregeneration.
How Does Red Light Therapy Work in the Context of Concussion?
Red/NIR light therapy influences multiple biological systems that are disrupted following a concussion. Here's how:
1. Mitochondrial Activation
Mitochondria, often referred to as the "powerhouses" of the cell, are vital for energy production. Concussions impair mitochondrial function, leading to decreased ATP availability in brain tissue. PBM stimulates cytochrome c oxidase, improving oxygen consumption and enhancing energy production in neurons.
2. Anti-Inflammatory Effects
Brain injuries frequently trigger a cascade of inflammatory responses. Red light therapy has been shown to reduce pro-inflammatory cytokines and microglial activation, creating a more favorable environment for neural recovery.
3. Cerebral Blood Flow
Impaired blood flow to specific brain regions is common in post-concussive states. PBM can improve regional perfusion, particularly in the prefrontal cortex, a key area for executive functioning and emotional regulation.
4. Neuroplasticity and Synaptogenesis
Emerging evidence suggests that PBM promotes brain-derived neurotrophic factor (BDNF) expression, supporting synapse formation and plasticity. This is critical in adapting to neural injury and restoring function.
Real-World Application: What This Means for Clinicians and Athletic Programs
In sports medicine settings, particularly at the high school and collegiate levels, the potential of red light therapy introduces an opportunity to support athletes beyond conventional rest-and-monitor protocols. For athletic trainers managing return-to-play decisions under the guidance of the Amsterdam 2022 Consensus Statement, integrating red light therapy may help reduce symptom burden during stages 1–3 of the graded recovery process. While PBM is not currently included in standardized RTP protocols, its growing body of research suggests value as a supportive therapy.
College-level programs with access to interdisciplinary care teams are already beginning to experiment with PBM devices. Given that red light therapy is generally safe, non-invasive, and increasingly accessible, its use in athletic training rooms and rehabilitation clinics is expanding.
For physical therapists and sports rehab clinicians, PBM aligns well with existing neurorehabilitation approaches, particularly when paired with vestibular therapy, oculomotor training, or exertional rehab. Several clinicians report that patients treated with red/NIR light therapy show faster resolution of symptoms like light sensitivity, cognitive fatigue, and sleep disturbances—common barriers to functional return.
Barriers and Considerations
While early results are promising, it’s important to view PBM through a realistic clinical lens. Larger, sham-controlled trials are still needed to firmly establish dosing protocols, long-term outcomes, and patient selection criteria. One such pilot study using a placebo design did show cognitive and mood improvements in individuals with chronic post-concussion symptoms, lending further credibility to PBM's effects.
Another practical consideration is accessibility. While PBM devices are becoming more affordable, they remain an investment, and not all clinics or athletic programs have the budget or infrastructure to implement them. Moreover, appropriate training is essential to ensure the therapy is applied correctly in terms of wavelength, duration, and frequency.
From a regulatory perspective, red light therapy is not yet FDA-approved specifically for concussion treatment. As such, any clinical use should be guided by a licensed provider with knowledge of concussion pathophysiology and the latest evidence in neuromodulation techniques.
Looking Forward
As the conversation around brain health expands, the need for multifaceted concussion care strategies is clear. Red light therapy represents a scientifically grounded, low-risk intervention that could complement traditional rehabilitation for individuals struggling with persistent symptoms.
A review of light-based interventions concluded that PBM shows potential in modulating neuroinflammatory responses, boosting mitochondrial health, and even triggering neurogenesis. These mechanisms are central to healing after a concussion, where damaged neural networks require energy, oxygen, and support to recover.
Red light therapy offers an exciting avenue for supporting concussion recovery—especially for individuals with lingering symptoms who have not responded fully to rest, rehabilitation, or traditional interventions. Its ability to target key recovery mechanisms like mitochondrial dysfunction, cerebral perfusion, and inflammation positions it as more than a trend—it may be a turning point in how we support brain health after injury.
