Aerobic Exercise for Post Concussion Syndrome


Concussion is common in contact sports, especially combat sports, and can result in an increased risk of musculoskeletal injury, as well as further concussion. The latter can have serious consequences. 


Whilst concussions typically resolve in 1-2 weeks, in some instances symptoms can persist for much longer (Post Concussion Syndrome), in which case secondary effects such as headache, restlessness, difficulty sleeping, vestibular sensitivity and altered mood may occur. Therefore, strategies aimed at speeding up the recovery of persistent concussion symptoms are advantageous for athletes, coaches and medical professionals working in the field. 


This symptomatic review looked at 12 studies examining the effect of sub-symptomatic threshold aerobic exercise (i.e. exercising at an intensity below that at which concussion symptoms worsened) on post concussion symptom recovery. 


The studies demonstrated significant improvement in symptoms following an aerobic exercise program. Although the details of implementation differed, the most commonly used protocols involved 20 minutes bouts of aerobic exercise at 80% of the heart rate at which symptoms occurred. 


It appears well established now that aerobic exercise is beneficial for concussion rehabilitation, future research should focus on the optimal dosage to maximise recovery.


  1. McIntyre M, Kempenaar A, Amiri M, Alavinia SM, Kumbhare D. The Role of Subsymptom Threshold Aerobic Exercise for Persistent Concussion Symptoms in Patients With Postconcussion Syndrome: A Systematic Review. Am J Phys Med Rehabil. 2020;99(3):257–264.

About the author

Sam Gilbert

Sam Gilbert is a registered physiotherapist with the Australian Physiotherapy Association (APA) and certified strength and conditioning specialist (CSCS) with the National Strength and Conditioning Association (NSCA). He holds a bachelor’s degree in Physiotherapy from Latrobe university (Melbourne, Australia) and a master’s degree in Exercise Science (Strength and Conditioning) from Edith Cowan University (Perth, Australia).

A 3rd Dan black belt in Shinkyokushinkai Karate under the World Karate Organisation (WKO), Sam participated for over 20 years in full contact competition, winning multiple state and national titles, and culminating in a 4th place in the heavyweight division of the Shinkyokushinkai World Cup in 2009.

As the co-founder and clinical director of Club 360, the premier multi-disciplinary health and fitness center in Tokyo, Japan, Sam has combined his practical experience with an in-depth study of sports performance in relation to combat sports, and strives to help other combat athletes reach their full competitive potential, whilst at the same time decreasing injury risk and increasing competition and training potential.

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By Sam Gilbert