Concussion symptoms still there after 4 weeks
Reviewed November 2026 by Online Concussion Clinic, a Perth-based telehealth concussion physiotherapy service. How this site is run
Most people recover from concussion within about four weeks. When symptoms last longer than that, they're called persisting symptoms (you may also hear “post-concussion syndrome”). It's common, it's treatable, and it doesn't mean there's permanent damage.
Common persisting symptoms
- Headaches
- Dizziness or feeling off-balance
- Neck pain or stiffness
- Tiredness and low energy
- Trouble sleeping
- Poor concentration or memory
- Sensitivity to light or noise
- Blurred vision or trouble reading or with screens
- Symptoms during exercise
- Feeling anxious, low or irritable
Why symptoms can hang around
There's usually more than one cause. Symptoms can come from the neck, the balance and vision systems, how the body handles exercise, sleep, stress and mood, or pre-existing conditions such as migraine, anxiety or depression. That's why the international consensus recommends a broad assessment, ideally by a team, rather than waiting it out.
What a proper assessment looks like
- A detailed history and symptom check
- Neck, balance and eye-movement (vestibular-ocular) testing
- An exercise tolerance test, usually on a treadmill or bike, to find a safe exercise level
- Screening for sleep, mood, concentration and memory problems
- Referral to other professionals where needed, such as a GP, sports physician, neuropsychologist or psychologist
Treatments that help
- Individual aerobic exercise set below the level that brings on symptoms, then built up over time.
- Neck and vestibular (balance and dizziness) rehabilitation for headache, neck pain or dizziness. The consensus recommends this from about 10 days if these symptoms persist, so there's no need to wait four weeks.
- Psychological support, such as cognitive behavioural therapy, when anxiety, low mood or stress are part of the picture.
- Sleep strategies and pacing your daily activity.
- A gradual return to school or work with adjustments, such as shorter days, breaks and less screen time.
Long periods of strict rest aren't recommended — staying gently active, with the right guidance, helps recovery.
Children and teenagers
Young people often take longer to recover than adults, so the AIS guidelines take a more cautious approach for anyone under 19. Return to learning comes first. Under-19s must be symptom-free for at least 14 days before contact training and wait at least 21 days before competitive contact sport. After repeated concussions, those times are longer.
Call 000 or go to the nearest emergency department if there is:
- Loss of consciousness, or getting drowsier or harder to wake
- A seizure or convulsion
- Severe or worsening headache
- Repeated vomiting
- Neck pain or tenderness
- Double vision or loss of vision
- Weakness, tingling or burning in the arms or legs
- Increasing confusion, agitation, restlessness or unusual behaviour
- A visible deformity of the skull
For children, the emergency department at Perth Children's Hospital (Nedlands) is open 24 hours. If you're unsure, call healthdirect on 1800 022 222 (24 hours) for nurse advice.
Find concussion care in Perth
Browse verified concussion providers across Perth — physiotherapists, GPs and neuropsychologists — and use the map to find one close to home. You don't need a referral to see a physiotherapist privately.
Where this information comes from
- Patricios JS, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport – Amsterdam, October 2022. British Journal of Sports Medicine 2023;57:695–711. doi:10.1136/bjsports-2023-106898
- Concussion Recognition Tool 6 (CRT6), from the same conference.
- Australian Institute of Sport. Concussion and Brain Health Position Statement 2024, and the Australian Concussion Guidelines for Youth and Community Sport. ausport.gov.au/concussion
This page is general information, not medical advice for your situation. Your own health professional's advice comes first, and your sport or school may have its own concussion rules.