EP 119: Cognitive Intolerance: The Concussion Symptom We Don't Talk About Enough

Are you treating all the right systems in your concussion patients, but still struggling to see meaningful progress? Even with a thorough multisystems assessment, treatment may not be working as expected. You may have identified vestibular, autonomic, and cervical dysfunction, yet your patient continues to feel stuck despite addressing each issue. The missing piece could be treatment sequencing. In concussion rehabilitation, the order in which you address each system matters. Understanding which systems are driving symptoms, establishing the right foundations, and building a treatment plan around your patient's capacity can help you achieve more stable, meaningful progress. BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER: Why treating multiple systems at once may not always lead to lasting improvements.

Ever wonder if that breakthrough treatment plan you handed your client on day one is actually keeping them stuck on a recovery plateau?

In this episode, we're taking a closer look at the otolith system, including the utricle and saccule, and how understanding their role can lead to more specific assessment and treatment. You'll learn what to look for when traditional vestibular testing doesn't fully explain a patient's symptoms and how to incorporate otolith screening into a more complete concussion assessment. BY THE TIME YOU FINISH LISTENING, YOU'LL LEARN: How the otolith system supports balance, spatial orientation, eye stabilization, and postural control

Why are your concussion clients still struggling even after their symptoms have completely vanished?

Could medication actually help support concussion recovery, or could it sometimes make things more complicated? When you're dealing with persistent concussion symptoms, it can be easy to rely on medication without fully understanding what each medication is targeting or whether it's still needed. With multiple medications potentially being prescribed for different symptoms, keeping track of how they interact and affect recovery becomes especially important. In this episode, we break down the role medications can play in concussion recovery, why they should be viewed as a tool alongside rehabilitation, and why understanding the purpose and effects of each medication matters. BY THE TIME YOU FINISH LISTENING, YOU'LL LEARN: Why there is no medication that directly treats concussion and how medications are instead used to target specific symptoms Common medication categories used for headaches, sleep, mood, cognitive symptoms, and autonomic issues How medication overuse, side effects, and polypharmacy can complicate concussion recovery Why understanding a patient's medications is important when assessing symptoms and planning rehabilitation Medication can have a place in concussion recovery, but understanding what it is treating and working with your physician is key to making informed decisions. Ready to raise your standard of care and stop hitting clinical ceilings? Join the waitlist for the revamped Concussion Nerds Fellowship 2.0! Doors open this fall for our brand-new cohort, limited to just 25 clinicians. Joining isn't a commitment—it simply gives you first priority to claim your seat before they're gone. 👉 Join the Waitlist Here: https://www.natashawilch.com/concussion-nerds-waitlist Let's connect! Instagram: @natasha.wilch https://www.instagram.com/natasha.wilch/ Email: [email protected] Website: https://www.natasha-wilch.com