Shift Concussion Management is dedicated to providing a high standard of care for all individuals and athletes who are at risk of sustaining a concussion. Managing a concussion thoroughly, in an individualized manner, and with evidence-based techniques is the best way to get our patients back to work, school, and daily activity safely.


When to go to the hospital:

Emergency evaluation is warranted in situations of deteriorating mental status such as increasing confusion and difficulty recognizing people or places. Other symptoms requiring immediate medical attention include worsening headache; worsening nausea or vomiting, and excessive drowsiness or lethargy.

When a concussion is suspected, we also recommend booking an initial assessment as early as possible with one of Shift’s healthcare providers. Even if you have not had a baseline assessment with Shift, we will assess your injury and provide you with a management strategy to aid in your recovery.

What to expect at your Assessment

Our Healthcare Providers will conduct a thorough post-injury evaluation in order to gain a complete picture of your injury and how it’s impacted you. This includes a detailed interview in order to obtain information on:

  • How the injury occurred
  • How you felt immediately after
  • How you’re feeling currently
  • History of previous concussions
  • Current and past medical conditions
  • Previous trauma/injury
  • Medications

The physical examination provides us with insight into the severity of your injury, as well as specific impairments that may need to be addressed as part of an ongoing management strategy. This portion of testing may include a combination of the following:

  • Computerized neurocognitive testing (ImPACT – Immediate Post-Concussion Assessment and Cognitive Testing)
  • Balance testing
  • Strength and Coordination testing
  • Screening of visual motor skills
  • Vestibular (or equilibrium) testing
  • Gait assessment
  • Generalized neurological screen
  • Orthopedic assessment of secondary injuries (e.g. neck, shoulders)

The above testing procedures may not all be completed on the first visit. The assessment methods used are tailored to the immediate needs of the athlete and each Healthcare Provider uses his/her discretion on a case-by-case basis.

“Last summer I sustained a concussion after a hard fall at work. The pain, anxiety and other symptoms caused by the concussion were so severe; I was truly at a loss and felt hopeless. I had no idea what a concussion was supposed to feel like or how long it would last. After a few weeks I decided it was time to seek help from a concussion expert, not only to get some answers but also to guide me through my recovery. In just one visit at Shift, it was discovered that I had a visual dysfunction (as well as other impairments that were contributing to my symptoms) and immediately I was referred to an optometrist who specializes in this area. Regular treatments and appointments at Shift significantly reduced my pain, increased the strength in my neck, and were extremely beneficial in helping me manage the anxiety associated with my concussion.

I would not be where I am today without the help of the team at Shift. Their extensive knowledge about concussion management and expertise has had a huge impact on my quality of life.

A concussion is an extremely complex injury, and seeing a professional who completely understands its nature is key to overcoming it. The team at Shift have been these experts for me, and I would highly recommend Shift to anyone suffering from a concussion and all of its symptoms.”

Stephanie Metzger, Founder/Owner Thrive Health & Wellness

Management Strategies

Following a concussion, the “sitting in a dark room” approach is only effective for so long. Concussions, like other sports injuries, should be properly managed and rehabilitated. While complete physical and cognitive rest is the mainstay of concussion care, having a health professional guide you through this step-by-step may prove to be invaluable.

Recovering from a concussion can be a difficult and frustrating time. At Shift, we understand that each patient is affected differently and as such, requires individualized care. Management strategies are used to limit the amount of impairment as well as expedite recovery as much as possible. These strategies may include any one or a combination of the following and are case-dependent:

  • Individualized resting strategies and home instruction
  • Specific recommendations around employment/academic demands
  • Manual therapy for associated complaints (neck pain, whiplash etc.)
  • Visual motor rehabilitation
  • Vestibular therapy
  • Physical exertion testing and exercise plans for return-to-sport

It is recommended that athletes and active individuals undergo a step-wise process of physical exertion testing once symptom free. Similar to weight training, athletes recovering from a concussion should not skip to 100% exertion from 0% in a short time frame. Physical exertion testing is important not only for physical re-conditioning, but to guard against symptom relapse and help prevent premature return-to-sport. Our Shift professionals can guide you through this process.

Baseline Testing

Because concussions can be difficult to diagnose and test for, many health professionals recommend that athletes or workers in high-risk environments obtain a baseline test prior to participation. A baseline test gives health professionals a point of reference or “snap shot” of your pre-season cognitive and physical function so that if you sustain a concussion, the after-injury results can be compared to your baseline test. Having a baseline test helps health professionals more accurately gauge the severity of your injury, objectively monitor your recovery, and determine when it is safe for you to return to play or work.

For more information on concussion care, visit