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Intermediate Post-Concussion Return Routine

A gradual return-to-activity session combining light cardio, balance, and neck/upper-back mobility in ~25 minutes.

Warm-Up

Settle symptoms, mobilize spine/neck, and prepare for light activity without provoking dizziness. Mobility and calm start focus.

Diaphragmatic Breathing
Diaphragmatic Breathing1 min
Cat-Cow Stretch
Cat-Cow Stretch1 min
Neck Range of Motion (Slow)
Neck Range of Motion (Slow)1 min

Circuit A

Keep effort moderate; take extra rest if symptoms rise above baseline.

March in Place
March in Place1 min
Step Jack (No Jump)
Step Jack (No Jump)1 min
Wall Push-Up
Wall Push-Up12x
Glute Bridge
Glute Bridge12x
Bird Dog
Bird Dog8x
Tandem Stance
Tandem Stance30 sec
Single-Leg Stance
Single-Leg Stance20 sec each side
2 rounds · 15 sec rest
1 min rest

Strength Reset

Controlled reps; exhale on effort. Use the chair for support if needed.

Sit to Stand
Sit to Stand10x

Cool-Down

Downshift the nervous system and gently mobilize the upper back. Breathing and mobility focus.

Thoracic Rotation (Open Book)
Thoracic Rotation (Open Book)1m 30s
Diaphragmatic Breathing
Diaphragmatic Breathing2 min
Vestibular Load Sequencing in Recovery

Vestibular Load Sequencing in Recovery

Diaphragmatic breathing and Cat-Cow prime the autonomic nervous system before any vestibular demand is introduced. Bird Dog and Single-Leg Stance progressively challenge the cerebellum's balance integration without triggering symptom spikes — each earns its place by adding postural complexity only after the nervous system is settled.

Why Concussion Recovery Isn't Just Rest

Why Concussion Recovery Isn't Just Rest

Post-concussion syndrome taxes the cervical spine's proprioceptive role in gaze stabilization — which is why Neck ROM and Thoracic Rotation appear here, not just for mobility. Sit to Stand and Glute Bridge restore neuromuscular sequencing in the kinetic chain, addressing the deconditioning that accumulates during symptom-driven inactivity.

Symptom-Threshold Training Explained

Symptom-Threshold Training Explained

This routine is structured around the 'just below threshold' principle — effort stays sub-symptomatic so the brain adapts without inflammatory setback. Step Jacks replace jumping to control intracranial pressure fluctuation. If Tandem Stance feels easy with eyes open, close them to increase vestibular demand without changing a single exercise.

Intermediate Post-Concussion Return Routine | Mighty Nimble | Mighty Nimble