Serving Pittsford and the greater Rochester, NY region. Persistent symptoms are not random. One system is typically limiting recovery at a given phase. Identifying it — and restoring its capacity before increasing demand — is what resolves the stall.
Persistent headaches that won't go away. Brain fog and difficulty concentrating. Dizziness when moving your head. Sensitivity to light and sound that makes normal environments overwhelming.
Feeling off balance or unsteady. Fatigue that limits daily activities, no matter how much you rest. Trouble with screens and reading. Anxiety or mood changes that weren't there before your injury.
These aren't signs of weakness. When symptoms persist beyond the expected recovery window, a Primary Constraint in one or more neurologic systems is usually present—one that won't resolve with rest alone.
Explore our specialized services designed to address your specific concussion-related needs
Local, specialized care for persistent post-concussion symptoms. Constraint-based evaluation identifies the Primary Constraint limiting your recovery.
Learn MoreWhen symptoms won't resolve on their own. Specialized treatment for persistent headaches, dizziness, cognitive fog, and fatigue.
Learn MoreEvidence-based therapy for dizziness, vertigo, balance problems, and visual-vestibular dysfunction after concussion.
Learn MoreConcussion recovery does not fail randomly. When recovery stalls, a Primary Constraint is present. While multiple systems may be involved, one is typically limiting progress at a given phase—forcing others to compensate and amplifying symptoms downstream.
Identifying that constraint—and sequencing care to restore its capacity before increasing demand—is what distinguishes durable recovery from symptom management.
We restore measurable capacity before increasing demand. Timelines do not determine readiness. Physiology does.
The systems below are the primary sites of constraint in concussion recovery. Each links to a detailed clinical explanation.
Processes visual motion, focus, and spatial accuracy, commonly contributing to headaches, dizziness, and screen intolerance after concussion.
Visual Dysfunction After Concussion →Regulates balance, orientation, and motion sensing, often driving dizziness, nausea, and movement sensitivity.
Vestibular Dysfunction After Concussion →Coordinates timing, sequencing, and motor prediction, contributing to clumsiness, slowed performance, and exertional fatigue.
Cerebellar Timing Deficits After Concussion →Controls energy regulation, heart rate, and recovery capacity, commonly underlying exercise intolerance and symptom flares.
Autonomic Dysfunction After Concussion →Supports attention, inhibition, and cognitive motor control, often involved in brain fog, overwhelm, and decision fatigue.
Executive Dysfunction After Concussion →Establishes baseline regulation and sensory gating, influencing sleep, light sensitivity, and symptom volatility.
Brainstem Dysfunction After Concussion →Integrates body position and movement feedback, contributing to disorientation, clumsiness, and movement insecurity.
Proprioceptive Dysfunction After Concussion →Modulates threat perception and protective responses, influencing symptom persistence, anxiety, and pain amplification.
Limbic Dysregulation After Concussion →What Durable Recovery Means
These are the functional benchmarks we use to define discharge readiness—not symptom absence alone.
Our evaluation distinguishes between the primary constraint and secondary compensation. This distinction determines the treatment sequence—addressing a compensating system first often prolongs recovery.
In persistent cases, the limiting factor can evolve. We reassess each visit to ensure sequencing remains aligned with physiologic readiness.
Progress is measured objectively at the start and at discharge within our Clinical Outcome Registry.
After a concussion, your brain's energy metabolism is disrupted. Normal activities now require more neural resources than you have available.
After concussion, metabolic demand increases while production capacity decreases. This mismatch explains symptom worsening with effort—and why progressive loading without capacity restoration prolongs recovery.
You might notice symptoms that worsen later in the day. Crashes after cognitive or physical exertion. A constant need for rest breaks. The inability to return to normal activity levels. Sleep that doesn't fully restore your energy. Mental exhaustion from tasks that used to feel simple.
Treatment is dosed to restore metabolic capacity incrementally. Load is increased only when physiologic readiness is confirmed—not based on time elapsed or symptom tolerance alone.
Clinical reference: Persistent Neurologic Symptoms After COVID-19, PPC Clinical White Paper Series.
A comprehensive assessment that goes far beyond standard concussion protocols
Progress is measured objectively at the start and at discharge
Detailed testing of all neurologic systems to identify the Primary Constraint
Clear explanation of which systems are affected and why you have symptoms
Targeted interventions sequenced to restore capacity before increasing demand
Explore our in-depth guides on specific post-concussion challenges and evidence-based recovery strategies.
Understanding why your eyes and inner ear aren't working together, and what targeted treatment looks like.
How ANS dysregulation causes fatigue, anxiety, and exercise intolerance after concussion.
When your brain's master clock is disrupted and recovery feels impossible to achieve.
Our clinical model reflects established consensus statements, peer-reviewed neuroscience literature, validated outcome instruments, and minimal clinically important difference thresholds. Citations and supporting documentation are available for professional and payor review.
A clinician-led evaluation identifies the Primary Constraint and sequences care to restore Adaptive Capacity before increasing demand. Progress is measured objectively at the start and at discharge.
Schedule EvaluationFree Patient Guide
Evidence-based strategies for the first 72 hours after concussion: what to do, what to avoid, and how to protect neurologic recovery before your evaluation.
Common questions about concussion treatment and recovery
Most concussion symptoms resolve within 7–10 days, but 10–20% of patients develop persistent symptoms lasting months or years. When recovery stalls, a Primary Constraint is typically present. Many patients notice measurable change within the first several visits once the Primary Constraint is identified. That early change is a signal of correct sequencing — not full recovery. Durable resolution requires sustained tolerance under load: full school, exercise, and cognitive demand without regression.
Traditional physical therapy focuses on exercises and symptom management. Our approach identifies the Primary Constraint—the specific system limiting recovery at a given phase—and sequences care to restore Adaptive Capacity before increasing demand. Physiology determines readiness, not time elapsed. Progress is measured objectively at the start and at discharge within our Clinical Outcome Registry, and sequencing is adjusted visit-to-visit based on physiologic response.
No referral is required. You can schedule directly through our website or by calling our office. However, we do coordinate with your primary care physician and any specialists involved in your care to ensure comprehensive treatment.
Neurologic Care is private-pay. This allows treatment to be sequenced according to physiologic response rather than authorization limits. A clear fee structure is provided at scheduling. Documentation for out-of-network submission is available upon request.
Yes. Persistent symptoms following concussion often reflect an unresolved Primary Constraint—one that has not been identified or sequenced correctly. The duration since injury does not determine whether durable resolution is achievable. A constraint-based evaluation identifies which system is limiting recovery and establishes a sequencing plan grounded in measurable physiologic readiness. Many patients who have struggled for 1–5 or more years achieve durable resolution once the correct constraint is addressed.
Your initial evaluation establishes a measurable baseline across the primary systems involved in concussion recovery. We identify the Primary Constraint—the system most limiting recovery at this phase—and document your baseline in our Clinical Outcome Registry. You leave with a clear sequencing plan: what is limiting recovery, what capacity must be restored first, and what objective criteria determine readiness to progress. The evaluation typically takes 60–90 minutes.
Each episode of care is structured around a single Primary Constraint — the main limiter keeping you stuck — because treating multiple complaints simultaneously prevents accurate attribution of progress to any specific intervention. When you address two complaints at once and improve, you cannot know which Care Track produced the change, which system was actually limiting recovery, or whether Readiness Gating was satisfied for each domain independently. One primary complaint per episode is not a limitation of scope — it is the structural requirement for Constraint-Based Medicine to produce reliable, measurable, and durable outcomes. If you present with multiple complaints, the most functionally limiting one is addressed first. Subsequent complaints are addressed in separate, sequenced episodes once the primary constraint has been resolved and Durability confirmed.
Stop waiting for symptoms to resolve on their own. Schedule your comprehensive neurologic evaluation today.