Persistent Post-Concussion Symptoms (PPCS) — The Chronic 5-20%
Clinical mastery for the concussion cases that don't resolve in standard timeframes. Vestibulo-ocular workup, cervical contribution, escalation pathways. For clinicians who already work in acute concussion and want the chronic-case framework.
What the course will cover
Identifying PPCS early
Clinical criteria, when "this isn't resolving" should change your plan, common missed presentations.
Vestibulo-ocular workup beyond VOMS
The ~70% of PPCS cases that need it. Full clinical workup, treatment frameworks, when to refer.
Cervical contribution to chronic symptoms
The ~54% of PPCS cases with cervical drivers. Differential, manual therapy applications, when whiplash overlap matters.
Escalation criteria + referral pathways
Who needs neurology, neuropsychology, vestibular specialist, headache clinic. When to refer and how to position the handoff.
Active rehabilitation protocols
Beyond "wait until symptom-free" (now obsolete under Amsterdam 2023). Sub-threshold exercise, graded exposure, return-to-school/work.
Why this course exists
Most concussion CPD is acute-focused — the first 4 weeks, SCAT6, return-to-play. That training is essential, but it doesn't prepare clinicians for the 5-20% of cases that don't resolve.
A 2018 scoping review explicitly identified persistent post-concussion symptoms as a clinician knowledge gap. The clinicians most affected aren't the sports-medicine specialists — they're the generalist physios, osteos, and GPs who see PPCS in the second week and don't have a framework for what comes next.
This course is for them. Built on the same evidence base as Concussion Clinical Mastery (Amsterdam 2023, AIS 2024 brain health), with a chronic-case clinical workup that leverages vestibulo-ocular + cervical depth.