Concussions

Eye and Balance Exercises

Follow the link for Eye and Balance Exercise vidoes
 
 
 
CONCUSSION HOME EXERCISES: VISUAL
The following exercises are to be started only under the expressed guidance of a trained concussion specialist, after an appropriate evaluation with discussion of an overall post-con- cussion treatment plan.
 
If you don’t feel that you can do the recommended number of these exercises, do only as many as you are comfortable doing.
 
Two Thumb Exercise for Convergence Insufficiency
 
  • Hold one thumb close to your face and the other hand out at arm’s distance.
  • Focus your eyes on the farthest thumb till the nail looks clear.
  • Hold that focus for 10 seconds.
  • Rapidly move your eye focus to the closer thumb and focus on the thumbnail.
  • Hold that focus for 10 seconds.
  • Return your eye focus to far thumb.
  • Repeat 5 times, building up your tolerance to repeat 10 times.
  • Be sure to take breaks if you start to have increased symptoms.
 
Saccades Exercise (Horizontal)
 
  • Place two sticky notes on the wall at eye level, about 12 inches apart. Write a capital letter on each sticky note. Stand about 3 feet from the wall. Or, stretch out your arms in front of you and hold up your index fingers at eye level, about 12 inches apart.
  • Keep your head still during all exercises; move only your eyes.
  • Start the exercise by quickly looking at the target to your right.
  • Then quickly move your gaze from the right to the left target, then back from the left to right target.
  • Repeat the back-and-forth eye motions for one minute.
  • Repeat the one-minute exercises three times a day.
 
Saccades Exercise (Vertical)
 
  • Place two sticky notes on the wall about 12 inches apart. Line one on top, about 6 inches above eye level, and the bottom one about 6 inches below eye level. Write a capital letter on each sticky note. Stand about 3 feet from the wall. Or, stretch out your arms in front of you and line up your index fingers about 12 inches apart, with one finger about 6 inches above eye level and the other about 6 inches below eye  level.

  • Keep your head still during all exercises; move only your eyes.
  • Start the exercise by quickly looking at the upper target with just your eyes.
  • Then quickly move your gaze from the upper to the lower target, then back from the lower to the upper target.
  • Repeat the up-and-down eye motions for one minute.
  • Repeat the one-minute exercises three times a day.
 
Vestibular Ocular Exercise
 
Eye Movements (keep head still)
  • Move eyes up and down, then side to side.
  • Repeat five times, twice per day.
 
Head Movements (move your head)
  • Move head up and down, then side to side, then diagonal to the right, then diagonal to the left.
  • Repeat five times, twice per day.
 
Eye-Head Movements
  • Hold your thumb up at a comfortable distance where the thumbnail is in focus.
  • Move the thumb up and down, and follow the thumb with your eyes and head.
  • Then move the thumb side to side, and follow the thumb with your eyes and head.
  • Perform 3-5 reps of each direction.
 
Gaze Stabilization
  • Place one sticky note on the wall at eye level. Write a capital letter on the sticky note. Stand about 3 feet from the wall.
  • Start the exercise by holding the target steady and turning your head from right to left while keeping your eyes on the target.
  • Repeat the back-and-forth motion for one minute. Then rest for one minute.
  • Next, keep the target steady but move your head up and down while keeping your eyes on the target.
  • Repeat the up-and-down motion for one minute.
  • Repeat both the side-to-side and up-and-down exercises three times a day.

CONCUSSION HOME EXERCISES: VESTIBULAR/BALANCE
The following exercises are to be started only under the expressed guidance of a trained concussion specialist, after an appropriate evaluation with discussion of an overall post- concussion treatment plan.
 
If you don’t feel that you can do the recommended number of these exercises, do only as many as you are comfortable doing.
 
One Leg Balance
 
  • Stand on one foot while brushing teeth, brushing hair or even texting.
  • Try to increase hold time to 30 seconds.
  • Repeat on other foot.
  • Repeat up to three times per day.
 
Tandem Gait
 
  • Walk heel-to-toe forward 5-10 steps, then backward 5-10 steps with eyes open.
  • Repeat up to three times.
  • If tolerated OK (no loss of balance, no increased symptoms), then walk heel-to-toe for- ward and backward with eyes  closed.
  • Repeat up to three times.
 
Individual Ball Exercises
 
  • Throw a small ball from hand to hand (above eye level) first seated, then standing, then walking forward and  backward.
  • Do for up to one minute.
 
Advanced Ball Exercises (in preparation for return to sport)
 
  • Walk a circle around another person who will throw you a ball, and catch and return the ball. Can do for one minute, rest one minute, with up to three repetitions.
  • Try light basketball shooting and rebounding (no impact or collision with others). Dribbling   is okay if the noise does not bother  you.
  • Try light table tennis, or toss a tennis ball against a wall, catch and repeat.
 
Exercises developed by Chris Koutures, MD, board-certified pediatrician and sports medicine specialist.
 
CHOC Children’s Concussion Program (888) 770-2462
choc.org/concussion
 

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