Cleared After a Concussion but Still Not Right? Here Is What Standard Care Misses
You hit your head. You had the scan, you passed the checklist, and a clinician told you that you were good to go. That should have been the end of it. Instead, weeks or months later, you are still getting headaches by mid-afternoon, still losing your train of thought, still feeling like your brain is running on a delay. If this sounds familiar, you are not imagining it, and you are not alone.
Persistent symptoms after a concussion are more common than most people realise, and the standard model of care is simply not built to explain them. It is built to catch the emergency. Once the emergency has been ruled out, the system largely moves on. What gets left behind is the question nobody is asking: why has your brain not finished recovering, and what is actually still wrong.
Clearance is not the same as recovery
Return-to-play and return-to-work protocols exist for a good reason. They are designed to protect you from a second injury while the brain is still vulnerable, and they do that job well. But being cleared through a graded protocol tells you that you tolerated a gradual increase in activity without your symptoms returning at rest. It does not tell you that the underlying biology has fully reset.
A CT or MRI scan is looking for something specific: bleeding, swelling, or a fracture. If none of that is present, the scan is reported as normal. That is accurate, and it is also incomplete. A normal scan cannot tell you whether your autonomic nervous system has regulated itself again, whether blood flow to your brain has returned to baseline, or whether inflammation triggered by the injury has actually resolved. Those are functional questions, and functional questions need functional testing.
Does this sound like you?
The standard concussion pathway is well designed for what it is built to do. It rules out serious structural injury, protects against a second concussion during the vulnerable recovery window, and provides a graded return to activity. These are genuinely important things.
What it is not designed to do is investigate what happens when the biology does not fully reset. A normal scan and a passed protocol are meaningful findings. They are not a complete picture of nervous system function, inflammatory status, or metabolic health.
For most people with persistent symptoms, that next layer of investigation is what has been missing.
Cleared. Normal scan.
Still not yourself.
What is actually going on when symptoms persist?
Autonomic nervous system dysregulation
One of the most consistently documented findings in people with lingering post-concussion symptoms. When the heart rate response is off, the body struggles to regulate blood pressure and blood flow properly, which shows up as fatigue, dizziness, and symptoms that flare with exercise or activity. We assess this directly using HRV analysis, which gives us an objective picture rather than guesswork.
Ongoing neuroinflammation
The brain mounts an inflammatory response to injury the same way any other tissue does, but that response is meant to resolve. In some people it lingers, and a lingering inflammatory response in brain tissue produces exactly the symptoms people describe: fog, fatigue, irritability, and headaches that do not have an obvious trigger.
Gut-brain axis disruption
If gut permeability increases after a significant injury, which it commonly does under physiological stress, inflammatory signals from the gut can cross into circulation and contribute to the same neuroinflammatory picture driving symptoms. Addressing gut function is not a replacement for concussion-specific care, but for many people it is a piece nobody has looked at.
Metabolic disruption
The brain is an extremely energy-hungry organ, and it becomes more dependent on stable fuel supply while it is trying to repair itself. Blood sugar swings that you might not have noticed before the injury can now produce brain fog and fatigue that feel disproportionate to what is actually happening in your day.
Where neurofeedback fits into the picture
One tool we use in this process, where it is appropriate, is neurofeedback. After a concussion, the brain's own regulation of its electrical activity can remain disrupted well after the initial injury has settled, even when a person feels broadly functional. Neurofeedback works by giving the brain real time feedback on its own activity, which supports the retraining of healthier patterns of self-regulation over time.
We do not use it in isolation. It sits alongside the autonomic, metabolic, and inflammatory picture we build through testing, because a brain that is still inflamed or a nervous system that is still dysregulated will not get the full benefit of neurofeedback on its own. If you want to understand more about how we use it and who it tends to suit, we have gone into more detail on our neurofeedback page.
What we actually look at
← Scroll to see full table
| Assessment | What it shows for post-concussion recovery |
|---|---|
| HRV Analysis (BioSign) | Autonomic nervous system function, sympathetic-parasympathetic balance, and adaptive reserve — giving an objective picture of how the nervous system is actually coping rather than relying on symptom report alone |
| Comprehensive Blood Chemistry | Inflammatory markers, nutrient status, thyroid function, and metabolic health at functional reference ranges relevant to brain recovery rather than standard disease thresholds |
| Organic Acids Testing | Mitochondrial energy production efficiency and neurotransmitter precursor availability — both of which are directly relevant to cognitive recovery and the brain's ability to sustain mental effort |
| Fasting Insulin and HbA1c | Blood sugar regulation and metabolic flexibility — identifying whether glucose instability is contributing to brain fog and fatigue by depriving an energy-dependent recovering brain of stable fuel supply |
| GI MAP or MicrobiomiX Stool Analysis | Gut microbiome health and intestinal permeability — identifying whether gut-derived inflammation is contributing to the neuroinflammatory picture maintaining post-concussion symptoms |
| Neurofeedback Assessment | Where appropriate, brain mapping to assess brainwave activity patterns that may have been disrupted by the injury and have not self-corrected — guiding targeted neurofeedback training protocol |
You do not have to accept feeling like this
The most common thing we hear from patients in this situation is some version of "I was told I would just have to give it time." Time matters, but time alone does not resolve a nervous system that is still dysregulated or inflammation that has not been addressed. Those things respond to targeted investigation and targeted treatment, and for most people that means real, measurable improvement rather than an open ended wait.
If you were cleared after a concussion and something still does not feel right, that feeling is worth listening to. We have written a more detailed breakdown of how we investigate and treat persistent post-concussion symptoms on our concussion recovery page, including the specific testing we use and what the process looks like from start to finish.
Dr Matt le Roux and the team at Wave Functional Health work with people across the Gold Coast, and via telehealth worldwide, who are still dealing with the after effects of a concussion long after they were told they were fine. If that is you, we would like to help you find out why.
Cleared but not recovered.
There is a next step worth taking.
If you were cleared after a concussion and something still does not feel right, that feeling is worth listening to. At Wave Functional Health we investigate the functional drivers that standard care is not designed to find.
Book a ConsultationDr Matt le Roux is a chiropractor and functional medicine practitioner at Wave Functional Health, Suite 326, 34-36 Glenferrie Drive, Robina QLD 4226. He works with patients across the Gold Coast and internationally via telehealth.