Concussion and Whiplash After an Accident: Why You Might Have Both

You’re weeks past the accident now.

You did the “right” thing. You went to physical therapy for your neck. The sharp pain is better. Your range of motion is improving. Everyone keeps telling you that you’re healing.

But something still feels off.

You’re dizzy when you turn your head.
Your headaches won’t fully go away.
Busy places like grocery stores, traffic, or sporting events suddenly feel overwhelming.
You’re so tired you’re falling asleep during the day, or you can’t sleep because your neck and shoulders won’t relax.
You feel lightheaded, foggy, or like you’re on a ship or mildly hungover.
Your heart races when you bend down or reach overhead.

And the most confusing part?

Your neck feels better, so why don’t you?

Here’s what no one may have told you yet: it’s very common to have both a whiplash injury and a concussion at the same time, and treating only one can slow or stall your recovery.

Why These Two Injuries Happen Together

Whiplash and concussion are not separate accidents. They come from the same physical forces.

When your body is suddenly accelerated or stopped in a car crash, fall, sports collision, or other impact, your torso moves first and your head follows milliseconds later. That rapid lag creates a whipping motion through the neck while also causing the brain to move within the skull.

The same force that strains the muscles, joints, and nerves of your neck can also disrupt how your brain processes balance, vision, and sensory information.

So why do they often get diagnosed separately?

• Different providers evaluate different body systems
• Neck pain is obvious early, while concussion symptoms can evolve over days or weeks
• Imaging often appears normal even when symptoms persist
• Many symptoms overlap and get mislabeled as stress, anxiety, or poor sleep

In my practice, I consistently see patients whose neck pain improves but who remain dizzy, overstimulated, fatigued, or guarded with movement. The pattern that often gets missed is how the brain and neck are still interacting.

What Having Both Injuries Can Feel Like

When concussion and whiplash occur together, symptoms often blend in ways that are confusing and frustrating.

Common Whiplash Symptoms

• Neck stiffness or pain
• Shoulder and upper back tension
• Headaches that start at the base of the skull
• Pain or restriction when turning the head, especially while driving
• A sense of guarding or fear with head movement

Common Concussion Symptoms

• Dizziness or lightheadedness
• Sensitivity to light or noise
• Difficulty concentrating or communicating
• Eye strain, blurred vision, or headaches with screens
• Fatigue or disrupted sleep

Overlapping Symptoms (The Confusing Ones)

• Headaches that change location or quality
• Dizziness that worsens with head movement
• Anxiety or nervousness in busy environments
• Feeling off balance or disconnected from your body
• Increased heart rate with position changes
• Reduced tolerance for work, screens, or exercise

One patient summed it up perfectly:

“My neck feels better, but I still don’t feel like myself. I’m exhausted all the time, and places that never bothered me before now feel overwhelming.

Why Treating One Without the Other Doesn’t Work

These injuries do not exist in isolation. They reinforce each other.

A brain injury can increase sensitivity in the nervous system, leading to protective neck guarding. Neck stiffness and altered joint input can disrupt balance and eye–head coordination, increasing dizziness. That dizziness raises anxiety, which further tightens the neck and shoulders.

Trying to treat only the neck or only the concussion leaves part of the system unresolved. Recovery happens when both are addressed together.

Ask Yourself: A Quick Self-Check

Ask yourself:

• Are you still dizzy when turning your head?
• Do headaches start at the base of your skull?
• Is your neck still stiff weeks into treatment?
• Are you more fatigued than expected?
• Are light or noise bothering you more than before?

If you answer yes to two or more, a comprehensive evaluation that looks at both concussion and whiplash is warranted.

How Physical Therapy Addresses Both

Effective care treats the neck, brain, and nervous system as one integrated system.

Whiplash-Focused Treatment May Include

• Manual therapy to reduce protective muscle guarding
• Targeted mobility for the cervical spine
• Proprioceptive retraining to improve your sense of where your head is in space

Concussion-Focused Treatment May Include

• Vestibular rehabilitation to retrain balance and motion tolerance
• Visual tracking and eye–head coordination exercises
• Careful management of physical and cognitive exertion

The Integrated Approach

When treating both injuries together, exercises are selected and progressed based on how symptoms respond, not just how strong or mobile someone appears. Neck movement is retrained while monitoring dizziness and visual symptoms, and vestibular work is adjusted to avoid reinforcing guarding.

Consistency, pacing, and communication are essential for progress.

What You Can Try This Week

While waiting for or between appointments, consider these gentle strategies:

1. Gentle Awareness Exercise
   Practice slow, comfortable head turns while seated. Stop before symptoms increase significantly.
2. Track More Than Pain
   Notice what increases dizziness, fatigue, or visual strain and how long it takes for symptoms to settle.
3. Modify Your Environment
   Reduce harsh lighting, limit screen time into shorter blocks, and take regular movement breaks.

Small changes can reduce overload while your nervous system heals.

When to Get Help

Seek immediate medical care if you experience worsening neurological symptoms, severe or progressive headaches, weakness, numbness, or changes in consciousness.

Physical therapy is appropriate when symptoms persist beyond the expected recovery window, imaging is normal but function is not, or progress has plateaued.

Look for a physical therapist who treats both cervical and concussion-related conditions and adjusts care based on symptom response. Bring a list of symptoms, details of the accident, and notes on what helps or worsens your symptoms.

Some cases require medical evaluation first, and a qualified provider will guide you appropriately.

Recovery Is Possible

You are not imagining this.
You are not weak.
You are not “just anxious.”

You may be dealing with two injuries that require two coordinated approaches.

In my practice, good recovery looks like less dizziness, less fatigue, fewer headaches, clearer thinking, better sleep, improved posture, and increasing confidence with daily activities.

When concussion and whiplash are addressed together, recovery becomes clearer, more predictable, and sustainable.

References 

1. Haldeman S, Carroll L, Cassidy JD, Schubert J, Nygren Å. The bone and joint decade 2000–2010 task force on neck pain and its associated disorders. Spine (Phila Pa 1976). 2008;33(4 Suppl):S5-S7.
2. Giza CC, Hovda DA. The neurometabolic cascade of concussion. J Athl Train. 2001;36(3):228-235.
3. Marshall CM. The role of the cervical spine in post-concussion syndrome. Phys Sportsmed. 2012;40(3):30-37.
4. Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Man Ther. 2008;13(1):2-11.
5. Alsalaheen BA, Mucha A, Morris LO, et al. Vestibular rehabilitation for dizziness and balance disorders after concussion. J Neurol Phys Ther. 2010;34(2):87-93.