Clinical Research Directory

Inclusion Criteria: * 13 - 19 years of age at the start of treatment * Diagnosed by the study physician with a concussion as per the 5th International Consensus Statement on Concussion in Sport1 * Glasgow Coma Scale 13-15 if recorded * Loss of consciousness \< 30 minutes if present * Post-traumatic amnesia \< 24 hours if present * Diagnosis within 2 weeks of injury * Moderate-severe symptoms of dizziness, neck pain, headaches, or sleep disturbance at \> one week and \< three weeks post injury reported on the PCSS (3-6 on 0-6 Likert scale for at least one of three symptoms) * Patients can have a history of migraine or a family history of migraine Exclusion Criteria: * Inability to communicate orally and/or in writing in English language * Significant developmental delay or intellectual disability * No access to smartphone or computer * Red flags or other clinical indication suggesting that further medical investigation is warranted (e.g., neurological scan - reflexes, dermatomes, myotomes, long tract signs, CN II-XII, Cerebellar Scan * Unresolved Benign Paroxysmal Positional Vertigo (BPPV) (Dix-Hallpike and Roll Test) * Inability to participate in physical activity for a reason other than concussion * Orthopedic or other injury precluding ability to participate * Medical history of neurological conditions: seizures (febrile SZ will be allowed), stroke, previous moderate/severe TBI, CNS cancers, SCI * Psychotic disorder * Inability to provide informed consent * History of surgery in the occipital region * Uncontrolled rheumatologic, inflammatory, or neurologic disorders (eg MS); Fibromyalgia/chronic fatigue syndrome; coagulopathy; immunosuppression * Active cancer * Herpes zoster infection in last 6 months * Pregnancy * Steroid injection to the greater or lesser occipital nerve infiltration in past 3 months * Previously enrolled in the trial