After a concussion, many people struggle to describe how they feel.
They’re not always in pain.
They’re not always dizzy.
They’re not always confused.
But they often feel… “off”.
Discombobulated.
Out of sync.
Not quite themselves.
This “discombobulated state” is one of the most common—but least clearly defined—experiences following concussion. And it may actually hold the key to understanding why most people recover quickly, while a smaller proportion go on to develop persisting symptoms.
In the days following a concussion, symptoms like dizziness, headache, visual strain, neck discomfort, fatigue, and mental fog often appear together. Traditionally, these have been treated as separate problems.
But clinically, they rarely occur in isolation.
Instead, what we often see is a temporary state of neural desynchronisation—a mismatch between systems that normally work seamlessly together:
Individually, these changes may be subtle. Together, they create a powerful sense of instability and unreliability.
That’s the discombobulated state.
For some people this feeling is genuinely frightening, especially if the mind is left to flounder and worry without advice and reassurance from a health professional.
The brain is not a single processor—it’s a distributed network of interacting systems. After concussion, many of these networks appear to fall temporarily out of phase.
This includes:
Processing Speed Delays
The brain’s ability to integrate information slows. Tasks that once felt automatic now require effort. This can feel like fogginess, slowness, or mental fatigue.
Visual–Vestibular–Cervical Mismatches
The visual system, inner ear, and neck proprioceptors normally provide tightly integrated and predictable information about where you are in space. After concussion, these signals can become misaligned, leading to:
Eye movements—saccades, smooth pursuit, vergence—can lose precision and timing. This can contribute to:
Altered Cervical Muscle Control
Concussion (a rapid head acceleration event) frequently co-occurs with neck injury. Changes in cervical muscle activation, joint position sense, and reflexes can amplify dizziness, headaches, and postural instability.
Postural and Movement Compensations
When the brain feels unreliable, the body compensates. People become stiff, cautious, guarded. This increases energy expenditure and fatigue.
The Overlay of Anxiety and Poor Sleep
Uncertainty about symptoms, fear of worsening (every week there are headlines about head impacts and neurodegenerative diseases), disrupted routines, and neurochemical changes all increase vulnerability to anxiety and sleep disturbance—both of which further destabilise brain networks.
For most people, this state is transient.
It can last:
During this time, the brain appears to be managing what some researchers describe as a temporary neurobiological energy crisis—a period where metabolic demand exceeds supply. It also a period to avoid another head impact!
When this energy mismatch is paired with a neck injury, sensory conflict increases further.
But crucially:
This does not necessarily represent ‘permanent brain injury’.
It is a state, not a trait.
Up to 70% of people recover from concussion within a few weeks.
But around 30% develop persisting symptoms.
Here’s where we need to be careful.
If we fail to differentiate between:
…we risk treating everyone as though they have a moderate brain injury.
In reality, persistent symptoms are often influenced by:
These factors may prolong the discombobulated state—or prevent it from resolving.
At Your Brain Health we will support researchers that:
Rather than thinking in terms of single symptoms—dizziness, headache, fatigue—we should be thinking in terms of network stability.
Concussion disrupts timing, coordination, and integration. That’s why we promote early cervico-vestibular, visual and physical rehabilitation to force the brain to adapt to this discombobulated state.
Early recovery is not just about rest.
It’s about re-synchronisation.
Associate Professor James McLoughlin
Associate Professor James McLoughlin is Chief Academic Officer at Your Brain Health and Director of Advanced Neuro Rehab.
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