Neurorehabilitation · London
Concussion VOMS rehab - London.
Specialist assessment and subtype-led rehabilitation for persistent post-concussion symptoms in adults, students and athletes. Berlin/Amsterdam consensus, Buffalo protocol, and a graded return-to-sport pathway.
Why families choose us
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Berlin/Amsterdam and Buffalo protocol trained
Named clinicians working to the 5th International Consensus on Concussion in Sport and the Buffalo Concussion Treadmill Test framework.
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Subtype-led rehabilitation, not one-size-fits-all
The VOMS 5-domain screen identifies which subtype is driving symptoms, so therapy targets vestibular, ocular, cervical, autonomic, mood-cognitive or migraine pathways.
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Independent, and free
We are paid by no clinic. The recommendation is impartial and costs you nothing.
What VOMS-based rehab is
Find the subtype. Treat the subtype.
Persistent post-concussion symptoms are not one thing. They break down into six subtypes, each with its own therapy.
VOMS-based rehabilitation is a specialist assessment and treatment programme for the 15 to 20 percent of concussions that do not fully resolve within two weeks. It sits on the 5th International Consensus on Concussion in Sport (Berlin 2016, Amsterdam 2022) and the Buffalo protocol developed at the University of Buffalo Concussion Clinic.
The clinician uses the 5-domain Vestibular/Ocular Motor Screen (VOMS) to identify which of six subtypes is driving your symptoms - vestibular, ocular, cervical, autonomic, mood-cognitive or migraine. Each subtype has a distinct therapy pathway.
The days of prolonged dark-room rest are over. The current evidence supports early, symptom-limited activity, sub-symptom threshold aerobic exercise, and targeted therapy for the affected system. Most people improve meaningfully within 6 to 12 weeks.
For athletes, the same assessment framework drives the 6-stage graded return-to-sport pathway required by rugby, football, motorsport and boxing governing bodies before contact training resumes.
Indicative pricing
What private concussion rehab costs in London.
Indicative ranges across our London network. Send us your story and we quote firm figures within one working day.
In short
Assessment £250–£450, per session £120–£220, typical 8–12 session programme £1,400–£2,800.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial specialist concussion assessment (SCAT-6, VOMS, BCTT) | £250–£450 | 75–90 min | Report in 3 days |
| Rehab session (vestibular, oculomotor, cervical or autonomic) | £120–£220 | 45–60 min | Weekly |
| Typical 8–12 session programme | £1,400–£2,800 | 8–12 wks | 2–3 months |
| Return-to-sport clearance review | £220–£380 | 45 min | Same week |
When to seek rehab
Two weeks in and still not right.
If symptoms are still meaningful at 14 days, or if an athlete needs return-to-play clearance, this is the point at which specialist assessment changes the trajectory.
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Persistent symptoms beyond 2 weeks
Headache, dizziness, brain fog, light or sound sensitivity, imbalance, blurred vision or fatigue that has not settled two weeks after the injury.
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Return-to-sport clearance
Athletes in rugby, football, motorsport, boxing, cycling and equestrian who need a staged, medically supervised return.
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Vestibular subtype
Room-spinning dizziness, motion sensitivity, imbalance in busy visual environments.
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Ocular subtype
Trouble focusing, blurred near vision, eye strain when reading or looking at screens.
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Cervical subtype
Neck pain and cervicogenic headache from the same impact that caused the concussion.
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Autonomic and exertion intolerance
Symptoms flare with heart rate rise, exercise or heat, characteristic of dysautonomia after concussion.
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Migraine subtype
Post-traumatic headache with migraine features, photophobia and nausea.
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Mood and cognitive subtype
Low mood, anxiety, poor sleep and slowed thinking that outlast the physical symptoms.
Assessment
The first 75 to 90 minutes.
The initial assessment covers the SCAT-6 symptom inventory and cognitive screen, the 5-domain VOMS screen, a cervical spine examination, the Buffalo Concussion Treadmill Test to establish your exercise tolerance threshold, the King-Devick rapid number-naming test, and a short sleep and mood screen.
You leave with a written report identifying the driving subtype, a heart rate ceiling for daily sub-symptom aerobic exercise, and a targeted rehabilitation plan for the next 6 to 12 weeks. Sessions run weekly, typically 45 to 60 minutes, with structured home exercises between visits.
Targeted interventions
One therapy per subtype, in parallel where needed.
Most people have more than one subtype driving symptoms. Rehabilitation runs the relevant tracks in parallel.
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Vestibular rehabilitation
Cawthorne-Cooksey exercises, gaze stabilisation and habituation drills for the vestibular subtype and motion sensitivity.
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Oculomotor and vision therapy
Sanet vision therapy, saccade and vergence work, or referral to a behavioural optometrist for the ocular subtype.
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Cervical spine therapy
Manual therapy, deep neck flexor retraining and proprioceptive work for cervicogenic headache and neck-driven dizziness.
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Buffalo sub-symptom threshold aerobic
Treadmill or bike exercise held just below the heart rate that provokes symptoms, progressed weekly. First-line for autonomic subtype.
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Migraine trigger management
Sleep, hydration, caffeine, screen and dietary triggers, plus early access to acute and preventive medication where indicated.
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Cognitive behavioural therapy
Short CBT programme for the mood and sleep dimensions, delivered alongside physical rehabilitation.
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Graded return-to-sport pathway
The 6-stage consensus pathway, with a symptom check between stages and medical clearance before contact training.
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Return-to-learn and work planning
Staged reintroduction of screens, study and workload, coordinated with school, university or employer.
Where in London
A small panel of London concussion specialists.
Named clinicians at the concussion services we recommend most often.
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Complete Concussions London
Dedicated concussion clinic delivering VOMS, Buffalo protocol and return-to-sport pathways for athletes and civilians.
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Fortius Clinic Concussion Programme
Sports medicine-led programme with imaging, neurology and rehabilitation under one roof.
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HCA The Wellington Neurorehabilitation Unit
Consultant-led neurorehabilitation, including complex and prolonged post-concussion presentations.
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London Sports Injury Clinic
Musculoskeletal and concussion physiotherapy with cervical spine and vestibular expertise.
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Chelsea and Westminster Sports Medicine Private
Sports and exercise medicine consultants delivering assessment and return-to-play clearance.
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Private neurologists via NHIS
Rapid access to consultant neurology when red flags, atypical features or complex migraine emerge.
What to expect
Recovery, honestly.
A short, honest summary of what post-concussion rehabilitation involves and where the boundaries sit.
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Persistent post-concussion is treatable
Around 15 to 20 percent of concussions have symptoms beyond 4 weeks. Targeted, subtype-led rehabilitation shortens recovery in most cases.
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Rest was the old advice
Prolonged rest beyond 48 hours is no longer recommended. Early, symptom-limited activity and sub-threshold aerobic work speed recovery.
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Red flags need urgent review
Worsening headache, repeated vomiting, weakness, seizures, slurred speech, or a change in consciousness needs A&E, not a rehab session.
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Athletes need medical clearance
Contact-sport athletes should not return to play without a documented clearance from a clinician trained in the Berlin/Amsterdam pathway.
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Second impact syndrome
A second concussion before the first has fully resolved carries a small but serious risk. The graded pathway is not optional.
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Mood, sleep and cognition matter
These often drive persistent symptoms as much as the physical injury and are treated in parallel, not afterwards.
Recognised by major UK insurers
Cover for concussion assessment and rehabilitation varies by insurer. We confirm cover in writing before booking.
Frequently asked
Everything we get asked about concussion rehab.
Quick answers on timelines, VOMS, Buffalo protocol, return to sport, insurance and referral.
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How long does post-concussion rehab take?
Most people with persistent symptoms improve meaningfully within 6 to 12 weeks of subtype-led rehabilitation. Complex or multi-subtype presentations can take longer. We review formally after 4 weeks and again at 12 weeks.
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What is the VOMS screen?
The Vestibular/Ocular Motor Screen is a 5-domain bedside test covering smooth pursuits, saccades, near-point convergence, vestibulo-ocular reflex and visual motion sensitivity. It takes about 5 minutes, and it is the single most useful tool for identifying which subtype is driving persistent symptoms.
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What is the Buffalo Concussion Treadmill Test?
A graded treadmill test that finds the heart rate at which your symptoms are provoked. That threshold sets the intensity of your daily sub-symptom aerobic exercise, which is now first-line therapy for exercise intolerance and the autonomic subtype.
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Can I return to rugby, football or motorsport?
Yes, once you have completed a 6-stage graded return-to-sport pathway without symptom recurrence and have medical clearance from a clinician trained in the consensus framework. We work with sports medicine physicians who provide this documentation for clubs and governing bodies.
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Will insurance cover this?
Most major UK insurers cover concussion assessment and rehabilitation when medically indicated and referred by a GP, consultant or A&E clinician. We confirm cover in writing before booking and offer self-pay for those without.
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Do I need to see a neurologist first?
Not always. A specialist concussion clinician can assess, screen and start rehab. If red flags or atypical features appear, they refer to a neurologist quickly, often through Nuffield Health Imaging Services partners or private neurology at HCA and The London Clinic.
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Start when you are ready
Let us match you to the right concussion specialist in London.
Send us your story. We come back within one working day with two or three thoughtful options and honest cost.