Carli working with a patient on visual retraining exercises following a concussion.
As a physical therapist, I’ve had the chance to help a lot of people regain their balance—both literally and figuratively—through vestibular rehabilitation therapy (VRT). If you’ve been dealing with dizziness, vertigo, or balance issues, this might be just what you need. I want to give you a quick overview of what VRT is, who it’s for, and what a treatment plan might look like for a couple of different conditions.
What is Vestibular Rehabilitation THERAPY?
Vestibular physical therapy targets disorders affecting your vestibular system—the complex part of your inner ear that helps sense things like head position, eye movements, and changes in your surroundings.
This system sends critical information to your brain, allowing your body to respond and maintain balance. When the vestibular system is impaired, it can cause symptoms like dizziness, vertigo, imbalance, and sometimes nausea or visual disturbances.
So, how can I help you?
After a thorough evaluation to pinpoint the root cause of your symptoms, we create a personalized treatment plan that may include any combination of the following to relieve your symptoms and address the underlying issue:
manual techniques
specific maneuvers
exercises
The exercises prescribed will depend on your specific condition but typically include head and body movements, balance retraining, and eye movement control. The goal is to help your body adapt to changes in your balance system, allowing you to regain confidence and move through your daily activities with ease.
how to know if Vestibular Rehabilitation Therapy is Right For you?
Below are a few conditions that can benefit from vestibular PT:
Benign Paroxysmal Positional Vertigo (BPPV): A common cause of vertigo, where you experience intense room spinning triggered by specific head movements, often due to displaced crystals in your ear.
Vestibular Neuritis or Labyrinthitis: Inflammation of the inner ear, usually caused by viral infections, leading to prolonged dizziness and imbalance.
Concussion-related Dizziness: Post-concussion syndrome can involve vestibular issues and headaches, making recovery more challenging.
Age-related Balance Issues: As we get older, our balance naturally declines, increasing the risk of falls. Vestibular PT can help prevent injuries by improving balance.
Cervicogenic Dizziness: Dizziness caused by the receptors in the joints of your neck.
If you’ve ever felt like the world is spinning or found yourself off-balance while standing or walking, vestibular therapy could be the solution you’ve been seeking.
Two Examples of Recovery
Crystals in the inner ear canals
BPPV
If someone experiences severe vertigo or a room-spinning sensation when turning their head or rolling over in bed, it’s likely benign paroxysmal positional vertigo (BPPV). During the evaluation, we use positional testing to confirm it—if it’s truly BPPV, the test will briefly trigger the vertigo. From there, we go straight into treatment using a repositioning maneuver, which is essentially a guided series of movements and holds to help "reset" the crystals in your inner ear. This often takes only 1-2 sessions to resolve!
Various types of head trauma
Concussion
If someone has a concussion, we start by addressing any dizziness or headaches with manual therapy and exercises focused on eye movements, head turns, and balance. To safely return to exercise or sport, we may perform a treadmill test, where you walk at increasing inclines while we monitor your heart rate. Once you reach your symptom threshold, we use that heart rate to guide your aerobic activity, gradually increasing intensity until your symptoms subside.
I’ve worked with many patients with these and other vestibular diagnoses. While everyone's experience is unique, this should give you a sense of what vestibular therapy might entail for you or someone you know. As mentioned above, a thorough evaluation is first completed to determine the cause of your dizziness before treatment begins. If you are currently struggling with dizziness, imbalance, or post concussion, schedule an evaluation HERE