Introducing Vestibular Physical Therapy 

Written by Luke Cancilla, PT, DPT 

What is vestibular therapy? 

Vestibular therapy is specialized physical therapy services that is used to manage a wide range of issues. From balance disorders and vertigo to migraines and head injury, physical therapists recommend vestibular physical therapy as an effective way to improve your overall balance and stability.

This type of physical therapy works to retrain the brain’s connection between the eyes, inner ear, and sensory organs to improve overall functioning. Various exercises are used in order to help strengthen muscles, improve coordination, and reduce dizziness.

How Can Vestibular Physical Therapy Help?

Similar to how we treat clients for a wide variety of pain and dysfunction, we also treat clients for a wide variety of types and sources of dizziness. Many people who benefit from vestibular therapy services often describe their dizziness as “the room spinning around me,” “like I am rocking on a boat,” “I’m uncomfortable walking in the grocery store,” and “like I’m still moving when I stop.” People often experience these symptoms with activities such as laying in bed, rolling over in bed, making quick head movements, and being in busy environments.

If these are similar symptoms that you experience, a vestibular therapy evaluation and treatment could be just what you need! We are also skilled in identifying when other medical providers are indicated for managing your care and providing you resources to meet with the appropriate professionals. 

What Conditions Can Vestibular Physical Therapy Treat?

There are a number of the common conditions that can be treated and managed with vestibular rehabilitation. Some of these conditions include benign paroxysmal positional vertigo (BPPV), persistent postural perceptual dizziness (PPPD), concussion, Meniere’s Disease, and conditions affecting the vestibular nerve. 

BPPV is a condition that causes intermittent vertigo symptoms that is predominantly related to changes in head position. This is caused when otoconia (small calcium carbonate crystals) become loose outside of their normal place within your inner ear and enter one of six fluid filled semicircular canals, causing abnormal stimulus that is interpreted as the room spinning around you. 

PPPD is a complex functional neuro-vestibular disorder characterized by a more chronic persistent dizziness and unsteadiness that is the most common vestibular syndrome seen in vestibular therapy. 

Concussion has received great attention throughout the past decade and our understanding of these brain injuries has greatly improved. Following a concussion, people often experience a variety of differing symptoms which coincide with various clinical profiles. Some of these symptoms often include dizziness, nausea, vertigo, blurred vision, and discomfort in busy environments. 

Meniere’s Disease is a condition that is commonly associated with dizziness along with symptoms of pressure in the ears, tinnitus and hearing loss that is exacerbated in prolonged episodes or attacks. 

Peripheral hypofunction is a category of conditions that affects the vestibular nerve and commonly causes dizziness or imbalance with quick turns or head movements, difficulty with visual fixation, and difficulty in environments with visual motion. 

How Does Treatment Take Place?

In vestibular therapy, we treat every client with matched individualized treatments. Just like we don’t treat someone with ankle pain with the same manual therapy and exercises as someone with neck pain, we don’t treat everyone with dizziness the same way. Just as pain can come from a different source, your dizziness can come from different sources that need to be treated based on that source. 

During your initial evaluation, you would be taken through a series of tests to make an appropriate diagnosis. This diagnosis along with your individual goals would then direct the interventions you would be treated with. 

If you are diagnosed with benign paroxysmal positional vertigo (BPPV), you would be treated with an appropriately matched canalith repositioning maneuver to utilize gravity to put your “crystals” back into place. For patients with a diagnosis related to their vestibular nerve, they would receive a variety of adaptation based exercises to restore normal functioning, similar to strengthening exercises to get your muscles strong again. Patients who are diagnosed with a concussion or other conditioning in which they experience increased dizziness or imbalance in busy environments or with increased motion in the surrounding area would be matched with appropriate graded exposure and habituation exercise to restore their symptomatic threshold and tolerance to these environments. 

Conclusion 

Vestibular therapy services are now an additional way we are here to help you or your loved ones get back to the activities they love the most and living their happiest life. We are now accepting new evaluations for those experiencing vertigo, dizziness, and imbalance so don’t wait to get your plan and solutions! 

if you are feeling dizzy or imbalanced or recovering from a concussion, work with our vestibular experts to get you back to doing the activities you love