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Vestibular Physical Therapy

  • Writer: Physical Therapy International Service
    Physical Therapy International Service
  • Mar 20
  • 3 min read

Authors: Anna Norton, Ella Bonner, and Livi Kovach



The vestibular system is located in your inner ear and is used for sensory. It is important for the position of your body in space, acceleration, and direction. Overall, it works together to help your body maintain its balance, posture, and eyesight. There are five different organs as part of it and three are for rotational movement with the other two for linear motion. It works by moving when the head moves which allows signals to be sent to the brain. 


In general, vestibular physical therapy is designed to help with issues caused by conditions in the vestibular system. It generally starts with balance tests and how well you can walk. From there, most sessions will work on eye stability which is when you focus on a point while moving your head in different directions. You may also work on your balance in various positions like both feet together, one leg lifted, or one foot in front of the other to name a few. One other thing you may work on is your walking especially when there are obstacles on the ground ensuring you are able to maintain balance and focus when moving. Overall, vestibular physical therapy is designed to decrease dizziness, help increase balance, and eye stabilization caused from various conditions.


One issue that can persist are vestibular migraines which are a type of migraine that mainly affect balance and the vestibular system. People with vestibular migraines often experience dizziness, vertigo, nausea, and sensitivity to motion. Some people may also have headaches, but not always. Because of these symptoms, everyday activities like walking in crowded areas, driving, or quickly turning the head can be difficult. Physical therapy can help manage these symptoms by working on balance and helping the brain adjust to movements that normally trigger dizziness. Vestibular rehabilitation often includes gaze stabilization exercises, where patients focus on an object while moving their head, as well as balance exercises in different positions. Therapists may also gradually introduce movements that normally cause symptoms so the body can learn to tolerate them better. Over time, these exercises can help reduce dizziness and make daily activities easier.


Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo and is another example of a vestibular condition. It happens when small calcium crystals in the inner ear move out of place and enter one of the semicircular canals. When the head changes position, these crystals shift and send incorrect signals to the brain, which causes the spinning sensation many people feel. Physical therapists can treat BPPV using repositioning maneuvers that help move the crystals back to their correct place in the inner ear. One of the most common treatments is the Epley maneuver. This involved a series of guided head and body movements performed by the therapist. These movements help reposition the crystals so they stop causing dizziness. In many cases, patients feel relief after only one of a few treatments, which makes vestibular physical therapy very effective for this condition.

 

Overall, the vestibular system is extremely important to our daily functions and when issues arise such as BPPV or vestibular migraines, treatment is needed to ensure patients can complete their tasks and live their life with the best quality possible. As physical therapists, we can help with balance and walking practice. Physical therapy can be an effective treatment and is why the specialty is important to focus on! Allowing patients to maintain or rebuild their independence from vestibular conditions is empowering for both the patient and the therapist! 



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