Your vestibular system is made up of your spinal cord, certain nerves, and your eyes. If something’s off with that system, odds are you feel pretty terrible sometimes.

Dizziness, vertigo, vision disturbances, balance issues—and the resulting headaches and nausea—can make it hard to move, work, drive, and even look at screens without feeling sick.

Thankfully, there’s vestibular rehabilitation: a type of physical therapy that works to correct dysfunction in your vestibular system. So you can stop feeling so “ick” and get back to living life on your terms.

Need a vestibular physio? Let’s get you booked in

If vertigo, dizziness, vision, or balance issues are keeping you from living life the way you want to, we’ve got you. Our knowledgeable physiotherapists are trained in vestibular rehabilitation and know exactly how to help.

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An Intro Into The Vestibular System

Put very simply, your vestibular system is made up of your spinal cord, certain nerves, and your eyes. Among other things, it is responsible for your sense of spatial orientation. That means its job is to help your body make sense of your environment and where you are in relation to the things in your environment. Whenever something is “off” within this system, your brain struggles to know where you are in space. And that struggle is what makes you feel sick.

This isn’t the most technical description of all time, but you could think of it like this: Instead of getting a smooth flow of accurate information, your brain receives data from your sensory system that’s either incorrect, choppy, or incomplete. As a result, your brain can’t “calculate” its position in space properly or efficiently. It has to work twice as hard, and even when it puts in that extra effort, it still may not be successful. This struggle your brain is experiencing—and the extra work it has to put in—is what leads you to feel sick, often triggering dizziness, vertigo, nausea, visual disturbance, or balance issues. (The core symptoms vestibular disorders are known for!)

The Role of the Vestibular System in Balance

You feel “balanced” when your brain can effectively communicate with your sensory system—which is made up of your inner ear, your sense of vision, as well as your skin, muscles, and joints. All of these body parts collect input from the world around you and send it to your brain, which, as we mentioned above, works to understand both the environment you’re in and where you are in relation to the things in your environment. Your central nervous system then takes this information from your brain and uses it to help you balance.

If the connection between your sensory, vestibular, and central nervous systems gets interrupted in any way (or at any point), your body won’t be able to process spatial information properly. When this happens, your body has to compensate, so it begins taking in more or different information from other places. And this compensation is what causes a sense of imbalance.

Thankfully, it is possible to repair the connection between your sensory, vestibular, and central nervous systems—and get your brain to stop compensating so it can return to its normal functioning! And the best way to do this is through vestibular physiotherapy, also known as Vestibular Rehabilitation Therapy or VRT.

How Vestibular Rehabilitation Therapy Works

Vestibular rehabilitation therapy works to restore the connection between your brain and your central nervous system. Its main goals are to help your brain return to its normal state of functioning and reduce vestibular symptoms that can seriously affect your ability to live your life the way you want to.

Vestibular physiotherapy can treat symptoms like:

What Does A Vestibular Physiotherapist Do?

Beyond the standard training required to become a physiotherapist, vestibular therapists have additional training in how to treat vestibular system disorders and symptoms. They’ll assess you, understand your history and symptoms, and then put together a vestibular rehabilitation treatment plan that’s tailored to you.

The goal of vestibular physiotherapy is always to reduce vertigo, dizziness, visual disturbances, nausea, and any imbalance you’re experiencing. To achieve this, vestibular physical therapists employ balance (re)training and other vestibular rehabilitation techniques, like manual head maneuvers (which is a fancy way of saying “head movements”). They also prescribe progressive exercise programs that include key exercises for vestibular rehabilitation as well as balance training exercises.

Conditions Treated with Vestibular Physiotherapy

Vestibular physiotherapy treatments can help to rehabilitate traumatic head injuries, like concussions, that often cause vestibular symptoms. They can also help reduce the vestibular symptoms that stem from vestibular conditions like:

Vertigo
Motion sickness
Motion sensitivity
Tinnitus
Dizziness
Ménière’s disease
Benign paroxysmal positional vertigo (BPPV)
Labyrinthitis
Vestibular neuritis
Migraine headache
Stroke
Post-concussion syndrome

Source: Cleveland Clinic

What To Expect During Vestibular Rehabilitation Physiotherapy

Before Your Vestibular Physiotherapy Assessment

It’s always a good idea to see your doctor when new vestibular symptoms come on. They can help you rule out any other causes for what you’re feeling. Your doctor may recommend you see an audiologist first to have tests done on your hearing and inner ears. Or, they might send you to a neurologist or recommend starting vestibular physiotherapy!

But if you’ve already seen your doctor or don’t want to wait, you may book with a physiotherapist directly. In British Columbia (where Capria Care Collective is located!), a doctor’s referral is not required to book with a vestibular physiotherapist.

During Your Vestibular Physiotherapy Assessment

Your first vestibular physiotherapy appointment will consist of a thorough assessment where your therapist will listen, ask questions, and understand what’s happening in your body and brain.

The assessment isn’t all talking, though! Beyond taking a detailed medical history, your assessment may include:

Gait assessment
Balancing testing
Reflex testing
Visual testing
Certain nerve and brain function tests
Tests that show us how your neck is functioning

Depending on the clinic you visit and the equipment available, your therapist may also perform positional testing (where you’re strapped to a table that gradually moves around in space) or tests that use infrared goggles to track your eye movements.

Then, once your assessment is complete, your physiotherapist will put together a vestibular rehabilitation treatment plan.

During Your Vestibular Physiotherapy Treatments

During your follow-up appointments, you’ll follow a vestibular exercise-based treatment program. Your therapist may also use manual therapy, gaze, and gait-related rehab techniques, or perform manual head maneuvers—if they think you’d benefit from those things.

How Long Does Vestibular Rehabilitation Take?

Vestibular rehabilitation can take anywhere from weeks to months to “complete”. It’s different for everyone! But regardless of your timeline, consistency is key. So even if your at-home and in-session exercises seem simple, you should perform them regularly if you want the best possible vestibular rehabilitation outcomes for yourself. (Which, trust us, you do!)

Exercises and Techniques Used in Vestibular Rehabilitation

Everyone with vestibular conditions experiences their symptoms differently so your vestibular physiotherapist will tailor your treatments to deliver what you need most. However, a typical vestibular rehabilitation program will include prescribed exercises that fall into one of three categories: adaptation, habituation, and substitution. These three types of exercises work together to contribute to you experiencing fewer symptoms over time. (Yay!)

Adaptation Exercises

When you have vestibular dysfunction, your brain is used to receiving incorrect information from your vestibular system. (That’s part of what’s making you feel so bad!) Adaptation-focused exercises gently “force” your brain to do a better job of processing this information. The point of these exercises is that as your brain becomes more efficient at processing this “incorrect” sensory information, you will experience fewer symptoms.

Habituation Exercises

Along with helping your brain better process incorrect information, we also want to help it “get used to” the new types of vestibular input you’re receiving, which is where habituation exercises come in. By providing gentle desensitization to the new types of visual stimuli (and other types of stimuli) your brain is receiving, these exercises will make you feel better gradually.

Substitution Exercises

With a vestibular condition, your body doesn’t have 100% vestibular functionality. (It’s kind of like there are gaps.) Substitution exercises teach your body to get that missing functionality elsewhere—essentially “filling the gaps” by borrowing functionality from other parts of your body. As your body learns to fill these gaps, you can expect to experience fewer and fewer symptoms.

Benefits and Outcomes of Vestibular Physiotherapy

Vestibular problems are serious, but vestibular physiotherapists know how to rehabilitate them. Most people recover completely in time, as long as they consistently follow their therapeutic plans.

How Vestibular Physiotherapy Can Improve Your Quality of Life

With consistent vestibular physiotherapy treatment sessions, you can expect:

Better balance
Less dizziness
Reduced risk of falling
Fewer instances of nausea or vomiting
An improved ability to focus
Better working memory
Improved gaze stability
Fewer visual disturbances
Better concentration
Better neck mobility
Less neck stiffness
Less fatigue

Vestibular Physio: Frequently Asked Questions

I think I have vestibular issues. What do I do?

It’s always a good idea to see your doctor when new vestibular symptoms come on. They can help rule out any other causes for what you’re feeling. But if you’ve already done that, or you just don’t want to wait, you are welcome to book with us directly. No doctor’s referral is required.

I just suffered a concussion. What should I do?

We’d recommend taking it easy for at least the first 2 days after your concussion, then coming to see us after that. Physiotherapists can diagnose concussions, so you don’t need to see your doctor first, but of course, you can if you prefer to. Learn more on our Concussion Physio page!

Do I need a referral to see a vestibular physiotherapist?

Nope! At least, not in British Columbia, where we are. The BC healthcare system doesn’t require that you see your physician before booking a physio appointment so if you’re in pain, just book right in! The only consideration is your insurance provider. Some of them do require a doctor’s referral. So if you plan on billing insurance for your treatments, just double-check your plan first!

Finding the Right Vestibular Physiotherapist

If you’re considering seeing a vestibular physiotherapist, look for someone who has specific and additional training in treating vestibular issues. (Not all physios seek out this education!) At Capria, our physiotherapists have this training and would be happy to help you!

We also recommend someone holding out until you find a safe clinic space and a therapist who understands your lived experiences (or, at the very least, respects and honours them). At Capria, we pride ourselves on providing safe and effective physiotherapy for everybody, including athletes, seniors, the LGBTQIA+ community, and folks who are pregnant, postpartum, or trying to conceive. If you haven’t found your safe and happy place yet, we invite you to reach out to us or book an appointment online.

Vestibular Physiotherapy Recap

To sum all this up, vestibular rehabilitation is a specialized form of physiotherapy, led by vestibular physiotherapists. It works by repairing the connections between your vestibular, sensory, and central nervous systems—connections that, when broken, lead to vestibular dysfunction (and those nasty vestibular symptoms that are giving you the “ick.”)

If you have a vestibular condition, or you’re suffering from vestibular symptoms like dizziness, vertigo, nausea, and imbalance, vestibular physiotherapy is a great idea for you!

Vestibular rehabilitation programs take time to work (anywhere from a few weeks to a few months is common!), but you’ll feel gradually better along the way. And if you’re consistently following the treatment plan your vestibular physiotherapist has laid out for you, chances of a full recovery are high.

Book Your Vestibular Physiotherapy Assessment

If vertigo, dizziness, vision, and balance issues are keeping you from living life the way you want to, we’ve got you. We have appointments available every week, and we’d love to have you in.

Complete the form below to book your first or next vestibular treatment:

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