Megan Moberg, DPT
However if you’ve ever stumbled dizzily off the Tilt-A-Whirl at the county fair you’ve experienced how vital our sense of equilibrium and balance are to our every move. This sense is mediated by our vestibular system.
The vestibular system consists of sensory organs in the inner ear and position sensors in the neck. Our vestibular system is our balance center that helps us maintain our equilibrium and our body position in space. It also helps keep our gaze focused on what we are looking at even when our bodies and heads are in motion.
When the vestibular system is not functioning properly you may experience dizziness, vertigo, loss of balance, tinnitus (ringing in the ears), or other symptoms. As we get older, problems with the vestibular system become more common. In fact dizziness complaints are a top reason for visits to the doctor for patients over 65 (more info on that here). Vestibular injuries can arise from a concussion, after a cold or flu, with migraines or with no obvious cause.
Did you know that physical therapists are able to treat dizziness and vertigo? Physical therapists can take advanced training to learn treatment techniques to address common causes of vertigo and disequilibrium.
Vestibular rehabilitation is a special program offered at Greenwood Physical Therapy, that is designed to treat and minimize dizziness, motion sensitivity, vertigo, and balance disorders to allow patient to return to a normal life.
At GPT, a physical therapist certified in Vestibular Rehabilitation will perform an evaluation of your vestibular system based on your history and symptoms to assess balance, postural control, tolerance to movement and reflexes. This will allow them to determine your cause of dizziness and develop a treatment plan to address your symptoms and get you feeling better.
There are two common categories of dizziness:
Imagine rolling over in bed one morning, standing up and immediately having intense vertigo that makes it seem as if the room is spinning around you violently. These are common symptoms of the onset of Benign Paroxysmal Positional Vertigo (BPPV). This occurs when crystals in the inner ear become dislodged from the otolith organs and travel into one of the three semicircular canals, causing an immediate sense of vertigo. It can commonly occur after a blow to the head (like a concussion or car accident injury), or after having your head tilted back for a long period of time (sitting in the dentist chair or at the hair salon). However most cases have no known cause. Those who have had a head injury, are over 50 years old or have been inactive for a long time are at greater risk of BPPV.
Physical therapy treatment for BPPV can be extremely effective. The physical therapist can determine where the problematic crystals are located. Next the PT will take you through a series of position changes called canalith-repositioning maneuvers to restore the crystals to their proper resting place. Treatment for BPPV is typically very quick and can often be completed in 1-3 visits.
The second category of dizziness includes anything that may cause the vestibular system to under-perform. This includes vestibular neuritis, peripheral vestibular loss, Meniere’s disease, labyrinthitis, cervicogenic dizziness and migraine related dizziness. In these cases, the physical therapist will craft an individualized exercise program consisting of adaptation, habituation and substitution exercises.
Adaptation exercises work to strengthen the vestibulo-ocular reflex (VOR) and help to jump start the connection between our ears, eyes and brain.
Substitution exercises train the body to use information from vision and other joints in the body to give us information about where our body is in space. We can use these exercises to help train our eyes to focus on a target without losing our balance in the process.
Habituation exercises expose a patient to an aggravating stimulus multiple times to fatigue the vestibular system. This reduces the severity of the vestibular dysfunction as the system gets used to the new stimuli.
Treatment for vestibular hypofunction can take anywhere from a couple of weeks to a few months in some cases. Vestibular rehabilitation can fully eliminate symptoms for some disorders and can help to minimize and manage symptoms for other disorders, allowing the person to live a more normal life.
For more information you can check out these two helpful websites: