What is Vestibular?


The vestibular system is made up of the small sensory organs (semicircular canals, vestibule, otoliths, and bony labyrinth) located in the right and left inner ear.  When movement of the head and neck occurs, the vestibular system detects the linear acceleration and rotation of the movement.  This function plays an important role in keeping us balanced.


The balance system is made up of the complex interactions of the vestibular system, the visual system, the musculoskeletal system (joints & muscles), and the brain to maintain spatial orientation and a sense of balance.  Disruption of the balance system can originate centrally (the brain and spinal cord) or peripherally (inner ears, eyes, and/or neck).  Aging, autoimmune disorders, and allergies can also affect proper functioning of the vestibular system. 


Dysfunction of the vestibular system can make basic tasks difficult or even impossible.  The origin, duration, and quality of symptoms greatly affect treatment plan and prognosis.  Similar to concussion, there is no "one size fits all" treatment plan.  Addressing specific symptoms, triggers, and goals is essential to reduce impairment and improve quality of life. 

Physical Therapy Evaluation

  • Determination of aggravating factors

  • Assessment for BPPV

  • Posture

  • Balance

  • Cranial nerve screen

  • Visual processing

  • Vestibular ocular reflex (VOR)

  • Coordination

  • Strength

  • Gait



Physical Therapy Treatment

  • Canolith repositioning (BPPV)

  • Habituation

  • Adaptation

  • Compensation

  • Yoga

  • Posture

  • Balance

  • Gait retraining

  • Strength training

  • Walking program

  • Nutrition guidance

  • Activity modification

  • Lifestyle changes

  • Sympathetic dampening (to calm the nervous symptom)

  • Coping strategies to help manage secondary symptoms such as anxiety or stress

Health Coaching

  • Activity modification

  • Symptom management strategies

  • Healthy eating and nutrition

  • Exercise progression

  • Caregiver and family education

  • Support and accountability

  • Holistic approach to health and wellness

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