Vestibular Physical Therapy

BPPV is a disorder of the inner ear that causes vertigo. Symptoms can be intense and highly distressing but the good news is that it is easily treated for the vast majority of people. BPPV is caused by displaced calcium carbonate crystals in the inner ear.

Treatment involves something called canalith repositioning maneuvers in which the patient’s head is moved into a series of positions. The aim of the maneuver is to return the aforementioned displaced calcium carbonate crystals into the right place. Symptoms are resolved once the crystals are returned to the right place in the inner ear.  

Vestibular migraine refers to a sub type of migraine headache that is associated with dizziness. It is considered a central disorder in that it the dizziness is caused by the brain versus an issue in the ear.

Treatment includes vestibular rehabilitation, addressing of any neck issues, and discussion on appropriate lifestyle modifications. Click here to learn more about how physical therapy can help with migraine

Cervicogenic means originating from the neck. Many people do not realize that neck dysfunction is also one of the leading causes of dizziness. 

There is ample evidence that physical therapy is highly effective for resolving cervicogenic dizziness. 

Treatment will include addressing of musculature imbalances, normalizing of neck motion, manual therapy/massage, and other modalities. 

Click here to learn more about how physical therapy helps with neck pain. 

Concussion is a mild traumatic brain injury that results from an impact injury to the head. The field of concussion rehabilitation is rapidly developing and it is well accepted that physical therapy is the gold standard intervention.

Concussion can also often be accompanied by something called labyrinthian concussion, in which damage is done to the soft tissue of the inner ear.

Treatment includes neck exercises, vestibular rehabilitation, and vision therapy. Click here to learn more about how physical therapy can help with concussion.  

Meniere’s disease is a disorder in which symptoms are caused by abnormal fluid pressure in the inner ear. It is a chronic condition that causes episodes of vertigo, ear ringing, and hearing loss. It is difficult to diagnose and can often be mistaken for BPPV.

Treatment includes vestibular rehabilitation to reduce symptoms between attacks and dietary/lifestyle changes. 

Vestibular neuritis refers to sudden inflammation of the nerves in the inner ear, thereby causing symptoms of dizziness and imbalance. It presents with a wide range of severity with some experiencing only mild symptoms and others more extreme. 

Vestibular rehabilitation is widely considered the standard for treating vestibular neuritis. Exercises involve challenging balance, eye movements, and more. 

PPPD is a chronic condition characterized by a persistent sense of dizziness or unsteadiness that doesn’t go away, even when the person is still. It’s often described as feeling like the world is moving or spinning, even when it’s not. This condition can be particularly challenging to diagnose as it doesn’t always have a clear underlying cause. It is believed to be related to changes in the brain’s processing of sensory information, specifically how the brain interprets signals from the eyes, ears, and other senses.

MdDs is a condition that causes a persistent sense of rocking or swaying. It typically starts after a prolonged period of passive motion such as being on a boat or a plane. The aforementioned rocking sensation persists long after the actual motion has stopped in MdDs. MdDs is thought to be related to an imbalance in the vestibular system, which is responsible for balance and spatial orientation. It’s as if the brain continues to perceive motion even when the body is stationary.

Preemptive vestibular therapy can help people heal faster from injuries such as concussion and is highly relevant to contact sports like football and combat sports. Moreover, since the vestibular system has a large influence on things like reaction time, balance, and hand-eye coordination, vestibular training proves to be a novel way to maximize performance for virtually every sport.

By working with a vestibular therapy specialist, you can ensure your body is ready for high-stakes activities, reducing the risk of injury and improving overall coordination.

Ehlers-Danlos Syndrome (EDS) and Postural Orthostatic Tachycardia Syndrome (POTS) are conditions that can contribute to dizziness, headaches, fatigue, and chronic pain. Because they affect the body’s connective tissue and autonomic regulation, symptoms often overlap with migraine and vestibular disorders. Our physical therapy approach can be tailored to address these underlying factors through gentle movement retraining, pacing, and autonomic conditioning.