Dizzy Balance

Physical Therapy for Dizziness and Vertigo

physical therapist assisting with balancing exercise

Saunders physical therapists perform a detailed evaluation that can help distinguish between the many potential causes of dizziness (vertigo), balance problems, and related symptoms like nausea and light-headedness. At its best, vertigo is extremely annoying. At its worst, it can lead to a serious fall.

Physical therapy can be an effective treatment for vertigo, especially when the condition is caused by certain types of vestibular disorders. Vestibular disorders affect the inner ear, which is responsible for balance and spatial orientation. Physical therapy aims to help patients improve balance, reduce dizziness, and manage vertigo symptoms. The type of physical therapy used for vertigo is called vestibular rehabilitation therapy (VRT). VRT involves specific exercises and techniques to promote adaptation and compensation for the dysfunction in the vestibular system. Here are some common components of VRT:

VRT Physical Therapy For Dizziness and Vertigo

Gaze stabilization exercises: These exercises involve focusing on a fixed object while moving the head. This helps train the brain to stabilize vision during head movements, reducing dizziness.

Balance exercises: Patients may practice standing on different surfaces or perform specific movements to improve their balance and reduce the risk of falls.

Habituation exercises: These exercises involve repeated movements that provoke dizziness to help the brain adapt and become less sensitive to the triggering movements over time.

Brandt-Daroff exercises: These are a set of exercises used to treat benign paroxysmal positional vertigo (BPPV), a common type of vertigo caused by loose calcium crystals in the inner ear.

Canalith repositioning maneuvers: These maneuvers are used specifically for BPPV and involve guiding the loose calcium crystals out of the affected inner ear canal.

Vestibular ocular reflex (VOR) exercises: These exercises focus on improving the coordination between eye movements and head movements to enhance gaze stability during motion.

Falls Prevention

It’s important to remember that physical therapy for vertigo should be performed under the guidance of a trained physical therapist. The specific exercises and techniques used by your Saunders physical therapist will depend on the underlying cause of the vertigo and your unique condition. Additionally, not all cases of vertigo can be treated with physical therapy. Some cases may require medical intervention or other forms of treatment, but Saunders Therapy Centers is a great place to start in your journey toward an accurate diagnosis and appropriate treatment plan.

Dizziness Caused by Migraine or Neck Pain

Migraine Causing Dizziness

There are many different causes of dizziness including conditions of the inner ear, medication side effects, changes in blood pressure, or prolonged bed rest. Did you know that migraine headaches and painful neck conditions can also cause dizziness?

When migraine is accompanied by vertigo, neck pain may also be present. The neck symptoms can vary, but often include:

  • Reduced range of motion
  • Pain on one side of the neck, radiating to the temple, forehead, or eye
  • Pain on one side of your cheek or face
  • Pain at one or both sides of the base of your skull
  • Sometimes, pain can radiate to one shoulder

Treating the neck symptoms often relieves the dizziness and lessens the severity of migraine symptoms. Saunders Therapy Centers’ physical therapists are experts at evaluating and treating musculoskeletal conditions of the neck, and can assess whether your dizziness is originating from migraine or neck symptoms.

Migraine Causing Dizziness

What Does A Physical Therapist Do for Dizziness Related to Migraine or Neck Pain?

Vertigo disorders are multi-factorial in nature and require a thorough exam to identify contributing factors. Our approach:

  • Musculoskeletal Evaluation: Your evaluation will include an assessment of your posture, muscle flexibility, muscle strength and gait analysis.
  • Dizziness/Balance Evaluation: Your evaluation will also include balance testing, as well as positional testing designed to establish the source(s) of dizziness. Sometimes, we may do simple tests to check your eye movements as they related to your symptoms.
  • Education: We spend time discussing your diagnosis and encourage self-management strategies as part of our comprehensive treatment approach.
  • Treatment: Our aim is to get you feeling better from the first visit. Depending on the results from your exam, you may respond well to manual therapy, or hands-on techniques designed to improve the symmetry and tone in the muscles of the head and neck. Simple home exercises are often an important part of your treatment plan.


Falls Prevention and Balance Training

Helping an older person walk

Dizziness, unsteadiness, and feeling a loss of balance is very unpleasant and frustrating. Individuals over the age of 65 are statistically at much higher risk of falls. Each year, millions of older people—those 65 and older—fall. In fact, more than one out of four older people falls each year. Falling once doubles your chances of falling again, and 1 out of 5 falls in the elderly cause a fracture or head injury. (Statistics from the CDC’s Facts About Falling)

Saunders physical therapists play a crucial role in fall prevention for their patients. Falls can lead to significant injuries and reduced quality of life, especially for older adults or individuals with certain medical conditions. Here are some strategies that our physical therapists can employ to prevent falls:

We Love to Help Prevent Falls!

Assessment and Screening: We will perform a detailed evaluation to objectively assess your fall risk

Individualized Exercise Programs: We will design specific exercises to strengthen your legs and the muscles that support balance. This personalized exercise program will focus on improving strength, balance, flexibility, and coordination.

Fall Risk Education: We will teach you about fall risk factors and how to recognize environmental hazards and navigate safely in your surroundings. We will problem-solve situations in your home to decrease your risk of falls

Gait Training: We will work on improving walking patterns and gait mechanics to enhance stability and reduce the risk of stumbling or tripping.

Use of Assistive Devices: If necessary, our physical therapists can recommend and train you on the use of assistive devices, such as canes or walkers, to provide additional support during mobility.

Balance Training: We can teach specific exercises that challenge balance and proprioception, helping you improve your stability and ability to recover from unexpected balance disturbances.

Vision Assessment: We definitely encourage our patients to have their vision checked regularly and ensure they you wear appropriate eye wear when necessary.

Medication Review: We remind you to consult with your healthcare providers about potential side effects of medications that may affect balance or increase fall risk.

Monitoring and Progression: We will regularly monitor your progress and adjust your treatment plan as needed to continue challenging appropriately.

Fall Recovery Techniques: Our experts can teach you techniques for safe falling and how to recover from a fall to minimize injury.

Community and Home-Based Programs: We encourage our patients to participate in community-based exercise programs or group classes specifically aimed at fall prevention.

Multidisciplinary Approach: Collaborate with other healthcare professionals, such as occupational therapists, physicians, and nurses, to create a comprehensive fall prevention plan for each patient.

Fall Follow-Up: After successful fall prevention training, we can continue monitoring as necessary to ensure you maintain your functional gains and do not develop new risk factors.

Home Safety Tips

At Saunders, we realize that fall prevention requires a multi-faceted approach, and physical therapists play a significant role in reducing fall risk and improving the overall safety and well-being of their patients.

BPPV – Benign Paroxysmal Positional Vertigo

BPPV dizziness

BPPV, or Benign Paroxysmal Positional Vertigo, is the most common source of vertigo. Vertigo is the false sensation that you are falling, or the room is spinning. The main symptom of BPPV is that your vertigo is triggered by head movements (suddenly looking up, down, or to the right or left.) Rarely serious, it is significantly disabling and can cause a risk of falling. Fortunately, it can be helped by physical therapy.

Tiny organs and fluid in your inner ear are responsible for balance. BPPV occurs when tiny calcium crystals called otoconia or “canaliths” come loose from their normal location in the inner ear.  When the ear crystals become detached, they can flow freely in the fluid-filled spaces of the inner ear, including the semi-circular canal – the organ that senses rotation of the head. These floating crystals create havoc, by falsely telling your inner ear that your position in space is changing. This is what causes the spinning sensation with head movement that people with BPPV describe.
Your physical therapist will perform a thorough evaluation to determine whether your vertigo/dizziness is likely caused by BPPV. If so, positional techniques called “Canalith Repositioning” can be very effective in resolving the symptoms.


What Does A Physical Therapist Do for BPPV?

Saunders Therapy Centers physical therapists are all skilled at performing Canalith Repositioning techniques.

The canalith repositioning procedure consists of several simple maneuvers for positioning your head. Guided by your therapist, the head movements attempt to move the loose particles from the fluid-filled semicircular canals of your inner ear into a location where they don’t cause trouble and are more easily resorbed.

This procedure often works immediately, and usually works after one or two treatments. Since BPPV can recur, you will be taught how to perform the procedure on yourself so that you can do it at home if needed.


BPPV dizziness


Vestibular Rehabilitation Therapy (VRT) for Vestibular Disorders

Dizzy woman overwhelmed

VRT and Physical Therapy For Dizzy and Balance Problems

VRT is designed to help patients compensate for, adapt to, and reduce the symptoms of vestibular dysfunction. It involves a series of exercises and activities that target the vestibular system and its connections with other sensory systems, such as vision and proprioception (sensations from muscles and joints).

The goals of VRT include:

  1. Decreasing dizziness and vertigo symptoms.
  2. Improving balance and stability.
  3. Enhancing gaze stability and reducing eye movement abnormalities (nystagmus).
  4. Increasing confidence and reducing fear of falling.
  5. Improving overall functional activities.

VRT is typically prescribed and supervised by a physical therapist who has experience in vestibular rehabilitation. The therapy is tailored to the specific needs of each patient based on their condition and symptoms. The exercises may include various head movements, eye exercises, balance exercises, and habituation exercises.

Saunders Therapy Centers physical therapists are skilled at many VRT techniques and can help by performing many techniques and exercises or referring you to a specialist as necessary.

Dizzy woman overwhelmed