Vertigo & Vestibular Rehab: When the World Won't Stop Spinning

Your sense of balance depends on three systems working in perfect coordination: your vestibular system (inner ear), your visual system (eyes), and your proprioceptive system (joints and muscles). When the vestibular system is disrupted, the brain receives conflicting signals — and the result is dizziness, vertigo, and a profound sense of unsteadiness.

The most common cause is Benign Paroxysmal Positional Vertigo (BPPV) — tiny calcium crystals in the inner ear that have moved out of position, sending false movement signals to the brain every time you change head position.

The good news: BPPV is highly treatable with specific repositioning maneuvers. Most patients experience dramatic relief within one or two sessions.

• Spinning Vertigo (BPPV): A sudden, intense spinning sensation triggered by rolling over in bed, looking up, or bending forward
• Persistent Dizziness: A constant "foggy" or unsteady feeling that never fully goes away
• Visual Disturbance: Difficulty focusing on moving objects, reading, or navigating busy environments like grocery stores
• Imbalance: Drifting to one side when walking, or fear of falling
• Nausea: Triggered by head movement or visual stimulation

Did your dizziness begin following a head injury or accident? This may indicate a concussion with a vestibular component — see our Concussion Recovery page for more information.

Most dizziness is vestibular in origin and safely treated with physiotherapy. However, seek immediate medical attention if dizziness is accompanied by:

• The 5 D's: Dizziness (constant and severe), Diplopia (double vision), Dysarthria (slurred speech), Dysphagia (difficulty swallowing), Drop Attacks
• Sudden severe headache unlike anything experienced before
• Neurological changes: Numbness, weakness, or difficulty speaking
• Hearing loss that comes on suddenly alongside vertigo

• Vestibular Physiotherapy in Okotoks: Comprehensive assessment to identify which vestibular system is affected and which canal is involved in BPPV — essential for selecting the correct repositioning maneuver.
• Canalith Repositioning (Epley Maneuver): A precise sequence of head movements that guides the displaced crystals back to their correct position in the inner ear. Highly effective — most patients feel significant improvement immediately after treatment.
• Gaze Stabilization Exercises: Retraining the eyes and brain to work together during head movement — essential for patients with persistent dizziness beyond BPPV.
• Cervical Physiotherapy in Okotoks: The upper neck communicates directly with the inner ear. Stiffness or dysfunction in the cervical spine can mimic or worsen vestibular symptoms — we assess and treat both.
• Balance and Gait Retraining: Progressive exercises to rebuild confidence and stability, particularly important for seniors at risk of falls.

• The Relief Position (Seated Stillness): When a vertigo episode strikes, sit down immediately on the nearest surface, fix your gaze on a single stationary point, and breathe slowly. Do not lie down until the spinning reduces — this can worsen BPPV.
• The Mobility Drill (Gaze Stability): Hold a card with a single letter at arm's length. Slowly move your head side-to-side while keeping the letter in sharp focus. Start with 30 seconds and build tolerance gradually.
• The Stability Focus (Tandem Standing): Stand with one foot directly in front of the other (heel-to-toe) near a counter for safety. Hold for 30 seconds with eyes open, then progress to eyes closed as your balance improves.

Please Note: Vestibular rehabilitation must be matched precisely to your specific diagnosis. The wrong exercises for the wrong vestibular condition can make symptoms worse. Your physiotherapist will create a customized vestibular rehabilitation program based on your full assessment findings.