Understanding the Vestibular System: How Physical Therapy Can Help With Dizziness

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Starting a new chapter at React, I’m excited to introduce myself as a physical therapist with a special focus in vestibular rehabilitation. Many people have heard of “vertigo,” but you may not know how the vestibular system works or how physical therapy can play a powerful role in treating dizziness and balance disorders. If you experience room spinning vertigo, unsteadiness during your daily life, blurring of vision, nausea/motion sickness, ear fullness, or headaches with brain fog in various situations you may have a vestibular dysfunction. Common triggers of these symptoms include busy environments such as grocery stores, busy intersections in the city, changing of head positions, dim lit situations, and walking on varying surfaces. 

What is the Vestibular System?

The vestibular system is located in your inner ear and communicates with your brain to help control balance, stability, and eye movements. It’s constantly working in the background of all activities to help keep you steady when you walk, turn your head, check for traffic before crossing the street, or even just get out of bed.

When this system isn’t working properly, the brain receives mixed signals about where your body is in space. This can lead to dizziness, imbalance, blurred vision, or even nausea.

Common Vestibular Conditions

Most people are familiar with vertigo, often caused by a condition called Benign Paroxysmal Positional Vertigo (BPPV). This happens when tiny otoconia crystals in the inner ear canals shift into the wrong place, causing a sudden spinning sensation with head movement.

But vertigo isn’t the only vestibular problem. Other conditions can include:

  • Vestibular Hypofunction: When one or both sides of the vestibular system don’t send clear signals, leading to unsteadiness and difficulty with quick movements. Common with aging or after suffering a concussion.
  • Vestibular Neuritis/Labyrinthitis: inflammation of the inner ear or nerve, which can cause sudden, intense dizziness or imbalance.
  • Meniere’s Disease: abnormal fluid buildup in the inner ear that can cause dizziness, tinnitus (ringing in the ear), and a feeling of fullness in the ear
  • Persistent Postural-Perceptual Dizziness (PPPD): a chronic condition with ongoing dizziness, unsteadiness, or rocking situations that often worsens in busy environments
  • Vestibular Migraines: migraine-related dizziness that can occur with or without a headache present. Triggers often include stress, sleep changes, certain foods, or hormonal shifts. 

These conditions are often very treatable with the right vestibular rehabilitation exercises.

Why the Vestibular System Matters for Athletes

The vestibular system isn’t just about preventing dizziness—it’s a key player in athletic performance. Athletes rely on it to:

  • Quickly scan their environment without losing balance or focus.
  • React to fast changes in play while keeping their eyes and body coordinated.
  • Reduce reliance on somatosensory input (like constant ground contact), which helps improve agility.
  • Lower injury risk by allowing the body to adapt and stabilize more efficiently during sudden movements.

Even when athletes haven’t had a diagnosed concussion or vestibular injury, the vestibular system plays a big role in performance and injury prevention. Functional training that challenges balance, head motion, and visual tracking helps sharpen vestibular input. Better vestibular function means an athlete can scan the environment more efficiently, make fast movements more safely, and reduce risk of orthopedic injuries and even overuse.

How Vestibular Physical Therapy Helps

Vestibular rehabilitation is a specialized form of physical therapy that retrains the brain and body to adapt, recover, and restore balance. Depending on your condition, therapy might include:

  • Canalith repositioning maneuvers (for BPPV) to put displaced crystals back where they belong.
  • Gaze stabilization exercises to reduce dizziness and improve visual clarity.
  • Balance and walking training to restore confidence and independence.
  • Decrease reliance on visual or touch input to maintain balance
  • Agility and movement drills for athletes to sharpen reaction time and injury prevention.

Why Get Evaluated?

If you’re experiencing dizziness, imbalance, or vertigo, you don’t have to live with it. A vestibular PT evaluation can determine what’s happening and create a personalized plan to help you stay safe, independent, and able to enjoy your daily life—whether that means walking around the block without fear of falling or returning to the field with more agility and control.