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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.  Vestibular disorders can effect these inner ear structures and how they interact with other sensory processing systems of the body.

What is Balance?

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. 

Sensory Integration

The brain is constantly processing sensory information from the vestibular system, visual system, and musculoskeletal system to determine where the body is in space.  If any of these systems give signals that are inconsistent with the other systems, it can be confusing to the brain leading to a variety of symptoms like dizziness, feeling off-balanced, a sense of lightheadedness, getting "pulled" in a direction, blurry vision, etc..

It is imperative to find what sensory system is the "weak link" and develop a plan to improve its function in order to reduce symptoms and improve function.


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

Yoga Therapy

  • Strength building

  • Balance and proprioception awareness

  • Habituation and movement tolerance

  • Breathing and meditation

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