Specialized therapy for dizziness, vertigo, balance problems, and visual-vestibular dysfunction. Evidence-based functional neurology approach to restore vestibular function.
Proven effective for BPPV, vestibular neuritis, post-concussion dizziness, and chronic imbalance
Quantifiable balance testing and vestibular function assessment at every visit
Customized exercises based on your specific vestibular deficits, not generic protocols
Your vestibular system is a complex network of structures in your inner ear and brain that controls balance, spatial orientation, and coordination between head and eye movements. When functioning properly, you don't notice it—you can walk, turn your head, and move through space without thinking about balance or experiencing dizziness.
When the vestibular system becomes dysfunctional, you experience symptoms like dizziness, vertigo, imbalance, motion sensitivity, and difficulty in busy visual environments. These symptoms can result from various conditions:
Crystals in the inner ear become displaced, causing brief episodes of vertigo with head position changes. Highly treatable with canalith repositioning maneuvers.
Inflammation of the vestibular nerve or inner ear structures, often following viral illness. Causes severe vertigo initially, then persistent imbalance and dizziness.
Concussion can damage vestibular pathways, creating persistent dizziness, imbalance, and motion sensitivity. Most common cause of chronic post-concussion symptoms.
Conflict between visual and vestibular information causes dizziness in busy environments, with scrolling screens, or during car rides. Common after concussion.
Persistent vestibular symptoms without clear cause, often resulting from incomplete recovery from previous vestibular injury or age-related decline.
Migraine variant causing episodic vertigo and dizziness. Vestibular rehabilitation helps reduce frequency and severity of episodes between acute attacks.
The vestibular system has remarkable capacity for adaptation and compensation—but it needs the right stimulus. Vestibular rehabilitation provides targeted exercises that retrain your nervous system to process vestibular information correctly, reduce symptoms, and restore normal function.
Evidence-based exercises targeting specific vestibular deficits
Exercises that train your eyes to stay focused on a target while your head moves. This improves the vestibulo-ocular reflex (VOR), which is critical for maintaining clear vision during head movement.
Example: Keeping your eyes focused on a letter while turning your head side to side. Sounds simple, but when the VOR is impaired, this becomes difficult and causes symptoms.
Progressive balance exercises that challenge your vestibular system in controlled ways. As your nervous system adapts, we increase difficulty by reducing visual input, changing surface stability, or adding head movements.
Example: Standing on foam with eyes closed while turning your head. This forces your vestibular system to work without relying on vision or stable surface feedback.
Repeated exposure to movements or visual stimuli that provoke your symptoms. This desensitizes your nervous system and reduces symptom severity over time. Particularly effective for motion sensitivity and visual-vestibular mismatch.
Example: Gradually increasing exposure to busy visual environments or scrolling screens. Your nervous system learns to tolerate these stimuli without triggering dizziness.
Exercises that train your brain to properly integrate visual and vestibular information. When these systems conflict, you experience dizziness. Integration exercises resolve this mismatch.
Example: Walking while tracking a moving target or navigating through visually complex environments. This forces your brain to reconcile visual and vestibular inputs.
Your first visit (60-90 minutes) includes comprehensive vestibular assessment: gaze stabilization testing, balance evaluation (static and dynamic), positional testing for BPPV, visual-vestibular integration assessment, and validated outcome questionnaires. We identify which specific vestibular deficits are causing your symptoms.
Most patients attend 1-2 visits per week. Each session includes guided exercises targeting your specific deficits, progression of home exercise program, objective measurement of improvement, and adjustment of treatment based on your response. Sessions typically last 45-60 minutes.
Vestibular rehabilitation requires consistent practice between visits. You'll perform prescribed exercises 2-3 times daily, typically 10-15 minutes per session. These exercises are tailored to your specific deficits and progress as you improve.
BPPV often resolves in 1–3 sessions with canalith repositioning. Post-concussion vestibular dysfunction and chronic vestibular conditions typically require 3–5 visits for single-constraint presentations, with Readiness Gating at each phase. Progress is measured objectively at each visit and the approach is adjusted based on physiologic response.
Some exercises may temporarily increase symptoms—this is expected and indicates the exercises are working. Symptoms during exercise typically decrease within minutes. As your nervous system adapts, exercises that initially provoked symptoms become easier and symptom-free.
Common questions about vestibular rehabilitation
Vestibular rehabilitation therapy (VRT) is a specialized, evidence-based intervention that restores normal vestibular function through targeted exercises for gaze stabilization, balance, and visual-vestibular integration. It is highly effective for treating dizziness, vertigo, and balance disorders caused by vestibular dysfunction. Unlike generic balance therapy, VRT directly targets the neurologic pathways governing spatial orientation and motion processing.
Vestibular rehabilitation effectively treats BPPV (benign paroxysmal positional vertigo), vestibular neuritis and labyrinthitis, post-concussion vestibular dysfunction, visual-vestibular mismatch, chronic dizziness and imbalance, Meniere's disease (between acute episodes), age-related balance decline, and vestibular migraine. It is particularly effective for persistent dizziness that has not resolved on its own, where a specific Primary Constraint in the vestibular system can be identified and targeted.
Duration is determined by restoration of measurable Adaptive Capacity, not a fixed schedule. BPPV may resolve in 1–3 sessions with canalith repositioning. Post-concussion vestibular dysfunction and chronic vestibular conditions typically require 3–5 visits for single-constraint presentations, with Readiness Gating at each phase. Progress is measured objectively at each visit and the Care Track is adjusted based on physiologic response.
Some exercises may temporarily increase symptoms as they challenge the vestibular system to adapt—this is expected and indicates the exercises are targeting the correct Primary Constraint. Exercises are graded to your current Adaptive Capacity and progressed only when Readiness Gating criteria are met. The temporary provocation leads to long-term improvement as your nervous system restores compensation.
Vestibular rehabilitation specifically targets the Primary Constraint in the vestibular system (inner ear and brain pathways controlling balance and spatial orientation), while generic balance therapy focuses on general strengthening and stability. VRT includes gaze stabilization, habituation to motion, and visual-vestibular integration—exercises that directly retrain how your vestibular system processes information. This constraint-based approach is more effective for vestibular-based dizziness than non-specific balance training.
Vestibular dysfunction is treatable. Schedule your comprehensive vestibular evaluation and discover exactly what's causing your dizziness.