September 29, 2022
Larainna Williams, SPT
Do you find yourself getting dizzy by watching the cars go by at a red light? Or by walking through a busy grocery store? If you experience dizziness from being in a busy environment where the things around you are moving, then your dizziness could be coming from a dysfunction in your inner ear. There is a reflex called the Vestibulo-Ocular Reflex (VOR) that occurs with proper communication between your eyes and ears to create a stable gaze during head movements. When there is poor communication between your eyes and inner ear, this causes dizziness with head movements or a busy environment and the feeling of unsteadiness.
What will you do in physical therapy?
We will start with an initial exam with some tests that will help us rule in or rule out where the source of your dizziness is coming from. Some common sources dizziness include neck range of motion, tight muscles around your neck, displaced crystals in your ear, and balance. We can conduct special tests to determine if your dizziness is coming from the poor communication between your eyes and ears or if it is from another source. Good news it, if we can make you dizzy in the clinic, we can treat your dizziness. Depending on what causes your dizziness and what your impairments are, we will create a custom treatment plan that best suites you2.
What does treatment look like?
We will do activities that retrain your VOR and enhance communication between your eyes and ears. These activities include head motions while fixing your eyes on a stationary object3,4 (pictured above). We will also do eye tracking which involves following a moving object with your eyes while keeping your head still4. These activities will be performed slowly at first because we want to find the speed at which your dizziness comes on and decrease it slightly so that you don’t get dizzy. Other treatment options include walking with vertical and/or horizontal head movements, walking and turning around quickly, and balance 4.
How can you help yourself?
Don’t completely avoid motions or activities that cause dizziness3. Safety is our number one priority, so listen to your body. If you are prone to get very dizzy, sit down or get in a safe environment. Exposing yourself to the stimuli that cause you to be dizzy has shown do decrease dizzy episodes down the road. Increase your physical activity level by taking the stairs instead of the elevator, parking further in the parking lot, and taking your dog for a walk5.
If you find yourself dizzy, give Imagine Physical Therapy a call to schedule an appointment. Get back to a dizzy-free life today.
1. Schubert MC, Tusa RJ, Grine LE, Herdman SJ. Optimizing the sensitivity of the head thrust test for identifying vestibular hypofunction. Phys Ther. 2004;84(2):151-158.
2. Tee LH, Chee NW. Vestibular rehabilitation therapy for the dizzy patient. Ann Acad Med Singap. 2005;34(4):289-294.
3. Clendaniel R. A. (2010). The effects of habituation and gaze stability exercises in the treatment of unilateral vestibular hypofunction: a preliminary results. Journal of neurologic physical therapy : JNPT, 34(2), 111–116. https://doi.org/10.1097/NPT.0b013e3181deca01
4. Hall, C. D., Heusel-Gillig, L., Tusa, R. J., & Herdman, S. J. (2010). Efficacy of gaze stability exercises in older adults with dizziness. Journal of neurologic physical therapy : JNPT, 34(2), 64–69. https://doi.org/10.1097/NPT.0b013e3181dde6d8
5. Shiozaki, T., Ito, T., Wada, Y., Yamanaka, T., & Kitahara, T. (2021). Effects of Vestibular Rehabilitation on Physical Activity and Subjective Dizziness in Patients With Chronic Peripheral Vestibular Disorders: A Six-Month Randomized Trial. Frontiers in neurology, 12, 656157. https://doi.org/10.3389/fneur.2021.656157