Physical Therapy For Vestibular Disorders

As I listen to music, I’m reminded of how wonderful & amazing our sense of hearing is!

Besides helping to protect & preserve us, our ears are part of an incredible sensory nervous communication & reasoning system which sets us apart from the animals.

Inner Balance

A major contributor to providing balance, coordination, and spatial orientation is the vestibular system with sensors in the inner ear.

The inner ear is crucial in helping us to accurately observe our world, effectively coordinate head & eye movements, & maintain balance & focus as we function.

With daily activities our brain needs to put information received into context & make decisions & learning adjustments extremely quickly; it does this based on essential information feedback it receives from sensors throughout our body.

Sensory perception of movement information is constantly being sent from areas including skin, muscles, joints, as well as the eyes, ears, & inner ear regions.

This ongoing complex neurological system processing allows us to stand & walk, also allowing gymnasts to dazzle us with incredible routines involving high level coordination, balance, & grace.

However, sometimes the inner ear doesn’t work correctly causing bogus information to be sent the brain. This creates neurological processing problems & functional turmoil.

Dizziness & Coordination Issues

When one or both of the inner ear receptors are damaged or dysfunctional, we get instability, dizziness & coordination problems.

As a cause example, with too much alcohol in our system, the viscosity of the fluid inside the inner ear semicircular canals (called endolymph) becomes abnormally changed causing it to transfer inaccurate information to the brain; this is why intoxicated people are unstable & uncoordinated.

Similarly, if calcium carbonate crystals start floating around inside these semicircular canal receptors, both dizziness & instability result as the brain is thrown off by faulty information regarding where the body is in space.

Other disorders of the inner ear regions can have similar outcomes, commonly made worse with movements of the head & neck. Outcomes can include instability, vertigo (spinning sensations), problems walking & falling.

Those impacted by vestibular disorders often are reluctant to move due to fear. When moving, they tend to walk robotically with inefficient guarded gait patterns. Often faulty posture, weakness & restrictive tightness can eventually become secondary dysfunctional results of this disorder making daily activities even more difficult.

Effects Medications & Aging

It’s important to consider the impact of medications. The Vestibular Disorders Association reports exposure to some medications can be ototoxic (poisoning to the ear) creating temporary or permanent damage to the vestibular nerve or inner ear hair cells. People should always discuss the risks versus the benefits of medications with a medical physician.

Also, many develop sluggish processing in the central nervous system with aging, as well as neuropathy & blood pressure issues which can also throw off balance.

Instability issues can involve a multitude of contributing factors often including back issues. Vestibular related balance problems can occur with & without dizziness. However, the disease process can often can be cured or controlled with appropriate interventions.

Life is about adapting. Physical therapy offers conservative options for managing vestibular disorders, often helping to reduce or eliminate cycles of restrictive dizziness & instability.


A doctor of physical therapy is highly trained to evaluate & provide treatment including education, therapeutic vestibular & postural adaptive exercises, manual therapy & neurological gait training.

With appropriate care, the nervous system can learn, adapt & function better. Direct access physical therapy can significantly reduce or eliminate the need for expensive diagnostic testing & invasive procedures. Besides improving function, skilled therapy also often reduces or eliminates the need for medication.

Finally, more & more consumers are discovering physical therapy evaluation & treatment in a cash-based clinic setting is a tremendous bargain in health care! While improving quality of life, it can also significantly save both time & money. It pays to shop around for value!


Dr. L. Voigt Smith, PT DPT CredMDT

About Dr. L. Voigt Smith, PT DPT CredMDT

Dr. Smith is a state licensed Doctor of Physical Therapy, owner of the Backsmith Advanced Physical Therapy clinic in Weston, Wisconsin, and inventor of the Backsmith Selective Stabilization Support. Dr. Smith prides himself on advanced and high value physical therapy care. He has been exceptionally effective with many outlier chronic pain patients. Dr. Smith is often able to save patients significant time and money, while restoring mobility and reducing chronic pain. Dr. Smith can be reached at the Backsmith Advanced Physical Therapy Clinic in Weston, WI (by appointment) or at (715) 298-5888.

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