Frequently Asked Questions

Vestibular Physiotherapy, also referred to as Vestibular Rehabilitation Therapy or VRT – is a specialized form of therapy intended to alleviate a variety of symptoms caused by vestibular disorders and dysfunction. Vestibular therapy is an evidence based approach designed to reduce vertigo and dizziness, reduce gaze instability, and/or reduce imbalance and fall risk as well as address any secondary impairments as a result of the vestibular disorder.

Unfortunately with most vestibular disorders, the deficit in the vestibular system is permanent. However, through vestibular rehab we can aim to decrease symptoms and improve function through neuro synaptic compensation and adaptation. Luckily the brain is very plastic, which means it has the ability to learn and use our other senses (vision and somatosensory – body sense) to compensate for the defective vestibular system. This compensation can occur naturally with time, however research has shown that vestibular rehab is very effective in assisting with recovery. It’s important to know that our brain is most plastic and best at learning these compensatory mechanisms early on after injury/illness. So it’s best to contact your vestibular physiotherapist sooner rather than later to maximize your recovery and return to daily activities as soon as possible.

Your vestibular system is a sensory system that is responsible for providing your brain with information about motion, head position, and spatial orientation. Your vestibular system plays a key role in helping you to keep your balance, as well as stabilizing your eyes, head and body during movement.

The vestibular system includes the parts of the inner ear and brain that process sensory information involved with controlling balance and eye movements. If disease or injury damages these processing areas, vestibular disorders can result. Vestibular disorders can also result from, or be worsened by, genetic or environmental conditions, or can occur for unknown reasons.

First and foremost vertigo is a symptom, not a diagnosis. Vertigo is the incorrect perception that you or the room around you is spinning or moving. People are often diagnosed with vertigo when health care providers don’t know what else to say, this is why finding a specialist is so important.

Vertigo is a symptom of vestibular dysfunction (as well as other conditions). If you have vertigo, you know it, what a vestibular physiotherapist can help with is figuring out WHY you have vertigo! The journey to a diagnosis can be a challenging one, but I am here to help and support you along the way.

Also still referred to as a mild Traumatic Brain Injury (mTBI), a concussion is the result of direct trauma to the head OR rapid acceleration-deceleration of the head without contact (ex. whiplash injuries).

Trauma to the brain can result in abnormal vestibular system functioning and cause the brain to receive inaccurate signals regarding the position and movement of the head in space. When vestibular information becomes unreliable, the brain has to rely on visual input and joint sensors (proprioception) to feel the body in space. If the brain is unable to effectively compensate, this results in dizziness and a sense of instability

It’s important to note that you do NOT need to hit your head, or lose consciousness to experience a concussion. Additionally, while you should rest for 24-48 hours, after that active rehab is best. I promise it’s not too early to reach out!

Anyone who is experiencing any form of dizziness for any reason!

Dizziness is a symptom that often times people are told they just have to live with. VRT is here to change that. Even if the cause of your dizziness is chronic and cannot be resolved (ex Meniere’s Disease), VRT can improve your symptom tolerance and make your day to day life better!

With that said, VRT is symptom provoking and frankly exhausting. People who benefit most are those who are ready to put in the work, and are able to tolerate mild-moderate increases in symptoms.

If you are in a constant flare ups where your symptoms are severe all day every day, it may not be the right time for active VRT. It may however be helpful to work together on nervous system soothing and symptom management. So please still feel free to book a discovery call or send me an email.

We'll start by getting a detailed history from you of what you have been experiencing, for how long, and if you've ever dealt with this in the past. A lot of what you have to tell me will cue me to look for certain diagnoses, so never think something is silly, tell me everything!

Based on what you tell me, that will guide the rest of the appointment. We may look at a combination of any of the following things: neck mobility/strength, neck proprioception, oculomotor function (the way your eyes move, rather than visual clarity), general balance and proprioception, assess for BPPV if indicated.

I also have access to VOG Assessment at Foundation. The clinic has a pair of infrared video goggles that allow us to assess with video, the movement of both your eyes during tracking activities without the effects of room light. Think virtual reality goggles, but no cool video game!

A lot of the time this first appointment can be quite triggering since we are sorting through so much to find the cause of your symptoms. I try to end the session with some manual therapy to settle things back down before sending you off again. Remember you're in charge, we can skip or leave any assessments for another day if you are not feeling up for it.

I wish I had a clear cut answer for this, but unfortunately it depends. It depends how long you have dealt with symptoms, how severe those symptoms are, and so much more.

Typically we start to see benefits of VRT after about 3-4 weeks of consistency, so it is important to know that this is not a quick fix, you have to be in the right headspace for this type of therapy for sure.

That said I will always give you my best estimate at prognosis as far as how long I think you'll need to come in. As things change throughout treatment I will always update you as well.

A common vestibular disorder that causes sudden, short term (up to 1 minute) vertigo (the sensation that you, or the room are moving), triggered by head position changes or rolling in bed.

BPPV occurs as the result of displaced crystals (otoconia) within the inner ear. Causes can include a head injury, a cold or virus, or unfortunately the cause is most commonly unknown. BPPV can be very scary, but luckily it is easily treated!

It’s important to note that there are maneuvers other than Epley’s for treating BPPV. We select the appropriate maneuver based on where the displaced crystals are located. So if you have tried Epley’s after watching a YouTube video and don’t feel better yet, you might need a different maneuver.

Vestibular disorders resulting from an infection that inflames the inner ear or the vestibulo-cochlear nerve. Neuritis results in dizziness but does not affect hearing, where as labyrinthitis results in both dizziness and hearing changes.  

Approximately 40% of individuals with migraine have an accompanying vestibular syndrome causing imbalance and/or dizziness.  A large portion of individuals with migraine actually have no head pain and instead their predominant symptom is vertigo. VM requires a multidisciplinary approach including a combination of medical management and comprehensive testing as well as active rehab. 

Simply put - dizziness related to the function of your neck. CD can exist in isolation, but it often occurs after another acute vertigo episode. For example if you had BPPV, the crystals may have cleared and you feel 90% better, but can’t quite get to 100%. When we feel dizzy for a period of time, or natural instinct is to hold our head still to avoid feeling dizzy. Over time this can lead to tight and stiff structures in our neck, as well as impaired strength and proprioception. All in all leading to our brain having a hard time distinguishing where our head is in space in relation to our body and therefore ongoing dizziness.