Your vestibular system helps you balance and stay upright while standing and walking. Your vestibular system can get weak like a muscle can get weak (this is called decreased vestibular gain.) This may lead to dizziness, decreased balance/falls and vertigo. VRT is vestibular rehabilitation training.
What’s vertigo? Isn’t that just another word for dizzy?
Vertigo is specifically the feeling of the room spinning or of you spinning. This commonly occurs if you have a crystal out of place in your inner ear, or BPPV
What is BPPV?
Benign Paroxysmal Positional Vertigo (there is a reason we call it BPPV!) is the feeling of the the room spinning that is caused by moving your head. You have crystals in your inner ear that have hairs on them that are activated/ turned on or deactivated / turned off when you turn your head. These crystals send a signal to your brain what position your head is in in space.
In BPPV, one or more of the crystal becomes dislodged from its normal spot in the semicircular canals of your inner ear. This crystal tries to do its job by sending the message where your head is, but the dislodged crystal is sending the wrong signal because it is out of place.
Your brain does not know how to process this and has the response of vertigo.
How do I treat it?
Fortunately, most BPPV is treatable in just a few PT sessions! There are specific maneuvers that your PT can use to put the crystal or canalith back in place depending on which of the semicircular canals it is in! The most common of these maneuvers is the Epley maneuver, which can be done in the office or at your home. Another term for these maneuvers is canalith repositioning.
What if I am just lightheaded?
Lightheadedness can be caused by several different factors including orthostatic hypotension, changes in blood pressure, not eating enough and more. Your medical doctor and your PT can work together to help you figure out the cause!
The room isn’t spinning, but it feels like I am on a boat….
This is called oscillopsia and is the feeling of your gaze not being able to stabilize. The good news is that Physical Therapy can help with this too! Your PT can teach you specific gaze stabilization exercises to retrain your vestibular system’s connection with your brain!
What is habituation training?
Habituation training is actually exactly what it sounds like! When your dizziness doesn’t improve with canalith repositioning or gaze stabilization, sometimes we just need to retrain the whole system. This means attempts the activities that make you dizzy over and over again (getting your vestibular system used to this “habit.”) The key is finding how to retrain the system without overdoing it. This is where skilled PT assessment and treatment come in. Just like you are training a muscle at the gym, you can overdo a session and be sore for days! It’s the same with your vestibular system, except you may have increased dizziness instead!

Have more questions? Reach out today and schedule a session today! Let’s get you better, together!
dr.cheryl.pt@gmail.com