Physiotherapy for Vertigo & Dizziness

Miriam McLean and Peter Hartley are our vestibular rehabilitation physiotherapists. They treat vertigo and dizziness with a comprehensive assessment focused on determining the specific causes of your symptoms. If you live in London Ontario and are looking for assessment and treatment of vestibular conditions, contact Physiohaus Health and Wellness.

What is Vestibular Rehabilitation?

Vestibular Rehabilitation Therapy treats the symptoms that patients may have with vertigo and dizziness. Treatment may simply involve specific positioning maneuvers to position crystals in the inner ear or you may require a series of exercises such as habituation, gaze stabilization, or balance training. The end goal of vestibular rehabilitation is to help speed up the body's compensation process that takes place once the vestibular system has changed.

What kind of vestibular symptoms make people seek Physiotherapy care?

Vertigo Symptoms

If you think you have vertigo or a change with your vestibular system, you may experience the following symptoms:

  • spinning
  • a feeling of being unbalanced or pulled in one direction
  • tilting
  • swaying
  • ringing in the ears
  • nausea

Vertigo, dizziness and balance problems account for about 5-10% of all physician visits. Vertigo is also the number one reason for physician visits in those over 65 years old. Vestibular physiotherapy can help diminish dizziness and balance problems, and its treatment efficacy can be determined within a few visits. This treatment uses careful assessment, specialized techniques and specific vestibular rehabilitation exercises to help yours system rebalance.

Causes of Vertigo & Dizziness


Benign paroxysmal positional vertigo (BPPV) is a vestibular disorder arising in the inner ear which is caused when a collection of calcium particles bunch in the inner ear canals. This can cause episodes of positional vertigo � a spinning sensation caused by changes in the position of the head. BPPV is the most common cause of the symptoms of vertigo. Assessment and treatment can help you recover faster than trying to manage it yourself.


Your eye movement functions to stabilize your gaze by countering movement of your head. In VOR, the semicircular canals of the inner ear measure rotation of the head and provide a signal for the oculomotor nuclei of the brainstem, which communicated with your eye muscles. These muscles counter-rotate the eyes in such a way that a rightward head rotation causes an equal leftward rotation of both eyes, with the result that your gaze direction stays stationary. Any delay or deficit of the vestibulo-ocular reflex will cause a mismatch within the entire vestibular system and cause a feeling of dizziness, swaying or light headedness. Some patients report the feeling of standing on a ship at sea. Assessment and treatment for a dysfunctional VOR can significantly improve these symptoms.


Any deficit or delay in neck proprioception can lead to a mismatch in sensory nerve integration within the vestibular system leading to dizziness and balance issues. Although the integration is quite complex, patients with poor cervical proprioception can improve their symptoms with specific exercises designed to retrain the neck proprioceptive system. While treatment effects are not as dramatic as those for BPPV, with time and persistence patients can significantly reduce and sometimes eliminate their persistent dizziness.


Recent research suggests that working with a trained therapist can be beneficial as early as a few days after a concussive event.  Every concussion is different, and each patient experience can vary.  A detailed assessment may include evaluation of the neck, balance system, eye tracking and aerobic system to help decide on the appropriate course of treatment.  The great news is that with treatment, athletes often return to activity earlier than those who don't seek treatment.

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