What's Causing Your Vertigo And How Do You Fix It? Physical Therapist Gives His Insight


It's important for us to start with a huge DISCLAIMER here. Please see a physician before starting any kind of exercise regimen. What I am listing below is a very general outline of what usually works for patients after a thorough evaluation to confirm the cause of their symptoms. It may not work for everyone or every case and you should seek a formal evaluation and assessment of your concerns. In general, any time you feel numbness and/or tingling in your face, head or jaw, down your arms, or have an upset stomach, abnormal bowel/bladder movements, please discontinue the exercise and seek professional advice.



Vertigo has been a very hot topic here at the clinic and across our social platforms. Our videos about vertigo have gotten a lot of traction as of late, so we thought it was important to dive a little deeper. Most of the time, BPPV is the go-to first thought when people think of vertigo. This is the type of vertigo that occurs when the crystals in your inner ear that are responsible for determining your position in space get out of whack. When this happens, they can create that spinning sensation when you move. But BPPV is NOT the only type or cause of vertigo. And oftentimes, these other causes and the techniques to manage them are overlooked by those who only look to BPPV.


So today we are going to look at all of the exercises I have in my physical therapy arsenal to manage vertigo, regardless of the cause.



Now if there are more types of vertigo than just BPPV, what are they and what are you supposed to do about it? Well, to start, nerves in your neck that travel to your ear can get tangled up and get their signals crossed. Weakness in the eye muscles can cause strain in the nerves. When these nerves are strained and overworked, it can be hard for your brain and eyes to properly communicate. And, of course, the crystals in your ears can play a major role in vertigo which is BPPV.


Below I am putting my favorite exercise to address each of those causes of vertigo! Remember, one or any combination of these exercises may alleviate symptoms of vertigo, but they can also make some types of vertigo worse. It is always best to be assessed by a physician to determine what kind of vertigo you have and the best treatments to alleviate the symptoms.


1. Tentorium Membrane Stretch - this exercise is to address those nerves in your neck and head that may need some extra space. Our environment is constantly trying to compress us. Gravity alone is pushing down on our bodies all day every day. We know it's important to give our muscles and joints and a little stretch sometimes, but it's important to make sure our nerves have space as well. That's exactly what this exercise does. The tentorium membrane is like the plastic wrap that sits around your brain. Tons of nerves and blood vessels innervate here. This exercise helps stretch that out a bit and gives your brain and nerves some space to breathe and have a good flow of fluid.



2. Vestibular Ocular Reflex Exercises - these simple exercises for your eyes can be a huge game-changer for those with vertigo. If you find that you are getting dizzy or having symptoms after you stare at a screen for an extended period of time or after reading, it may be because your eyes just don't have the right strength to be that engaged. These quick exercises train your eyes to reintegrate with your brain and will use the proper muscles and stimulate the nerves properly


3. Epley Maneuver - this is the exercise most commonly given to those who suffer from BPPV. The goal of the exercise is to abruptly reposition the crystals causing vertigo. It aims to stick em back in the right spot so they stop giving you the symptoms of dizziness and difficulty determining spatial awareness. You want to start by determining which ear and which canal in that ear are affecting using the Dix Hallpike test. Using that information, you can move on to doing the Epley Maneuver in the corresponding direction.



Hopefully, one or a combination of these exercises over time start alleviating the symptoms of vertigo. There are some other causes of vertigo that aren't quick as mechanical such as ear infections. That's why it's always very important to be checked out by a physician if you're experiencing vertigo!


Remember, we can and we will get better together!



Dr. Justin C. Lin