If you’ve ever experienced dizziness, vertigo, or balance problems, you’re not alone. These issues can arise from various causes, including sports injuries, concussions, or simply as a result of aging. Vestibular therapy offers a comprehensive solution to these challenges, helping individuals regain their balance, reduce dizziness, and improve their overall quality of life.

What is Vestibular Therapy?

Vestibular therapy, also known as vestibular rehabilitation therapy (VRT), is a specialized form of physical therapy designed to address disorders of the vestibular system. This system, located within the inner ear, plays a crucial role in maintaining balance and spatial orientation. Vestibular therapy aims to alleviate symptoms such as dizziness, vertigo, and imbalance through targeted exercises and interventions.

Common Causes of Balance Problems

Balance problems can stem from a variety of factors, including inner ear disorders, neurological conditions, and musculoskeletal issues. For athletes, sports-related injuries are a significant concern. Concussions, whiplash, and repetitive head trauma can all disrupt the vestibular system, leading to balance disturbances. Whether you’re a professional athlete or a weekend warrior, it’s essential to recognize the signs of vestibular dysfunction and seek appropriate treatment.

What is the Vestibular Therapy Rehabilitation Process?

The vestibular therapy rehabilitation process typically begins with a comprehensive evaluation by one of our trained therapists. This assessment helps identify specific impairments to tailor treatment accordingly. During therapy sessions, patients may engage in a variety of exercises including:

1. Balance Training

Balance training is a crucial component of vestibular therapy, aimed at enhancing a patient’s ability to maintain stability and prevent falls. These exercises challenge the body’s balance systems, including the vestibular system, proprioception, and vision, to work together more effectively. During balance training, patients may perform activities such as standing on one leg, walking heel-to-toe, or using balance boards. By progressively increasing the difficulty of these exercises, the therapist helps patients develop better coordination and stability, which can significantly reduce dizziness and improve overall balance.

2. Gaze Stability

Gaze stability exercises focus on improving the control of eye movements, which is essential for maintaining clear vision while the head is in motion. This aspect of vestibular therapy addresses issues like oscillopsia, where the visual field appears to bounce or move. Patients typically perform exercises such as the “X1” and “X2” paradigms, where they fixate on a stationary or moving target while moving their head in various directions. These exercises help retrain the brain and the vestibulo-ocular reflex (VOR), leading to better synchronization between head and eye movements, and ultimately reducing symptoms of dizziness and vertigo.

3. Canalith Realignment Procedures

Canalith realignment procedures involve a physical therapist using specific head and body positions to guide the displaced crystals in the ear canal back into the correct areas. The dislodgment of these crystals into a particular canal causes benign paroxysmal positional vertigo (BPPV). By using certain tests, a physical therapist can identify which ear canal is affected, allowing the physical therapy team to tailor the treatment to the patient accordingly. Note that this is best done by a professional physical therapist as using the wrong method can worsen the condition by further dislodging the crystals.

4. Habituation Training

Habituation training involves exposing patients to movements or environments that trigger their dizziness in a controlled manner. The goal is to gradually reduce the sensitivity of the vestibular system to these stimuli through repeated exposure. During habituation exercises, patients might perform specific head and body movements that provoke their symptoms. Over time, these repeated exposures help the brain become accustomed to the stimuli, decreasing the intensity and frequency of dizziness episodes. This type of training is particularly beneficial for individuals with motion sensitivity or conditions like BPPV, though often only if other treatment methods fail to yield the desired results.

How to Treat Balance Problems From Home

While awaiting a therapy appointment, individuals can take proactive steps to manage balance problems at home. Simple strategies such as maintaining a consistent sleep schedule, staying hydrated, and avoiding sudden head movements can help minimize symptoms. Additionally, practicing mindfulness techniques and relaxation exercises may reduce feelings of dizziness and anxiety.

1. Sleep Schedule

Maintaining a consistent sleep schedule is crucial for managing balance problems from home. A regular sleep pattern helps regulate your body’s internal clock, promoting better overall health and reducing the likelihood of dizziness and imbalance. Aim for 7-9 hours of quality sleep each night, and try to go to bed and wake up at the same time every day, even on weekends. Avoid caffeine and electronic devices before bedtime, as they can disrupt your sleep cycle.

2. Stay Hydrated

Proper hydration is essential for maintaining good balance and overall health. Dehydration can lead to dizziness, fatigue, and difficulty concentrating, exacerbating balance issues. Aim to drink at least eight glasses of water per day, and more if you’re active or in hot weather. Pay attention to signs of dehydration, such as dark urine or thirst, and replenish fluids promptly. Avoid excessive alcohol and caffeine consumption, as they can contribute to dehydration.

3. Avoid Sudden Movements

Sudden movements can trigger or worsen balance problems, especially if you’re prone to dizziness or vertigo. Take precautions to move slowly and deliberately, particularly when getting up from a lying or sitting position. Avoid sudden head turns or quick changes in direction, as these actions can disrupt your vestibular system and lead to disorientation or falls. If you need to turn or change direction, do so gradually and with awareness of your surroundings.

4. Mindfulness Techniques

Mindfulness techniques can help reduce feelings of dizziness, anxiety, and stress associated with balance problems. Practice mindful meditation, deep breathing exercises, or progressive muscle relaxation to promote relaxation and calmness. Focus on the present moment and observe your thoughts and sensations without judgment. Incorporate mindfulness into your daily routine, even if only for a few minutes each day, to cultivate a greater sense of balance and well-being.

5. Relaxation Exercises

Engaging in relaxation exercises can alleviate tension and promote physical and mental relaxation, which can help alleviate balance problems. Try gentle stretching, yoga, or tai chi to release muscle tension, improve flexibility, and calm the mind. Experiment with different relaxation techniques to find what works best for you, and make time for regular practice to reap the benefits.

Top Exercises for Vertigo Treatment

Experiencing vertigo can be disorienting and debilitating, but incorporating specific exercises into your routine can significantly help in managing and reducing its symptoms. These exercises are designed to improve balance, enhance coordination, and mitigate the dizzying sensations associated with vertigo. While you’re waiting for a physical therapy appointment, practicing these exercises at home can be a proactive way to start managing your vertigo symptoms effectively.

NOTE: Before starting these exercises, ensure you are in a safe environment where you can sit or lie down if you become dizzy. If you have any underlying health conditions or if your vertigo persists, it’s crucial to consult with a healthcare provider.

Brandt-Daroff Exercises

How to do it

  1. Sit on the edge of a bed or sofa.
  2. Quickly lie down on one side, keeping your head looking up at a 45-degree angle.
  3. Stay in this position for about 30 seconds or until dizziness subsides.
  4. Sit up and wait for another 30 seconds.
  5. Repeat on the other side.


Perform 5-10 repetitions, 2-3 times a day.

Epley Maneuver

How to do it

  1. Sit on a bed with your legs extended and turn your head 45 degrees to the side that causes vertigo.
  2. Quickly lie back with your head still turned and stay in this position for about 1-2 minutes.
  3. Turn your head 90 degrees to the opposite side without raising it, and hold for another 1-2 minutes.
  4. Roll your body in the same direction until you are lying on your side. Hold for 1-2 minutes.
  5. Slowly return to a sitting position.


Perform this once before bed each night until you experience relief.

Semont Maneuver

How to do it

  1. Sit on the edge of a bed.
  2. Quickly lie down on your affected side and stay in this position for 30 seconds.
  3. In one quick motion, move to lie down on the opposite side without stopping in the upright position. Keep your head facing upwards.
  4. Hold this position for another 30 seconds.
  5. Slowly sit back up.


Perform this maneuver 2-3 times a day until symptoms improve.

Vestibular Rehabilitation Exercises

How to do it

  1. Stand up and focus on a stationary object in front of you, like a picture on the wall.
  2. Move your head from side to side while keeping your eyes focused on the object.
  3. Continue this for about 1 minute.
  4. Repeat the same process but with head movements up and down.


Do this exercise 2-3 times a day.

Vestibular Therapy in Maryland

If you’re in Maryland and in need of vestibular therapy, consider contacting Herlong Sports Physical Therapy. As experienced clinicians, we offer comprehensive care to help you get back on your feet. With four convenient locations across Maryland, Herlong Sports Physical Therapy provides personalized treatment plans tailored to your needs. Best of all, no doctor’s referral is required, and we accept all major insurance plans. Don’t let balance problems hold you back—take the first step toward recovery with Herlong Sports Physical Therapy.



10312 Governor Lane Boulevard #5007
Williamsport, MD 21795

Located inside of TrueAP




1438 Liberty Rd, STE 10A
Eldersburg, MD 21784

Located inside of MadLab Performance




2470 Longstone Ln, STE A
Marriottsville, MD 21104

Located inside of Campanaro Strength & Conditioning




12447 Clarksville Pike
Clarksville, MD 21029

Located inside of Campanaro Strength & Conditioning