Vestibular - Professional Rehabilitation Services


Are you experiencing Vertigo?

Have You Ever Experienced?

  • Dizziness?
  • Episodes of spinning?
  • Periods of light-headedness?
  • Trouble focusing or reading?
  • Loss of balance?
  • Increased fatigue?

If you answered yes to any of these questions, you may have a vestibular problem.


Vertigo is an illusion of movement or dizziness.


It is made up of three small, semicircular canals, two sensory organs called the utricle and saccule, and the vestibular nerve, located in the inner ear. The vestibular system helps us detect changes in head movement or body position to maintain balance.


  • Stroke
  • Neurological diseases
  • Tumors
  • Head trauma
  • Inner ear dysfunctions
  • Blood pressure problems
  • Neck problems
  • Aging
  • Loss of sensation in the feet


Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is one of the most common types of peripheral vertigo. Its exact cause is unknown. It becomes more common as we age, may begin following a head trauma, or may be idiopathic (cause unknown).

This condition involves the inner ear where free floating calcium particles move into the semicircular canals, causing symptoms of vertigo or spinning, with changes in head position. The debris consists of small calcium carbonate crystals often referred to as "ear rocks". These calcium carbonate crystals move through the canal as head position changes. This sends incorrect signaling to the brain producing the sensation of vertigo. Provoking head positions and movements are to often getting in or out of bed, bending over as to pick something off the floor or tie shoes, or looking up when reaching for something overhead. These symptoms may not occur every time you do one of the previous activities and may occur with only one or all of them.

Vestibular Labrynthitis or Neuritis

Vestibular neuritis and labyrinthitis are caused by an irritation of the vestibular nerve within the inner ear due to an infection. The infection is typically viral and can be preceded by any systemic viral infection like the common cold. The infection can move to the inner ear and cause irritation of the vestibular nerve. The irritation of the nerve results in an often-sudden attack of vertigo, possible nausea and loss of balance and is initially severe and can last for a period of 1-4 days with gradual improvement over the next several weeks. For many, these symptoms will resolve on their own. For others, activities like driving, walking through the grocery store, crowds, malls, airports, or just down the street continue to cause dizziness and imbalance. These individuals may also notice difficulty concentrating, fuzzy vision, and symptoms worsening with fatigue.

Disuse Equilibrium and Fear of Falling

After episodes of dizziness, normal movement feels awkward and loss of balance increases the risk of falling. Muscles and joints become stiff and even walking becomes difficult.

Motion Sensitivity

Certain motions cause a sensation of spinning, lightheadedness, or nausea. The eyes, head, and body become out of sync and everyday motions like turning the head to drive become problematic.

Central Vertigo

A condition caused by damage to the central nervous system from a stroke or head injury that affects the vestibular system. Symptoms include dizziness or loss of balance.


When the vestibular system has been affected due to one of the above conditions the brain cannot rely on the information it is receiving from the vestibular system. The patient's ability to maintain balance is now dependent on vision and signaling from muscles and joints. This can lead the patient to compensate for the change by avoiding various head positions and movements because these increase their symptoms. The avoidances help decrease the number of instances of dizziness and nausea but result in headache, muscle stiffness, fatigue, and decreased ability for the brain to adapt to the change in the vestibular system. Overall these avoidances make symptoms worse and increase the need for Vestibular Therapy.

Vestibular therapy is specialized physical therapy directed at the vestibular component of the nervous system. The vestibular system uses information from the eyes, inner ear and extremities to tell the brain how the body is moving or how the body is positioned in space. Sometimes, this information is incomplete or distorted, causing dizziness or a loss of balance. The purpose of vestibular therapy is to restore good communication between these sources of information and the brain to help eliminate or reduce the symptoms. The inner ear is the cause of most treatable forms of dizziness

*At Professional Rehabilitation Services Vestibular Therapy is provided by certified and skilled licensed physical therapists specifically trained in vestibular therapy.

For each program:

Your therapist will evaluate you to determine:

  • Positions or movements that may cause dizziness.
  • Balance deficits, which may interfere with your ability to perform daily activities such as dressing, bathing, walking, driving or shopping.
  • We evaluate your eye tracking ability / visual function as it relates to eye-head coordination required for reading, driving, or walking.
  • Balance, gait, motion sensitivity.
  • Strength, sensation, flexibility and coordination
  • One of the standard tests done in the investigation of dizziness or vertigo involves asking the patient to wear Frenzel glasses to look in different directions while the clinician observes the patient's eyes in order to detect an abnormal eye movement called nystagmus. In the normal clinical environment, patients with vestibular problems will exhibit this particular symptom since their eyes will be held steady by observation of the surroundings. Frenzel glasses comprise a pair of very thick lenses which serve to completely blur the patient's observed environment while giving the clinician a magnified view of the patient's eyes.

Your Vestibular Therapy Program May Include:

  • Special maneuvers to help you reduce or end symptoms of dizziness
  • Balance training and exercises
  • Compensatory techniques you can use to decrease symptoms of dizziness and imbalance while performing daily activities
  • Home exercises to improve function and independence
  • Eye reflex exercises
  • Strengthening exercises
  • Manual therapy to address neck problems
  • KoreBalance™ Treatment - This state-of-the-art computerized balance and exercise system offers the latest in virtual and interactive technology providing a high-tech way for balance assessment and training. For more information about KoreBalance

Please click here to see some of the treatments that can be performed:

Canal Repositioning Maneuvers: (BPPV Maneuver)

When the patient has been affected by BPPV canal repositioning maneuvers are indicated. During the evaluation it will be determined what canal the debris lies in. Once the physical therapist has determined this, a canal-repositioning maneuver will be used to dislodge or reposition the debris within the affected canal. The patient will return back in one week to repeat the same procedure on the other side. Then will follow up with their physician on the results. Patients diagnosed with benign positional vertigo (BPPV) usually improve in one to three sessions in 90% of cases.

Gaze Stabilization Exercises:

When a patient has had vestibular neuritis or labyrinthitis the information the brain receives from the vestibular system has been changed. Adaptation exercise may be used in order to help the patient's brain adapt to new signaling from the affected vestibular system. Visual fixation on a target during head movement is a key gaze stabilization exercise given to assist in this retraining.

Balance Retraining Exercises:

When the vestibular system has been affected by vestibular neuritis or labyrinthitis the nerve signaling related to balance and walking has also changed. When this occurs, balance training is also indicated. Balance retraining involves exercises designed to improve coordination of muscular responses as well as the organization of sensory information (eye sight, vestibular system) for balance control.


The duration of a course of vestibular therapy depends on the diagnosis.For example, dizziness due to an inner ear problem may take only 1 or 2 sessions, whereas imbalance related to aging may require 8-12 sessions spread over 2-3 months. Ask your therapist for details. In some cases patients may experience an increase in their dizziness and imbalance. It is not uncommon to see an exacerbation of symptoms before improvement.

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From Pawleys Island to Myrtle Beach and Conway, Professional Rehabilitation Services provides Physical Therapy Services for the Georgetown, Pawleys Island, Surfside Beach, Murrells Inlet, Socastee, Myrtle Beach, Conway and Little River South Carolina communities.