Vertigo: What Exercises can help?

Vertigo: What Exercises can help?

Vertigo, or a dizziness that feels like your surroundings are spinning, is common within the general population, accounting for approximately 54% of cases of dizziness (1).

This condition can be extremely limiting, and often is associated with other symptoms such as nausea, vomiting, ringing in the ears and hearing loss.

There are many different causes of dizziness, such as changes in the vestibular system, blood pressure, low blood sugar, cardiac conditions, neurological conditions such as multiple sclerosis, along with different types of vertigo such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis and Ménière’s disease. It is important that you seek a formal diagnosis of your dizziness to correctly manage and guide best treatment.

Most dizziness is caused by the inner ear and is treatable. The following exercises may be useful for you to try at home to reduce your symptoms. It is really important to make sure that you are in a safe environment before you start any of the exercises and preferably have someone with you. When doing these exercises, it is normal to feel a mild dizziness.

 

General Vestibular Rehabilitation

Cawthorne Cooksey Exercises (2)

These exercises should be done slowly at first, then progressed to quicker as you feel more comfortable. About 10 times of each exercise is recommended. You should build up these exercises slowly.

1. In bed

Eye movements

– Up and down

– From side to side

– Focusing on finger moving from 90cm to 30 cm foot away from face

Head movements

– Bending forward and backward

– Turning from side to side

– Above with eyes closed

2. Sitting

Eye movements and head movements as above

Shoulder shrugging and circling

Bending forward to pick up objects from the ground

Bending side to side to pick up objects from the ground

3. Standing

Eye, head and shoulder movements as above

Changing from sitting to standing position with eyes open and progress to shut

Throwing a small ball from hand to hand (above eye level)

Throwing a ball from hand to hand under knee

Changing from sitting to standing and turning around in between

4. Moving – this should be completed with another person for safety

Walk up and down slope

Walk up and down steps

Throw and catch a ball

A game involving skills such as aiming, crouching e.g. bowling

 

Gaze Stabilisation Exercises (2)

These exercises help to move your eyes separate to your head movements, and to focus on something whilst the head is moving.

– Look straight ahead at something that is at eye level

– Turn your head from side to side and keep your eye on the target in front of you. Start this movement slow, then build up to be faster. If this makes you too dizzy, slow down the speed. You should be able to clearly see the target you are looking at.

– Do this exercises for an amount of time that it takes to build up a mid –moderate level of dizziness. Try to build up to 1 minute

You can do this exercise looking up and down as well.

 

Recreational Activities

Incorporating recreational activities that challenge your balance, in a safe and supported environment, are also great ways to rehabilitate the inner ear or the vestibular system.

Sports such as golf, tennis, ping-pong, or even walking and looking around and side to side are good ways to challenge you balance and allow your body to make changes to improve your balance.

 

BPPV

If you have been to a GP, physiotherapist or any other specialist who has diagnosed you with BPPV, the following exercises may be better for you. It is best to see a physiotherapist and practice these with them initially to ensure it is safe to do at home.

Brandt-Daroff exercises

1. Sit in the middle of a bed with your feet on the floor. Turn your head 45 degrees to the right.
2. Without moving your head, lie down on your left side. Pause for 30 seconds.
3. Return to the starting position. Pause for 30 seconds.
4. Turn your head 45 degrees to the left. Repeat Steps 2 and 3 on the right side.
5. Return to the starting position. Pause for 30 seconds.
6. Complete one set of five repetitions on each side.

 

 

Written by Lucy Mayo, Physiotherapist at myPhysioSA Mount Barker. 

References for text. 

1. Cranfield S, Mackenzie I, Gabbay M. Can GPs diagnose benign positional paroxysmal vertigo and does the Epley manoeuvre work in primary care? Br J Gen Pract 2010;60(578):698–99.
2. Brain and Spine Foundation 2017. ‘Vestibular Rehabilitation Exercises’ Brain and Spine Foundation. <https://www.brainandspine.org.uk/wp-content/uploads/2018/02/BSF_Vestibular_rehabilitation_exercises.pdf>