Vestibular Therapy for Concussion

Why vestibular problems are so common after concussion

The vestibular system — your inner ear and its connections to the brain — is one of the systems most frequently affected by concussion. Research suggests that vestibular dysfunction is present in up to 60% of concussion cases.

This happens because the same forces that cause concussion also disturb the delicate structures of the inner ear and the brainstem pathways that process vestibular information. The result is dizziness, vertigo, balance problems, nausea, and difficulty tolerating head movement or visually busy environments.

The good news: vestibular dysfunction after concussion is one of the most treatable aspects of the injury. With the right assessment and targeted rehabilitation, most patients see significant improvement.

What vestibular therapy involves

Vestibular rehabilitation is a specialized form of physiotherapy that uses specific exercises and techniques to help the brain recalibrate how it processes balance and spatial orientation signals. It's not general exercise — it's precisely targeted to the type of vestibular dysfunction identified in your assessment.

BPPV treatment

Benign paroxysmal positional vertigo (BPPV) occurs when tiny calcium crystals in the inner ear become displaced. This causes brief but intense episodes of vertigo triggered by head position changes — rolling over in bed, looking up, or bending down. BPPV is treated with specific repositioning manoeuvres that guide the crystals back to their correct location. It can often be resolved in one to two sessions.

Gaze stabilization exercises

When the vestibular system is disrupted, the vestibulo-ocular reflex — the mechanism that keeps your vision stable during head movement — doesn't work efficiently. Gaze stabilization exercises retrain this reflex so your vision stays clear while your head is moving.

Habituation exercises

If certain movements or visual environments consistently trigger dizziness, habituation exercises provide controlled, repeated exposure that gradually reduces the brain's overreaction to those stimuli.

Balance retraining

Progressive balance exercises challenge your vestibular, visual, and proprioceptive systems in a controlled way — retraining your brain to integrate these signals accurately rather than relying on compensation strategies.

Visual-vestibular integration

Many patients struggle in visually busy environments — grocery stores, scrolling screens, driving in traffic. Exercises targeting visual-vestibular interaction help your brain process conflicting visual and vestibular input without triggering symptoms.

What makes our approach different

Our physiotherapists hold advanced training in vestibular assessment and rehabilitation. This matters because vestibular dysfunction has many subtypes, and the treatment that helps BPPV is completely different from the treatment that helps visual-vestibular mismatch. A generic "balance exercise" program doesn't work — you need a treatment plan matched to the specific vestibular mechanism involved.

We also recognize that concussion-related vestibular dysfunction rarely exists in isolation. Most patients have concurrent cervical spine involvement, headache, or cognitive symptoms. Our assessment and treatment address all contributing systems, not just the vestibular component alone.

How quickly does vestibular therapy work?

The timeline depends on the type and severity of vestibular dysfunction. Some patients — particularly those with BPPV — experience dramatic improvement after a single session. Others with more complex central vestibular involvement may need several weeks of consistent rehabilitation.

What's consistent across nearly all cases: patients improve faster with targeted vestibular therapy than with rest alone. If you've been waiting for dizziness to resolve on its own and it hasn't, that's not a sign that it won't get better — it's a sign that your brain needs the right input to recalibrate.