Every year, one in three adults over 65 falls at least once. For many, it’s not just a slip on ice or a stumble on the stairs-it’s the result of something deeper: a quiet, invisible breakdown in balance. If you’ve ever felt dizzy when standing up, struggled to walk in the dark, or avoided turning your head because it made the room spin, you’re not alone. These aren’t just normal signs of aging. They’re signals your vestibular system needs help-and the good news is, there’s a proven, drug-free way to fix it.
What Is Vestibular Rehabilitation Therapy?
Your inner ear holds tiny sensors that tell your brain where your body is in space. This is your vestibular system. When it gets damaged-by an infection, injury, or just aging-it sends mixed signals. Your brain gets confused. You feel off-balance. You might get nauseous. You start avoiding movement because it triggers dizziness. That’s when vestibular rehabilitation therapy (VRT) steps in.
Vestibular rehabilitation isn’t magic. It’s science. Developed in the 1980s by physical therapists working with balance disorders, VRT uses targeted exercises to retrain your brain. Instead of fighting dizziness, you learn to work with it. Your brain adapts. It finds new ways to interpret signals from your eyes, muscles, and joints to keep you steady. Studies show VRT improves gaze stability by 68%, balance by 73%, and cuts nausea by 42%. For many, it also reduces headaches by 37%.
How VRT Stops Falls Before They Happen
Falls aren’t accidents. They’re the end result of a system that’s been breaking down for weeks or months. VRT breaks that chain. It doesn’t just make you feel better-it makes you safer.
One patient, Rhonda, from Texas, used to have dizzy spells three or four times a week. She stopped walking her dog. She avoided grocery stores. After eight weeks of VRT, she could turn her head without spinning. She could walk on uneven pavement. She stopped falling. That’s not rare. Clinics report that 89% of patients regain the daily activities they’d given up within 6 to 8 weeks.
How? VRT targets the root causes of instability:
- Gaze stability training: Keeping your eyes locked on a target while you move your head. This stops the world from bouncing when you walk.
- Balance retraining: Standing on one foot, walking heel-to-toe, or standing on foam. These force your body to use muscles you’ve forgotten how to control.
- Habituation exercises: Repeating movements that trigger dizziness-like spinning or looking up quickly-so your brain learns to ignore them.
- Posture and strengthening: Weak core or leg muscles make balance harder. VRT includes stretches and moves to rebuild that foundation.
And here’s the kicker: you don’t need fancy equipment. No machines. No expensive gadgets. Just your body, a wall, and a few minutes a day.
The Exercises That Actually Work
VRT isn’t one-size-fits-all. But there are five core exercises that form the backbone of most programs. These are safe, simple, and backed by decades of research.
- Head Turns with Fixed Gaze: Sit or stand still. Focus on a spot across the room. Slowly turn your head left and right, keeping your eyes locked on that spot. Do 10 reps. Once you can do this without dizziness, add walking while turning your head.
- Shoulder Shrugs with Head Movement: Stand with feet shoulder-width apart. Shrug your shoulders up and down while slowly turning your head side to side. This trains your brain to coordinate eye and body movement.
- Heel-to-Toe Walk: Walk in a straight line, placing the heel of one foot directly in front of the toes of the other. Do 10 steps. Hold onto a wall if needed. This improves your body’s sense of position.
- Standing on One Foot: Hold onto a chair. Lift one foot off the ground. Hold for 10 seconds. Switch feet. Do this 3 times a day. As you improve, try it without holding on.
- Marching in Place: Stand tall. Lift your knees one at a time, like you’re marching. Move your arms naturally. Do this for 30 seconds. Gradually increase to 2 minutes. Add head turns while marching to challenge your vestibular system further.
These aren’t meant to be painful. But they should make you slightly dizzy. That’s how you know you’re working. Avoiding dizziness slows recovery. The goal isn’t to feel perfect-it’s to feel challenged, then gradually better.
How Often Should You Do These Exercises?
Consistency beats intensity. You don’t need to spend an hour a day. In fact, doing 5 to 10 minutes, three to five times a day, works better than one long session.
Think of it like learning a language. You don’t become fluent by studying for six hours on Sunday. You become fluent by practicing a few minutes every day. The same goes for your balance system. Your brain rewires itself through repetition.
Most people start seeing results in 2 to 4 weeks. Full recovery usually takes 6 to 8 weeks. But progress isn’t linear. Some days you’ll feel stronger. Other days, you might feel worse. That’s normal. It means your brain is working. Keep going.
Who Can Benefit?
You don’t need a diagnosis to start VRT. If you’ve had:
- Benign Paroxysmal Positional Vertigo (BPPV)-the most common cause of dizziness, affecting 2.4% of people
- Meniere’s Disease
- Vestibular neuritis or labyrinthitis
- Chronic dizziness after a concussion
- Unexplained falls or fear of falling
…then VRT can help. It works for people in their 20s and their 80s. It works whether your dizziness started yesterday or five years ago.
And it’s especially critical for older adults. 65% of people over 65 experience dizziness. One in three falls each year. Falls are the leading cause of injury-related death in seniors. VRT cuts fall risk by 53%-more than any medication.
What to Expect From a Therapist
You don’t have to figure this out alone. A vestibular physical therapist will assess your movement, eye control, and balance. They’ll design a personalized plan. Most patients meet with a therapist once or twice a week, then do daily home exercises.
Therapists don’t just hand you a list. They watch you. They adjust. They teach you how to recognize when you’re pushing too hard-or not enough. They help you build confidence. One patient on Reddit went from falling 3-4 times a week to zero falls in 12 weeks. Another could finally read on the bus without the world spinning.
VRT is covered by most insurance plans, including Medicare. You don’t need a referral in every state, but it helps. Talk to your doctor. Ask for a referral to vestibular rehabilitation.
What Doesn’t Work
Medication won’t fix this. Antihistamines or anti-nausea drugs might mask symptoms, but they don’t rebuild your balance system. In fact, long-term use can make things worse by slowing your brain’s ability to adapt.
Surgery? Only in rare cases-like severe Meniere’s that doesn’t respond to anything else. VRT is the first-line treatment for nearly all vestibular disorders.
And don’t wait. The longer you avoid movement, the more your brain forgets how to stay upright. Avoiding dizziness doesn’t protect you-it traps you.
Real Progress, Real Life
VRT isn’t about getting back to “normal.” It’s about getting back to living.
One man in Manchester, 72, stopped walking his dog because he was afraid of falling. After 7 weeks of VRT, he walks two miles every morning. Another woman, who couldn’t turn her head to check traffic, now drives without fear. A college student who couldn’t read while walking on campus finished her degree without dropping out.
These aren’t miracles. They’re results.
Your balance system is powerful. It just needs the right kind of training. And you’re never too old, too weak, or too far gone to start.
Can vestibular exercises be done at home without a therapist?
Yes, many people start with home exercises after a single evaluation by a therapist. But it’s best to get assessed first. Some dizziness comes from neck issues, inner ear crystals, or neurological conditions that need different treatment. A therapist can rule out red flags and tailor exercises to your specific problem. Once you’re on the right plan, daily home practice is where real progress happens.
How long until I see results from vestibular therapy?
Most people notice small improvements within 2 to 4 weeks-like less nausea or being able to turn their head without dizziness. Full recovery usually takes 6 to 8 weeks with consistent daily practice. Progress isn’t always steady. Some days will feel harder. That’s normal. Stick with it.
Are vestibular exercises safe for older adults?
Absolutely. VRT is designed for older adults, including those with arthritis, diabetes, or heart conditions. Exercises are modified based on fitness level. Many patients start by holding onto a chair or wall. The goal is to move safely, not to push to exhaustion. In fact, staying active through VRT reduces fall risk more than any medication.
What if vestibular exercises make me dizzy?
Mild dizziness during exercises is expected-and a good sign. It means your brain is being challenged. The goal isn’t to avoid dizziness but to control it. If you feel extremely nauseous, faint, or have new symptoms like numbness or slurred speech, stop and contact your doctor. Otherwise, keep going. Dizziness during exercise fades as your brain adapts.
Can vestibular therapy help with vertigo caused by BPPV?
Yes, but BPPV often needs a specific maneuver first, like the Epley maneuver, to reposition loose crystals in the inner ear. Once those are cleared, vestibular therapy helps your brain adapt and prevents future episodes. Many therapists combine both approaches for the best results.
Is vestibular rehabilitation covered by insurance?
Most major insurance plans, including Medicare, cover vestibular rehabilitation when prescribed by a doctor. It’s typically billed as physical therapy. Check with your provider, but don’t assume it’s not covered-many people are surprised to find it’s included.
Next Steps: What to Do Today
Don’t wait for the next fall. If you’ve been avoiding movement because of dizziness, here’s what to do now:
- Write down when and how often you feel unsteady. Note what triggers it-turning your head, standing up, walking in the dark.
- Ask your doctor for a referral to a vestibular physical therapist. If they’re unsure, ask for a referral to physical therapy and mention “vestibular rehabilitation.”
- Start with one exercise today: sit down, focus on a spot, and slowly turn your head left and right 10 times. Do it three times today.
- Clear your path at home. Remove rugs, add nightlights, install grab bars. Safety isn’t just about balance-it’s about environment.
Your body remembers how to balance. It just needs the right cues. Start small. Stay consistent. And don’t let fear keep you still. The ground won’t move-you will.
