How the vestibular system works
Your vestibular system is located in the inner ear and is responsible for sensing head position, movement, and spatial orientation. It works together with your vision and proprioception (body position sense) to keep you balanced and stable during everyday activities.
When something goes wrong with the vestibular system — whether from an infection, displaced crystals, head injury, or age-related changes — the result is often vertigo, dizziness, imbalance, or a combination of all three. These symptoms can range from mildly disorienting to completely debilitating.
What vestibular rehabilitation therapy treats
Vestibular rehabilitation is effective for a wide range of conditions that cause dizziness and balance problems. The most common conditions we treat at Burlington Vestibular Therapy include:
- BPPV (Benign Paroxysmal Positional Vertigo) — the most common cause of vertigo, caused by displaced calcium crystals. Treated with canalith repositioning manoeuvres such as the Epley manoeuvre.
- Vestibular neuritis and labyrinthitis — inner ear inflammation causing sudden, severe vertigo. Treated with gaze stabilization exercises and balance retraining.
- Post-concussion vestibular dysfunction — dizziness, visual motion sensitivity, and balance problems following a concussion or head injury.
- Chronic dizziness and imbalance — persistent symptoms from inner ear dysfunction, medication side effects, or neurological conditions.
- Visual vertigo and motion sensitivity — dizziness triggered by busy visual environments treated with habituation therapy.
- Age-related balance decline and fall prevention — progressive balance retraining to reduce fall risk and restore confidence.
- Ménière's disease — management of episodic vertigo, hearing changes, and tinnitus through vestibular exercises and lifestyle strategies.
How vestibular therapy works
Vestibular rehabilitation uses several specific techniques depending on your diagnosis. Your physiotherapist selects the right combination based on a thorough assessment of your symptoms, triggers, and vestibular function.
Canalith repositioning manoeuvres
For BPPV, specific head and body movements (such as the Epley manoeuvre or Semont manoeuvre) are used to guide displaced calcium crystals back to their correct position. BPPV is often completely resolved in just 1–3 sessions.
Gaze stabilization exercises
These exercises train your brain to keep your vision clear and stable during head movements. They're essential for treating vestibular neuritis, labyrinthitis, and post-concussion vestibular dysfunction.
Habituation training
Habituation exercises gradually expose you to the specific movements or visual environments that trigger your dizziness. With repeated, controlled exposure, your brain's sensitivity decreases. This is particularly effective for visual vertigo and motion sensitivity.
Balance retraining
Progressive balance exercises challenge your stability in a controlled, safe way — gradually increasing difficulty to rebuild confidence and reduce fall risk.
Most patients notice meaningful improvement within 4–6 sessions of vestibular rehabilitation. BPPV — the most common type of vertigo — can often be resolved in just 1–3 visits.
What to expect at your first visit
Your initial vestibular assessment takes approximately 60 minutes and includes:
- Detailed history — We discuss your symptoms, when they started, what triggers them, and how they affect your daily life.
- Eye movement testing — We observe your eye movements to assess vestibular function and identify the specific type of dysfunction.
- Positional testing — Specific head and body positions help determine whether BPPV or positional vertigo is present.
- Balance evaluation — Standing and dynamic balance tests assess how well your systems coordinate.
- Diagnosis and plan — You'll leave with a clear explanation of what's causing your symptoms and a personalized treatment plan.
Who provides vestibular therapy?
Vestibular rehabilitation is provided by registered physiotherapists with advanced training. At Burlington Vestibular Therapy, our team focuses exclusively on vestibular care — it's all we do.
Stephanie and Juhi are vestibular physiotherapists with advanced training in BPPV repositioning, concussion rehabilitation, gaze stabilization, and balance disorders. Both have pursued continuing education in vestibular assessment and concussion management.
Do I need a referral?
No. In Ontario, you do not need a doctor's referral to see a physiotherapist. You can book directly with our vestibular specialists. Some insurance plans may require a referral for reimbursement — check with your provider or ask us and we'll help you sort it out.
Is vestibular therapy covered by insurance?
Yes. Vestibular therapy is provided by registered physiotherapists and is covered under most extended health benefit plans in Ontario. We offer direct billing to many major insurers, which means you typically won't need to pay out of pocket.