Remember as a child when being dizzy or having dizziness was fun? You probably recall hopping off a merry-go-round with your friends and trying to walk a straight line or attempting to stand still without falling down. It was all fun and games because you were able to recover quickly and run off to your next adventures.

But what if you have these symptoms without being on the merry-go-round and that feeling is actually causing you or a loved one to limit their activities? Maybe you see them walk nervously from one piece of furniture to another in their home. Or perhaps worse, that feeling contributes to you falling. Why are you feeling this way and what can you do about it?

Sometimes a medical condition such as an irregular heartbeat, excessively low blood pressure, or an intestinal bleed can cause these symptoms. In absence of a medical issue being the problem however, feelings of being off balance or dizziness are attributed to “aging”, “being out of shape” or “slowing down”. While these symptoms can certainly creep up on us as we age, aging alone does not explain the cause of these symptoms.

Our body maintains a stable and upright posture through the interactions of three primary systems – our visual system, our somatosensory system and our vestibular system. Let’s explore each of these.



The visual system is quite obvious. It’s what we see in the world around us! Are we oriented to vertical? We determine this by comparing ourselves to objects around us such as a door, a light post or a building. This is a very powerful reference for us. When we can’t see a clear reference point, we are unsure of our position. Think of what you feel in an airplane that is banking left or right when while taking off. Our sense of vertical can become quite compromised without an accurate visual reference. The same can be felt in a dimly lit room or while being outside at night.



The second system that helps us is our somatosensory system. This system collects information through our skin and joint receptors by way of contact with our environment. If you are sitting right now you feel the surface of the floor under your feet, the chair contacting your legs and spine. If you’re standing, you feel the floor under you and perhaps your shoulder leaning against the wall. This is your somatosensory system doing it’s job.



Finally, our vestibular systems acts as our internal gyroscope. Inside of each ear is a system of boney loops that hold fluid that moves with any slight motion of our head. If there is a problem in one of the loops themselves, as in the case of benign paroxysmal positional vertigo or BPPV, then one might feel very acute vertigo, dizziness, such as the world spinning around, resulting in very poor balance. Remember the merry-go-round? That same sensation can now be quite scary as you contemplate a fall! There is one more important role that the vestibular system also performs. It coordinates all the information taken in from what we see (visual), what we feel (somatosensory) and the motions of the head and computes the information through the brainstem and prompts us to physically react in order to maintain an upright and secure position. Many times it is a problem with the coordination process that can lead one to feel insecure, imbalanced or prone to falling.



“It’s our ability to effectively collect and act on the information our systems detect that allows us to maintain good balance and avoid falls”, says Matt Whitaker, Physical Therapist. A physical therapist trained to assess and treat each of these systems can help you increase your confidence and get back to safely walking in the home and community and returning to the activities you want to do, or what we call being Active For Life!


Next: Balance Therapy, Part 2

Plus 3 bonus exercises!

Further Explore balance and dizziness problems, how we treat them and what you can do to start helping yourself: Balance Therapy, Part Two – Plus 3 Balance Exercises


central dizziness head spinning dizzy Vestibular RehabilitationListen to our expert physical therapist, Matt Whitaker, PT, discuss Vestibular Rehabilitation: What Works and What Doesn’t as a guest on VEDA’s ICU podcast series.

VEDA is the authoritative resource for patients for all things vestibular, providing education to understand these challenging conditions.



If you or someone you know has these types of dizziness problems, don’t wait for a fall and more potential problems that come with it, contact us today to schedule an appointment to get back on track to Move Better, Feel Better & Live Better.



Evolve Physical Therapy Logo

For a thorough evaluation and individualized treatment, contact our Sherwood clinic or our Bethany clinic today, and be seen in less than 48 hours.

Check out what injuries we commonly treat and what to expect during an appointment.



Matt Whitaker has treated the dizzy and imbalanced patient for over 19 years with certification in Vestibular Rehabilitation through the University of Miami School of Medicine Division of Physical Therapy.