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Neurology

Exercises for preventing vertigo

Why should I exercise?

Depending on the cause of vertigo, some exercises can be helpful to reduce vertigo events. For instance, if you have balance problems, you might consider doing balance exercises to improve your condition1. You need to determine what kind of exercises are suitable for you together with your doctor. Take one minute of your time, grab your phone, and book an appointment.

Did you know?
A study shows that 75-80%1 of patients who practice balance exercises feel better within a few months. In contrast, patients who did not practice those exercises had no signs of improvement.

What type of exercises can improve my vertigo?

As mentioned above, the best exercises to practice depend on the cause of your vertigo, and therefore, you need to talk with your doctor.

Simple exercises to perform at home.

During these exercises, you might feel dizzy. This is totally normal; your brain is getting used to new movement. You need to build tolerance. It is like an exercise when you work your muscles. Pause and rest if you feel nauseated.  

A. Eye exercises

If your vertigo and imbalance are due to eye movements, doing eye exercises might prevent future vertigo attacks1. Those exercises aim to train your eyes movement, so your brain gets used to those kinds of movements2.

Here are examples of eye exercises2:

Exercise 1

  1. Hold and keep eyes fixed on a single target.
  2. Slowly move your eyes from side to side (left to right) for 30 seconds while your head stays still.
  3. Perform this exercise in sitting position
  4. Then progress to the standing position
  5. Now repeat moving up and down
  6. Repeat this exercise 20 times and three sessions per day.

Exercise 2

This exercise will include both eye and head movements:

  1. Hold and keep your eyes fixed on a single target (use your finger or a pen).
  2. Slowly move your eyes and head from side to side (left to right), then up and down for 30 seconds.
  3. Perform in the sitting position and then progress to the standing position as tolerated
  4. Repeat this exercise three times and three sessions per day.

B. Head exercises2

Head movements, when rolling over in bed or getting up in the morning can trigger vertigo3. Doing head exercises can get your brain used to and reduce future vertigo attacks2. Here are simple head exercises to do:

In a sitting position:

  1. Bend your head down to look at the floor then up to look at the ceiling.
  2. Lead your head with your eyes focusing on the floor and the ceiling.
  3. Repeat this 10 times. Stop and wait for symptoms to resolve, about 30 seconds.
  4. Repeat entire process 2 more times.

C. Walking exercises2

  Some of the exercises must be done with eyes closed to work out your balance. When this is the case, please call for assistance, and have a person nearby when you perform those exercises.

Due to balance problems, patients can have vertigo when walking. If you have experienced vertigo attacks when walking, walking exercises can help to reduce future attacks1. Here are exercises you can perform:

Simple tip: Make sure to create a safe environment to practice these exercises. It is important to clear paths throughout your house. You should move rugs and items on the floor.

Exercise 1

  1. Practice walking in a straight line within the room.
  2. First, try to walk with your eyes open.
  3. Repeat walking within the same area, but now with eyes closed.
  4. Practice the above two steps alternatively three times.

Exercise 2

  1. Practice walking in a straight line.
  2. Try to walk with one foot in front of the other or “heel to toe” (the heel of one foot touching the toe of the other foot).
  3. If this is too hard at first, practice walking “almost heel to toe” and gradually work to heel-to-toe touching.
  4. Practice this exercise for five minutes.

Exercise 3

  1. Practice walking in a straight line.
  2. While walking, turn your head and eyes as follows: when you step with your right, look right, and when you step with your left, look left.
  3. Walk on a distance of six meters.
  4. Repeat this exercise three times.
  5. Repeat the entire exercise, but this time, looking at the floor or ceiling.
  6. Rest between repetitions to reduce symptoms.

D. Epley’s Maneuver

Benign paroxysmal positional vertigo (BPPV), a condition affecting the inner ear, is the most common cause of vertigo4. To recover from vertigo due to BPPV, there is one efficient exercise called Epley’s maneuver.

Did you know?
A study found that 72% of patients recovered immediately after Epley’s maneuver, and 92% reported feeling better after one week3.

Epley’s exercise must be done with the assistance of a doctor!4 Discuss this exercise with him or her, he or she will tell you if you are suitable to perform it.

How is Epley’s maneuver performed?5

  1. You are seated, and the doctor turns your head 45 degrees horizontally toward the affected ear.
  2. The doctor tilts you backward to a horizontal position with your head kept in place at a 45-degree turn, hanging. This step might enhance vertigo. You are held in this position until the vertigo stops, usually within a minute.
  3. The doctor turns your head 90 degrees toward the unaffected ear. The doctor then rotates you onto the side of the unaffected ear to make you look at the floor.  This movement can provoke another attack of vertigo. You should stay in this position until the vertigo stops, usually within a minute.
  4. The doctor helps you back to a seated position.

Consult with your doctor to determine which exercises fit your needs. Do not hesitate to ask your doctor questions to make sure that you do the exercises in the right way to make them efficient for your health.

References

  1. Vestibular Disorders Association. Home-based Exercise. https://vestibular.org/article/diagnosis-treatment/treatments/home-based-exercise/. Published 2020. Accessed October 30, 2020.
  2. The University of Mississippi. Vestibular Exercises. https://www.umc.edu/Healthcare/ENT/Patient%20Handouts%20-%20ENT/Otology%20Handhouts/vestibular-exercises-2016.pdf. Published 2020. Accessed October 30, 2020.
  3. Better Health, Victoria State Government. Benign paroxysmal positional vertigo (BPPV). https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/benign-paroxysmal-positional-vertigo-bppv#:~:text=Symptoms%20of%20BPPV,-Activities%20that%20bring&text=Getting%20out%20of%20bed%20or,called%20’top%20shelf%20vertigo. Published 2020. Accessed October 30, 2020.
  4. Gaur S, Awasthi S, Bhadouriya S, Saxena R, Pathak V, Bisht M. Efficacy of Epley’s Maneuver in Treating BPPV Patients: A Prospective Observational Study. Int J Otolaryngol 2015:1-5.
  5. Michigan Medicine. Epley and Semont Maneuvers for Vertigo https://www.uofmhealth.org/health-library/hw205519. Published 2020. Accessed October 30, 2020.
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