With physical therapy, balance problems can be treated to help decrease your fall risk and prevent serious injury. Physical therapists are trained to understand which body systems are out of sync and how to address them. Here’s a closer look at how balance issues develop, how we find where they’re coming from, and what physical therapy for balance actually looks like.
How balance issues develop
We have three major balance systems in our bodies. The brain receives input from each and sends signals to our muscles to make the postural changes that keep us upright.
- Inner ear (vestibular system): gives the brain information about spatial awareness, motion, and head movement, and helps stabilize our head and body during movement. Inner ear problems can develop from aging, trauma, poor nutrition, or disease.
- Vision: helps us navigate the world around us and understand our position in it. As we age, vision can deteriorate and eye tracking can worsen.
- Proprioception (body awareness): sensory receptors in our muscles and joints send detailed information to the brain about how we’re moving. Muscle strength, flexibility, and joint mobility all support this system. Sedentary lifestyles and conditions like diabetes can affect it.
The cardiovascular system matters too: a sudden drop in blood pressure when sitting up or standing can cause lightheadedness or fainting, and heart problems or dehydration can make that worse.
What a balance evaluation looks like
Your physical therapist conducts a detailed evaluation that includes your health history and questions about your balance, such as whether you feel imbalanced with head movement or rolling over in bed, whether you’ve fallen recently, or whether you feel unsteady standing, swaying, or holding onto things while walking. The evaluation then assesses your movement, coordination, strength, balance, and visual tracking, and your therapist will coordinate with other physicians for further testing if needed.
If you answered yes to feeling dizzy or imbalanced
The single most common cause of dizziness treated in the clinic is vertigo, or BPPV. In the inner ear, tiny crystals can break free and fall into one of the semicircular canals, changing how that canal responds to gravity during movement. This type of vertigo typically happens with a change in head position (lying down, rising, rolling over, bending, looking up) and is short-lived. A skilled physical therapist can identify which canal the crystals have fallen into and reposition them, after which the dizziness usually resolves. Any residual unsteadiness can be addressed through targeted exercise and activity.