• Brittany Hollenbeck, DPT

What’s the BIG DEAL about the Vestibular System?

Your vestibular system is a very small structure deep inside your ear (inner ear) that actually plays a HUGE role in your ability to maintain balance, stability, and spatial awareness. This system detects linear and rotational acceleration of your head and helps activate reflexes to keep your eyes on a target while your head moves. If this system wasn’t working properly, you wouldn’t be able to check your blind spot when driving, move your head to scan aisles at a grocery store, or tilt your head back to wash your hair in the shower without a sense of dizziness or disequilibrium. The vestibular system is responsible for allowing you to perform a majority of your daily tasks with balance, and we typically take it for granted.



MAJOR PLAYERS of the Vestibular system

  1. Semi-circular Canals: these 3- little loops are filled with fluid which shifts when your head nods up and down, shakes side to side, or tilts on a diagonal to the left or right. The movement of fluid activates sensory receptors ultimately stimulating a nerve, called the Vestibulocochlear Nerve, and sends signals to your brain to coordinate head, eye, and bodily movements to keep you upright and balanced.

  2. Otolitic Organs: the Utricle and Saccule also play a role in detecting gravitational forces and movement in the horizontal and vertical plane, like jumping up and down on a trampoline or rocking your baby to sleep.

  3. Vestibulo-ocular reflex: this mechanism connects the vestibular system to the muscles of your eyes to allow for stabilization of your gaze when your head moves. In other words, it allows you to have direct contact with your child’s eyes while quickly shaking your head “No!”




With all of these players working together, we can go about our daily activities without dizziness, disequilibrium or vertigo. Problems arise when there is a disruption of one or all of these systems which can result in vertigo. Vertigo is a common symptom that people experience if they have a vestibular disorder. Vertigo makes you feel as if you are spinning or that your environment is spinning. Unless you’re on the Tea Cups ride at Disneyland, this sensation is not normal.


The good news is that there are ways Physical Therapists can treat these symptoms to restore equilibrium within your vestibular system. Vestibular Rehabilitation is a service that we offer here at Rehab United, which includes a thorough examination to determine if you show signs and symptoms of a vestibular disorder, from which we can formulate a plan of care and exercises to help you recover and restore balance in your life.


Brittany Hollenbeck, PT, DPT, FAFS, ATC, BFRC, is a physical therapist, certified vestibular physical therapist, and Clinic Director of Rehab United in La Mesa. She received her Doctorate in Physical Therapy in 2015 from San Diego State University and has stayed at the forefront of evidence-based treatment techniques through various continuing education courses. She has treated numerous injuries and disorders involving musculoskeletal, nervous system, and vestibular pathologies with great success.

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