Concussion Care, Vestibular Rehab and Dizziness

Concussion recovery is challenging, but can be improved with timely care. Dr. David Blair will assess your symptoms and work with you to design a program to gradually improve your tolerance levels for work and play. We treat using hands-on therapy and acupuncture for neck, back, and shoulder pain.

Concussion management includes:

• Thorough assessment of each body system

• Education to patient and family

• Clear communication with coaches

• Detailed written return to play schedule

• Home program to maximize recovery

• Balance & agility retraining

• Visual retraining

Concussions are mild traumatic brain injuries resulting in changes to our:

• Balance

• Mood

• Physical performance

• Emotions

• Cognition

• Memory

• Visual disturbance

Vertigo is a specific type of dizziness where you feel like you or your surroundings are spinning or moving, even when you’re still. It’s a symptom — not a disease — and usually relates to problems in the vestibular system, which includes:

• The inner ear (balance organs)

• The vestibular nerve

• The parts of the brain that process balance

Common Causes of Vertigo

1. Benign Paroxysmal Positional Vertigo (BPPV)
   The most common cause. Tiny calcium crystals in the inner ear become displaced, triggering brief spinning episodes with head movement.

2. Vestibular neuritis
   Inflammation of the vestibular nerve, often after a viral infection. Causes sudden, intense vertigo.

3. Ménière’s disease
   Associated with vertigo, hearing loss, ear fullness, and ringing (tinnitus).

4. Vestibular migraine
   Vertigo related to migraine activity, sometimes without a headache.

A Vestibular Physiotherapist has advanced training in assessing and treating balance disorders.

1. Accurate Assessment

They perform specialized testing:

• Eye movement testing

• Positional testing (like the Dix-Hallpike test)

• Balance and gait assessment

This helps identify whether it’s BPPV, neuritis, migraine-related, etc.

2. Repositioning Maneuvers (For BPPV)

If you have BPPV, they use specific head movements such as:

• Epley maneuver

• Semont maneuver

These reposition displaced crystals — often resolving symptoms in 1–3 treatments.

3. Vestibular Rehabilitation Therapy (VRT)

For ongoing dizziness, they design exercises to:

• Improve brain adaptation (neuroplasticity)

• Reduce motion sensitivity

• Improve balance and stability

• Reduce fall risk

Exercises may include:

• Gaze stabilization drills

• Balance training

• Gradual exposure to triggering movements

How Vestibular-Certified Chiropractors Help

Some chiropractors complete additional training in vestibular rehab.

They may provide:

1. BPPV Treatment

Many are trained to perform:

• Epley maneuver

• Canalith repositioning procedures

2. Balance & Neurological Rehab

Some focus on:

• Eye–head coordination exercises

• Proprioceptive training

• Postural correction

3. Cervicogenic Dizziness Management

If dizziness originates from neck dysfunction (after whiplash, poor posture, injury), treatment may include:

• Gentle cervical mobilization

• Soft tissue therapy

• Postural retraining

• Strengthening deep neck stabilizers

Vertigo can sometimes signal something serious. Seek immediate medical attention if you experience:

• Sudden severe headache

• Double vision

• Slurred speech

• Weakness or numbness

• Difficulty walking

• Chest pain

These could indicate stroke or other neurological emergencies.