I like to begin my vestibular physiotherapy assessments with a simple statement: Tell me your story. Everyone has one and they often begin the same way: they’re dizzy. Almost every time, I rudely interrupt them and say:

You’re not allowed to use the D word.

A perplexed, confused, sometimes angry look often crosses the story teller’s face. But why, they ask? That’s what they feel!

Here’s the thing with the word “dizzy” - it means completely different things to different people. Maybe your dizziness feels like the world is spinning around you, or maybe you’re spinning in the world. Maybe you feel like you’re on a boat, rocking side to side or forward and back in a rhythmical fashion. Maybe the ground just won’t stay where it’s supposed to and it comes up at you from the left, from the right with no sense of rhythm whatsoever. Maybe it just feels like you can’t stay on your feet and someone is pushing you to the side, that you’re off balance all the time.

All of these experiences can be very dizzying but they all come from different sources. When you tell your story, using words other than “dizzy” allows me to figure out where your story is going.

Hold on, blog readers - here’s where I go super nerdy.

The inner ear has two parts - the auditory half (this is the snail looking part, the cochlea) and the vestibular half. On the vestibular side, there are two parts:

Semi-circular canals - these fluid filled canals respond to rotation. You have three of them that are at 90 degree angles to each other so they can respond to all the different directions your head can rotate: turning left and right, looking up and down, etc. When you turn your head to the right, the fluid in the horizontal canals turn to the left, trip the little lever in the canal (aka the cupula) and tell you which way your head is turning.
Otoliths (utricle and saccule) - literally meaning “ear rocks”, the otoliths respond to gravity. The crystals, or otoconia, are attached to a glue membrane which together make up the macula. The otoconia are more dense than the fluid in the inner ear and sink, just like rocks in a pool. When you tilt your head, the otoconia pull on the glue membrane, which pulls on the hair cells and tell your brain which was is down.

Different problems with different aspects of your ears will give you different kinds of dizziness. If your story involves vertigo, my brain goes to the semi circular canals - since these are the guys that detect rotational acceleration, they are often somehow involved in your story. When you include a boat or rocking sensation in your story, your sense of gravity is off and the otoliths are often involved.

Maybe your story has a bit of everything - those stories are common! With a thorough vestibular assessment and a good overview of your story, we can often determine the cause of your dizziness (after this blog, how dare I use this word?!) and a treatment plan. If you’re struggling with vertigo, imbalance or anything in between, we can help. Give us a call at (778) 630-8800 or book online at ladnervillagephysio.com.

Thanks for getting nerdy with me!