ICU – “I See You” Podcast
Yoga for Balance
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In this episode of the ICU Podcast, we exploring how yoga can be a powerful, complementary tool for improving balance in people with vestibular disorders. Vestibular conditions disrupt the delicate interplay between the inner ear, vision, and somatosensory systems, often leading to dizziness, instability, and compensatory stiffness. Yoga offers a gentle, embodied pathway to re-train balance by engaging controlled movement, focused breathing, and meditative awareness — all of which can help patients recalibrate their vestibular reflexes, reduce dizziness episodes, and restore coordination and confidence in movement.
Guests
Emma Rodgers is a certified yoga teacher, originally from the UK and now based in Melbourne, Australia. Emma’s journey began after finding yoga and meditation incredibly beneficial for managing her own symptoms of Vestibular Migraine and PPPD, which led her to train as a teacher. She uses her personal experience to inform her teaching style, making it more accessible through safe, gentle practices.
Denise Schneider is a physical therapist who has been practicing in outpatient orthopedics clinics for 23 years. During this time, she has furthered her education to receive a doctorate in physical therapy, a fellowship degree in differential diagnosis and manual therapy, a certificate in vestibular rehabilitation, and a certification in dry needling. She received her 200-hour yoga training certification in 2023. Since then, she has taught various classes and also utilizes this knowledge in her physical therapy practice. Denise is dedicated to providing the utmost patient experience by incorporating evidence-based practice and individualized care to include all aspects of one’s health and well-being. She is a proud ambassador of and contributor to VeDA.
Summary
Emma’s Journey: From “Dark Shadow” to Sustainable Life with Vestibular Migraine and PPPD
Emma describes being about seven years out from her first vestibular symptoms and now living a “consistent quality of life.” She still has dizzy days and flare-ups, but she emphasizes that her dizziness no longer holds her back from major life goals—she’s even relocated from the UK to Melbourne, Australia. Because her life now feels stable, she doesn’t talk about her recovery as much, but she knows how far she’s come.
Her symptoms began suddenly in 2018, when she was working as a primary school teacher—a role she describes as overstimulating, consuming, and demanding, especially for someone with perfectionist tendencies. Already a migraine sufferer with visual aura since her teens, she was pushing herself hard, “burning the candle at both ends” in a noisy, visually busy classroom environment. Then, in a single instant, she felt as if a “dark shadow came down and never lifted.” From that moment, she no longer felt normal, and the change was both dramatic and frightening.
The early months were marked by confusion, fear, and a lack of understanding—both her own and that of the medical professionals she saw. She had never heard of balance disorders, didn’t know anyone with similar issues, and bounced between different specialists—neurologists, ENTs, chiropractors—chasing any suggestion of hope. She was signed off work for months and eventually had to leave teaching altogether because her body was stuck in a state of panic and disorientation.
Emma didn’t receive a diagnosis for about a year and a half. It was actually the online patient community that first pointed her toward the concept of vestibular migraine. Reading about symptoms like feeling “spaced out” and “almost like I’m not here” finally gave language to her experience. From there, she pursued more targeted specialists, eventually receiving a diagnosis of vestibular migraine and starting the long process of trial-and-error treatment.
In the very beginning, even walking outside felt beyond her capacity. That’s when she discovered yoga, initially through very short, gentle YouTube videos—five or ten minutes at a time, entirely floor-based. Practicing on her living room floor felt safe: if she was already on the ground, she couldn’t fall. She gravitated toward “slow flow” and “gentle flow” styles, deliberately avoiding the fast-paced, visually intimidating vinyasa practices she saw on social media, where people stood on one leg or did advanced balances—something that felt unthinkable while dizzy.
Over time, these small practices became more manageable, and she slowly expanded what she could tolerate. She emphasizes that the big turning point wasn’t just the movement, but the way yoga gave her tools she could use in everyday life—especially meditation and breath work. These practices helped her calm her nervous system during real-world triggers: on public transport, at work, or in moments of anxiety unrelated to dizziness. Yoga stopped being just something she did “on the mat” and became a portable set of tools to regulate her body and emotions.
Emma also highlights the psychological impact of recovery stories. Early on, she mostly saw worst-case scenarios online—people struggling for decades with no clear hope. The rare stories of people who had come through the darkness to regain a good quality of life became lifelines. That’s why she believes it’s crucial to share positive trajectories: for someone in crisis, simply knowing that “it can get better” is sometimes enough to get them out of bed on a hard day.
As a teacher now, Emma builds into her classes the lessons she learned from her own dizziness:
- Starting low to the ground and keeping the stance wide to feel more grounded.
- Practicing barefoot to increase contact and feedback from the floor.
- Slowing transitions—for example, coming up from a forward fold with eyes closed, pausing, then opening the eyes slowly to avoid abrupt sensory shifts.
- Framing yoga as an internal, non-competitive practice, where the goal is not a “perfect pose” but what feels safe and supportive in your body that day.
- Encouraging students to communicate with their teacher about symptoms and to feel empowered to pause, modify, or opt out of poses.
She notes that everyone wobbles in balance poses—even people without vestibular disorders. As a teacher, she can see a whole room subtly swaying, and she wants vestibular patients to know that wobbling is normal, not a sign that they’re uniquely failing. Yoga challenges the balance system in all bodies; dizziness just makes us more aware of it.
Ultimately, the greatest gift yoga has given her is nervous system regulation. She came to yoga for movement and balance, but stays for the mental health and autonomic benefits. The fight–flight–freeze response is so often triggered in vestibular disorders, and meditation and breath work have become long-term companions that will support her well beyond the acute phase of her illness.
Denise’s Clinical Perspective: Where Yoga and Vestibular Rehab Overlap
Denise, a vestibular physical therapist who also holds yoga training, explains that there is substantial overlap between conventional vestibular rehabilitation and yoga. In the clinic, she works on:
- Balance and proprioception (body awareness in space)
- Mindfulness and relaxation
- Postural and core strength
These are also foundational elements of many yoga practices. Depending on where a patient is in their recovery, yoga-informed strategies can be integrated at different levels of intensity.
For more sensitized patients whose systems need calming, Denise might focus on meditation, mindfulness, gentle breathing, and restorative poses rather than vigorous movement. For those who are a bit further along—able to tolerate more motion but still needing caution—she may incorporate chair-based yoga, seated sequences, or mat-based practices with slow, controlled transitions. As patients progress and their balance improves, they can advance to more standing work or flow-based sequences such as vinyasa, if appropriate.
Denise points out that in physical therapy, she doesn’t always use “yoga language,” especially with patients who are skeptical of yoga or have preconceived notions about it. Instead, she frames movements and strategies in clinical terms while still drawing on yoga principles. For patients who do enjoy yoga or want to return to it, she deliberately facilitates that, either by guiding relevant movements in the clinic or helping them find classes and resources elsewhere.
From a safety standpoint, Denise emphasizes several clinical considerations when introducing yoga-like movement to vestibular patients:
- Balance support: Early on, it may be safer to emphasize mat or seated work. If patients are standing, she recommends having a chair or support nearby and ensuring the patient feels safe, not just that they look objectively stable.
- Positional triggers: Poses like downward-facing dog can be problematic for people whose symptoms are triggered by bending, head movements, or rapid changes in head position.
- Visual input: Some patients are more comfortable with eyes open, fixed on a target; others may do better with eyes closed. This is individualized and should be factored into practice.
- Environment: Busy, cluttered, or crowded spaces—whether a PT clinic on a hectic day or a packed yoga studio—may overwhelm some vestibular patients. Scheduling quieter times or choosing calmer settings can help.
- Sensory sensitivity: People with vestibular migraine may react strongly to smells, bright lights, and other environmental stimuli, so these need to be considered when selecting where and how they practice.
Clinically, Denise uses both objective tests and patient-reported experience to decide when someone is ready to progress—from lying to sitting, from sitting to standing, and from simple to more complex balance challenges. She assesses vestibulo-ocular reflex function, balance with eyes open/closed, and tolerance for specific positions. Just as importantly, she evaluates “irritability” of symptoms: how intense they are, how long they last after activity, and how quickly a patient recovers. If mat-based exercises become easy and minimally symptomatic, that’s a cue to gently advance to more challenging positions.
In terms of yoga styles that align well with vestibular rehab, Denise highlights:
- Restorative yoga: Long-held, supported poses that promote deep relaxation and allow the nervous system to settle.
- Hatha yoga: Slower, more deliberate transitions and longer holds, as opposed to fast vinyasa flows.
- Meditation and mindfulness: Encouraging patients to tune into bodily sensations, notice mild dizziness without panic, and use habituation principles—feeling a little bit of discomfort, then easing out before the system becomes overwhelmed.
She also resonates with the idea that patients often feel pressure to be the “best” therapy patient, pushing too hard and worsening symptoms. In vestibular rehab, as in yoga, more is not always better. The work has to be paced, patient-led, and responsive to the nervous system’s limits.
Together, Emma and Denise paint a picture of yoga as a flexible, highly adaptable companion to vestibular rehabilitation—one that can start with five minutes on the floor at home and grow into a lifelong toolkit for balance, nervous system regulation, and resilience in the face of ongoing symptoms.
