Dear Fiona,
I’ve been doing my vestibular rehabilitation exercises for several months now. They’ve helped, but I’m wondering—how long do I need to keep doing them? Will I ever be able to stop?
—Tired of Tilting
Dear Tired,
First, I would like to acknowledge your dedication to vestibular rehabilitation therapy (VRT). Maintaining such consistency is not easy, especially when progress can feel slow or unpredictable. Your commitment is commendable, and your question about the duration of these exercises is one I hear often.
Here’s the short answer: it depends on your unique situation, including your diagnosis, your progress, and your goals. But I’ll break it down for you.
🔁 Vestibular Rehab Is a Process, Not a Quick Fix
Vestibular rehabilitation retrains your brain and body to adapt to changes in balance, motion sensitivity, and spatial orientation. For many people with vestibular disorders—like vestibular migraine, bilateral vestibulopathy, PPPD (Persistent Postural-Perceptual Dizziness), or BPPV—VRT is essential in reducing symptoms and regaining function.
Some people see progress after six weeks of vestibular therapy. However, others may need a long-term or even lifelong maintenance routine to stay stable.
🧠 Think of It Like Brain Training
Like physical fitness or managing a chronic health condition, your vestibular system may need ongoing support. If you stop the exercises too soon, mainly before your system has fully compensated or habituated, you might notice symptoms creeping back in. But rest assured, we’re here to support you every step of the way.
That’s why many vestibular therapists recommend:
🧍♀️ Gradually tapering the frequency and intensity of exercises instead of stopping cold turkey.
⏱️ Checking in with a vestibular therapist every few months to assess progress and adjust your routine.
🚶♂️ Maintaining a base level of activity, especially if motion, visual stimuli, or stress trigger your symptoms.
🧰 Signs You May Still Need VRT
You might still benefit from continuing your vestibular exercises if:
- You’re experiencing fluctuating or recurring symptoms
- You’re avoiding specific movements or environments due to the fear of dizziness
- Your balance feels off when you’re tired, stressed, or in a busy visual environment
If that’s the case, VRT can serve as a tune-up tool—not something you have to do for hours a day, but something you can use as needed.
🏁 When Can You Stop?
Some people with less complex vestibular issues—like positional vertigo (BPPV)—may be able to stop once their symptoms resolve. Others with chronic or fluctuating vestibular conditions may benefit from having a “maintenance plan” in place indefinitely, even if it’s just 5–10 minutes a day.
The key is to listen to your body and work closely with your healthcare provider or vestibular therapist to monitor your progress. Remember, you are an active participant in your recovery, and your efforts are crucial.
Keep in mind that general conditioning exercises play a crucial role in recovery, beyond simply alleviating symptoms. Individuals with vestibular dysfunction often become deconditioned due to avoiding provocative activities and/or being fearful of activities and negotiating particular environments. Consider walking and stationary biking to get you moving more—progress beyond that by walking in busier environments and on uneven surfaces, and also by biking outdoors. If there’s a particular recreational activity you enjoy, go for it! Being active will improve your prognosis, function, and overall health.
💡 Fiona’s Final Thought
Don’t think of your exercises as a burden—they’re a tool to help you stay grounded, mobile, and confident. Even if you eventually reduce how often you do them, having them in your toolkit gives you control over your symptoms. And that’s powerful.
You’ve come this far. Keep going—you’ve got this. 💪
Wishing you steadier days,
Yours truly, Fiona Flamingo, Your Vestibular Support Guide at VeDA, with help from my PT buddy, Denise Schneider, DPT, FAAOMPT, ATC
