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    Move Forward Guide

    Physical Therapist's Guide to Inner Ear Trauma

    Your inner ear is critical to keeping your balance. Sometimes when the head is injured in an accident or a fall, the inner ears are injured as well.


     

    What Is Inner Ear Trauma?

    Trauma—such as hitting your head in a fall or injuring your neck in a car accident—can damage the structures of your inner ear. The inner ear contains the “peripheral vestibular system, which plays a big role in keeping your balance. The inner ears tell the brain how the body is moving in relation to gravity. In addition, the inner ears communicate information about head motion, which is used to coordinate eye motion.

     

    Signs and Symptoms

    When the inner ears are injured, you may have:

    • Vertigo (you feel like the room is spinning)
    • Dizziness (you feel lightheaded)
    • Unsteadiness
    • Unclear vision
    • Neck pain

    Symptoms vary from person to person and usually depend on the type and extent of injury.

    Because of the unpleasant symptoms, you might begin to restrict your level of activity, and you might even stop participating in your roles at home and at work. But restricting your activities because of these symptoms can actually slow your recovery from an inner ear injury.

     

    How Can a Physical Therapist Help?

    First, your physical therapist will perform tests to determine the causes of your symptoms and also to assess your risk of falling. Depending on the results of the tests, your therapist may recommend further testing or consultation with your physician.

    Based on your physical therapist's evaluation and your goals for recovery, the therapist will customize a treatment plan for you. The specific treatments will depend on the cause of your symptoms. Your therapist's main focus is to help you get moving again and manage the symptoms at the same time. Treatment may include specialized exercises to:

    • Decrease or eliminate dizziness
    • Improve balance
    • Restore clear vision when the head is moving

    If you also have stiffness or pain in your neck, your physical therapist will prescribe exercises and treatments such as manual therapy to help reduce the pain and stretch your muscles. In addition, your physical therapist might prescribe exercises to improve your strength, your flexibility, and your heart health—with the goal of improving your overall physical health and well-being.

    Recovery takes patience and time, sometimes months; so it's very important that you get back to your normal activities as soon as possible. Avoiding movements and activities that make you dizzy may only complicate your recovery from inner ear problems caused by trauma.

    Your physical therapist will teach you strategies to help you cope with your symptoms

    • Do certain activities or chores around the house cause you to become dizzy? Your therapist will show you how to do those activities in a different way to help reduce the dizziness.
    • Have simple activities become difficult and cause fatigue and more dizziness? Your therapist will help you work through these symptoms right away so you can get moving again and return to your roles at home and at work more quickly.
     

    What Kind of Physical Therapist Do I Need?

    All physical therapists are prepared through education and experience to treat dizziness and balance problems. You may want to consider:

    • A physical therapist who is experienced in treating people with neurological problems. Some physical therapists have a practice with a neurological or vestibular rehabiliation focus.
    • A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in neurological physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.

    You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

    General tips when you're looking for a physical therapist (or any other health care provider):

    • Get recommendations from family and friends or from other health care providers.
    • When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people with inner ear injury.
    • During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.

     Authored by Lisa Dransfield, PT, DPT; Bob Wellmon, PT, PhD, NCS; and APTA's Section on Neurology. Reviewed by the MoveForwardPT.com editorial board.

     

    Further Reading