How Your Brain Learns to Rebalance After Dizziness

Feeling dizzy or off-balance can be really disruptive, and can make you feel isolated and like you've lost your confidence in yourself. Thankfully, balance rehabilitation can help your brain "rewire" itself to cope after a vestibular problem of the inner ear or a brain injury. A physical therapist can help your brain do this through three main processes: adaptation, habituation, and substitution. Think of them as different ways your brain learns new tricks to keep you steady.

Adaptation: Your Brain Actively Adjusts

Adaptation is like your brain going to the gym to train its balance skills. When your brain or your inner ear isn't working quite right, your vision might get blurry when you move your head. Adaptation helps your brain fix this. It's about actively practicing movements so your brain learns to make tiny, precise adjustments that improve your gaze stability (keeping your eyes steady) and overall balance. I like to explain this as helping to "re-calibrate" everything back into harmony. A common exercise for this is called VOR (vestibulo-ocular reflex) exercises. You'll move your head while keeping your eyes focused on a target, helping your brain recalibrate how your eyes and head work together.

Habituation: Getting Used to What Makes You Dizzy

Habituation is a bit more like getting used to something that initially bothered you. If certain movements or visual patterns trigger your dizziness, habituation helps your brain become less sensitive to them over time. It involves repeatedly exposing yourself to these triggers in a controlled and gradual way, so that it doesn't feel too overwhelming for your nervous system. The goal isn't to make the dizziness disappear instantly, but to gradually reduce how strong and long-lasting your symptoms are. So, if looking at busy patterns makes you dizzy, your therapist might have you look at them for short periods, slowly increasing the time as your brain learns to "ignore" the problematic stimulus.

Substitution: Finding New Ways to Stay Steady

Substitution is all about finding new strategies when a part of your brain or vestibular system isn't working as it should. Your brain learns to rely more on other senses to keep you upright. This often means using your vision (what you see) and somatosensory information (what you feel through your body, like your feet on the ground) more effectively. For example, you might learn to anticipate movements or use visual cues in your environment to guide your balance, essentially finding alternative ways to perform tasks that used to rely heavily on your inner ear, in the case for a vestibular problem.

So, in short:

• Adaptation helps your brain improve the balance functions you still have.

• Habituation helps you become less bothered by things that trigger your dizziness.

• Substitution teaches your brain to use other senses to make up for any lost balance function.

These three processes, guided by a vestibular rehabilitation specialist, like at Great Hope Neuro Physical Therapy, work together to help you regain your balance and reduce dizziness, getting you back to feeling more stable and confident.