• ChoosePT Guide

    Physical Therapy 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. If you have experienced a head injury, please seek medical attention immediately.

    Physical therapists work with people with inner ear trauma to help them restore their balance and movement. They provide treatments to help maintain clear vision during head movements and decrease or eliminate dizziness in many cases.

    You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.

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    What Is Inner Ear Trauma?

    Trauma, such as hitting your head hard enough to cause concussion or injure your neck in a fall while playing sports or in a car accident, can damage the structures of your inner ear. The inner ear contains the peripheral vestibular system, which plays a major role in keeping your balance. The system is composed of five sensory organs — three semicircular canals, the saccule, and the utricle — and sits close to the sensory organ for hearing called the cochlea. These inner ear structures convert movement and sound into signals sent to the brain.

    InnerEar_ChoosePT Illustration

    The inner ears tell the brain how the body is moving in relation to gravity and help us keep our heads stable as we move. In addition, the inner ears communicate information about head motion, which the brain uses to coordinate eye motion. All of these systems work together to maintain our proper balance and movement. When one part of this signal chain experiences trauma, it can disrupt the flow of information, causing a range of symptoms.

     

    Signs and Symptoms

    When the inner ears are injured, you may experience:

    • Vertigo (you feel like the room or you are spinning).
    • Dizziness (you feel light-headed).
    • Unsteadiness (you feel off-balance when walking or standing).
    • Unclear vision and/or double vision.
    • Neck pain.
    • Problems with hearing.

    Symptoms vary from person to person and usually depend on the type and extent of injury. You may notice that your symptoms increase when you move your head.

    When you experience unpleasant symptoms like these, you might begin to restrict your level of activity. You may even stop participating in some tasks at home and at work. But restricting your activities can slow your recovery from an inner ear injury.

     

    How Can a Physical Therapist Help?

    Your physical therapist will first evaluate your condition. They will ask you questions and perform tests to determine the causes of your symptoms and assess your risk of falling. These tests will also examine how your head and eyes move. Depending on the results of the tests, your physical therapist may recommend further testing or suggest that you consult with your physician.

    Based on their findings during your evaluation and your goals for recovery, your physical therapist will customize a treatment plan just for you. The specific treatments will depend on the cause of your symptoms. Your physical therapist's main focus is to help you manage your symptoms and to get you moving again.

    Treatment may include specialized exercises to:

    • Decrease or eliminate dizziness.
    • Improve balance.
    • Restore clear vision during head movements.

    If you also have stiffness or pain in your neck, your physical therapist will prescribe exercises and treatments to help reduce the pain and improve your ability to move your neck.

    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 well-being.

    Recovery from inner ear trauma takes patience and time. It's very important that you get back to your normal activities and movements as safely and as soon as possible. Your physical therapist will help you do just that. Avoiding movements and activities that make you dizzy may only complicate your recovery.

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

    • If certain activities or chores around the house cause you to become dizzy, your physical therapist will show you how to do those activities in a different way to help reduce your dizziness.
    • If simple activities become too difficult and cause fatigue and more dizziness, your physical therapist can help you work through these symptoms right away. Early treatment will help you 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 rehabilitation focus.
    • A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in neurological physical therapy. This physical 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, friends, or other health care providers.
    • When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people with an 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.

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    Further Reading

    The American Physical Therapy Association believes that consumers should have access to information that could help them make health care decisions, and also prepare them for a visit with their health care provider.

    The following articles provide some of the best scientific evidence related to physical therapy treatment of inner ear trauma. The articles report recent research and give an overview of the standards of practice both in the United States and internationally. The article titles are linked either to a PubMed abstract of the article or to free full text, so that you can read it or print out a copy to bring with you to your health care provider.

    Dunlap PM, Holmberg JM, Whitney SL. Vestibular rehabilitation: advances in peripheral and central vestibular disorders. Curr Opin Neurol. 2019;32(1):137–144. Article Summary in PubMed.

    Kleffelgaard, I, Soberg, HL, Tamber, AL, et al. The effects of vestibular rehabilitation on dizziness and balance problems in patients after traumatic brain injury: a randomized controlled trial. Clin Rehabil. 2019;33(1):74–84. Article Summary in PubMed .

    Whitney SL, Alghadir AH, Anwer S. Recent evidence about the effectiveness of vestibular rehabilitation. Curr Treat Options Neurol. 2016;18(13):13. Article Summary in PubMed.

    Kolev OI, Sergeeva M. Vestibular disorders following different types of head and neck trauma. Funct Neurol. 2016;31(2):75–80. Article Summary in PubMed.

    Reviewed and revised in 2020 by Jasmine Edwards, PT, DPT, board-certified clinical specialist in neurologic physical therapy, on behalf of the American Academy of Neurologic Physical Therapy. Authored in 2011 by Lisa Dransfield, PT, DPT; Bob Wellmon, PT, PhD, board-certified clinical specialist in neurologic physical therapy; and the American Academy of Neurologic Physical Therapy.

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