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Vestibular rehabilitation exercises: a balance routine for dizziness

For dizziness or unsteadiness that has lasted after an inner-ear illness, once a GP has checked it and agreed these exercises suit you. Start with the head turns, nods and gaze exercise from our vertigo guide, sitting down, then do this balance work next to a kitchen counter or a sturdy chair. It should make you mildly dizzy: that's how it works. Do it every day, ideally between attacks rather than during one. It won't treat benign paroxysmal positional vertigo (BPPV), the brief spins when you lie down or roll over, which needs a repositioning manoeuvre.

15 minBeginner7 movesA wall · Cardio machineCalves · Hip abductors · Hip flexors · Glutes · Quads
Follow along: a timer, a cue and the next move, one step at a time.

Settle, sitting (about 5 minutes)

  1. Slow breathing (6 breaths a minute)1 min
    Beginner · 3D demoSit on a firm chair with a bed or sofa beside you, and breathe slowly: no more than one breath every 4 to 6 seconds. Then do the head turns, nods and gaze exercise from the vertigo guide, still sitting, before you standEasier: Breath reachHarder: Crocodile breathing (prone diaphragmatic breathing)

Balance at the counter (about 4 minutes)

  1. Semi-tandem stance2 holds of 20 s each side
    Beginner · Calves, Hip abductors · 3D demoFingertips on the counter. When this is steady, turn your head slowly from side to side as you hold, if your physio has shown youHarder: Tandem stance and heel-to-toe walk
  2. Tandem stance and heel-to-toe walkHold 20 s, then 5 to 10 steps
    Beginner · Calves, Hip abductors · 3D demoLook ahead, not at your feet. Once it's easy, turn your head slowly side to side as you hold, if your physio has shown youEasier: Semi-tandem stanceHarder: Single-leg stand
  3. Single-leg stand2 holds of 5 to 10 s each leg
    Beginner · Hip abductors, Calves, Glutes · 3D demoFingertips on the counter; lift one finger at a time as you improve. Add head turns only when the hold is easyEasier: Tandem stance and heel-to-toe walkHarder: Single-leg reach matrix

Stepping (about 2 minutes)

  1. Standing march1 min
    Beginner · Hip flexors, Abs, Glutes · 3D demoNext to the counter. When you're steady, turn your head slowly left and right as you marchHarder: Standing band hip flexion
  2. Side-stepping (sideways walking)10 steps each way
    Beginner · Hip abductors, Glutes, Adductors · 3D demoAlong the counter, eyes aheadHarder: Lateral band walk

Walk (5 to 10 minutes)

  1. Treadmill walking5 to 10 min
    Beginner · Quads, Calves, Glutes · 3D demoAlong a corridor or outdoors, with someone at first. When you're steady, turn your head left and right every few stepsHarder: Treadmill jogging

Finish

  1. Slow breathing (6 breaths a minute)1 min
    Beginner · 3D demoSit until any dizziness settles before you get upEasier: Breath reachHarder: Crocodile breathing (prone diaphragmatic breathing)

Tips

  • Before the balance work, do the head turns and nods and the gaze exercise from the steps on our vertigo guide, sitting down: 10 movements in 10 seconds, rest 10 seconds, then 10 more. Score how dizzy each makes you from 0 to 3, and practise the ones that score 1 to 3 every day.
  • Do everything next to a wall, a kitchen counter or a sturdy chair, with a bed or sofa nearby, on a clear floor in good light.
  • Mild dizziness during and just after is expected. Stop, and see a doctor before restarting, if you get anything new or severe: sharp or lasting pain in your neck, head or ear, a full feeling or new noises in the ear, deafness, double vision, fainting, or numbness, weakness or tingling in your arms or legs.
  • Call 999 (911 in the US) for vertigo with double vision or loss of vision, hearing loss, trouble speaking, or weakness or numbness in an arm or leg.
  • Head turns during the balance moves are a later step: add them once a hold is steady, and only if your physiotherapist has shown you or the hold feels easy.
  • Recovery takes about 6 weeks even with the exercises. A physiotherapist can tailor them for you, and you may be able to refer yourself.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

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Questions people ask

How long does the vestibular rehabilitation exercises: a balance routine for dizziness take?

About 15 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: A wall, Cardio machine. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 3 of its 7 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.