Physio Focus · Dizziness, vertigo and balance
Vestibular Rehabilitation in Sydney's Sutherland Shire
Vestibular rehabilitation is physiotherapy for some types of dizziness, vertigo and unsteadiness. At Physio Focus Cronulla, physiotherapist Ned Coleman assesses what may be causing your symptoms and, where physiotherapy is suitable, builds an exercise-based plan to help you get back to moving with confidence. We see people from across the Sutherland Shire and southern Sydney.
- Where 3/18 Laycock Ave, Cronulla NSW 2230
- Who Ned Coleman, physiotherapist
- Referral Not needed to book
- Claiming HICAPS for on-the-spot health fund claims
Get medical help first
Call 000 or go to your nearest emergency department if dizziness or vertigo is sudden or severe, or comes with a severe headache, weakness or numbness in the face, arm or leg, facial droop, slurred speech, double vision, difficulty walking or swallowing, sudden hearing loss, chest pain or fainting. When should dizziness be checked by a doctor?
The basics
What is vestibular rehabilitation?
Your vestibular system, the balance organs in your inner ear and the parts of the brain that process their signals, works with your eyes and body to keep you balanced and your vision steady when your head moves. When part of this system isn't working properly, you can feel dizzy, see the world spin, or feel unsteady on your feet.
Vestibular rehabilitation (also called vestibular physiotherapy) is an assessment-led, exercise-based form of physiotherapy. Depending on the cause of your symptoms, it may include repositioning manoeuvres for BPPV, exercises that help your brain adapt to and compensate for faulty balance signals, and balance and walking training.
Research supports vestibular rehabilitation as safe and effective for many people with inner-ear (peripheral) vestibular problems. It isn't the right treatment for every cause of dizziness, which is why it starts with an assessment.
Why people book
Symptoms that may lead to a vestibular assessment
People come to see us when they notice things like:
Spinning (vertigo)
A feeling that you or the room is spinning or moving when you're still, often brought on by rolling over in bed, lying down or looking up.
Dizziness with head movement
Feeling dizzy, "off" or sick when you turn your head, bend down or move quickly.
Unsteadiness
Feeling off-balance when standing or walking, especially in the dark, on sand or uneven ground, or when turning.
Busy places and screens
Dizziness in supermarkets, crowds or traffic, or when scrolling or watching moving images.
Blurred vision when moving
Trouble keeping your vision steady when you walk or turn your head, such as when reading signs.
Lingering symptoms
Dizziness or imbalance that hasn't settled weeks after an inner-ear illness or a vertigo episode.
These symptoms have many possible causes, and not all of them are physiotherapy problems. Not sure what you're feeling? Read vertigo vs dizziness: what's the difference?
Conditions
Conditions vestibular physiotherapy may help with
Your assessment helps work out which of these, if any, fits your symptoms. Some are managed by physiotherapy alone. Others are led by your GP or a specialist, with physiotherapy as one part of the plan.
BPPV (benign paroxysmal positional vertigo)
Brief spinning vertigo triggered by head position, caused by tiny inner-ear crystals moving into the wrong place. It is one of the most common causes of vertigo and is usually treated with a repositioning manoeuvre such as the Epley. BPPV explained
After vestibular neuritis or labyrinthitis
Inflammation of the balance nerve or inner ear can leave ongoing dizziness and unsteadiness. Exercises help the brain compensate for the reduced balance signal from the affected side.
Vestibular migraine
Recurring vertigo or dizziness linked with migraine, sometimes without a headache. It is diagnosed and medically managed by your doctor. Physiotherapy may help with movement sensitivity and balance between episodes. Headaches and dizziness
Persistent postural-perceptual dizziness (PPPD)
Ongoing non-spinning dizziness, often worse when upright, moving or in busy visual environments. It is usually managed by a team, and graded vestibular exercises can be one part of that.
Neck-related (cervicogenic) dizziness
Unsteadiness linked with neck pain or stiffness, considered once other causes have been ruled out. It may be managed with neck treatment and balance exercises. See also neck pain physiotherapy.
Imbalance and reduced walking confidence
Feeling unsteady, or worried about falling, can come from the balance system, strength, or a mix of both. Balance and walking training is tailored to what the assessment finds.
Conditions such as Ménière's disease are medically managed by a GP and ENT specialist. If your assessment suggests a cause that needs medical review, we'll recommend you see your GP.
Your first appointment
What happens at a vestibular assessment
Your first appointment starts with a detailed history and an assessment. This helps work out whether your symptoms are likely to come from the vestibular system, and whether physiotherapy is suitable for you.
Read the full guide to a vestibular assessment
Your story
What the dizziness feels like, how long episodes last, what triggers them, your hearing, headaches, medications and general health, plus screening for warning signs.
Eye-movement tests
Because the inner ear and eyes are closely linked, how your eyes move with your head tells us a lot about the balance system.
Positional tests
If your symptoms come with head position, tests such as the Dix-Hallpike check for BPPV. These can briefly bring on vertigo, which is expected.
Balance, walking and neck
Standing and walking tasks show how well your body is compensating, and a neck screen checks movement and safety for testing.
Findings and a plan
An explanation in plain language, and either a treatment plan or a recommendation to see your GP.
Treatment
How vestibular rehabilitation treatment works
Treatment is matched to the cause of your symptoms and progressed as you improve. Depending on your assessment, it may include:
Repositioning manoeuvres
For BPPV: guided head and body positions, such as the Epley manoeuvre, that move loose inner-ear crystals back to where they don't cause symptoms. The manoeuvre is chosen to suit the affected ear and canal.
Gaze stabilisation
Exercises that train the reflex keeping your vision steady while your head moves, so the world stops blurring or jumping when you walk or turn.
Habituation
Controlled, graded repetition of the movements or environments that trigger your dizziness, so your brain gradually becomes less sensitive to them.
Balance and walking training
Progressive balance tasks built around your goals, whether that's walking on the sand, getting back to the gym, surfing or returning to sport.
Most programs include exercises to do at home between sessions, with education about your condition and advice on returning to normal activity. How vestibular exercises work
Your physiotherapist
Meet Ned Coleman
Ned graduated with a Bachelor of Physiotherapy (Honours) from the Australian Catholic University in 2018 and has worked in private practice ever since. He works at Physio Focus Cronulla.
Ned has a strong interest in vestibular rehabilitation for patients with vertigo and dizziness, and has completed training overseas with experts in this field. He also treats acute sporting injuries and chronic musculoskeletal conditions, and is experienced in running assessment, Pilates and sports physiotherapy.
A keen surfer, runner, AFL and soccer player himself, Ned believes good rehabilitation is the key to minimising the risk of recurring problems.
Physio Focus
Why choose Physio Focus for vestibular rehabilitation
Assessment first
We start by working out whether physiotherapy suits your symptoms, and tell you if something needs a doctor's review instead.
A plan you can follow
Clear explanations and a home program progressed at each review.
Part of a wider team
Physio Focus has four Sutherland Shire clinics, including headache physiotherapy, Pilates and a rehab and performance centre.
Easy claiming
No referral needed to book, and HICAPS for on-the-spot health fund claims.
Where vestibular rehabilitation is offered
Physio Focus Cronulla
Vestibular appointments with Ned are held at our Cronulla clinic.
Address: 3/18 Laycock Ave, Cronulla NSW 2230
Phone: (02) 9544 4884
Email: cronulla@physiofocus.com.au
Opposite Monro Park and a short walk from Cronulla station, convenient for people across the Sutherland Shire, including Cronulla, Woolooware, Caringbah, Miranda, Sutherland, Engadine and Kurnell, and from neighbouring southern Sydney suburbs. More about the Cronulla clinic
Opening hours
| Monday | 2:00pm – 7:30pm |
|---|---|
| Tuesday | 7:30am – 7:30pm |
| Wednesday | Closed |
| Thursday | 7:30am – 7:30pm |
| Friday | 7:30am – 12:30pm |
| Saturday | Closed |
| Sunday | Closed |
Questions
Vestibular rehabilitation FAQs
Do I need a referral?
No. You can book directly with Physio Focus Cronulla. If your dizziness is new and hasn't been checked by a doctor, it's a good idea to see your GP as well. If you want to claim through Medicare, you'll need a chronic condition management plan from your GP.
Can physiotherapy help vertigo?
It can for some causes. BPPV, one of the most common causes of vertigo, is usually treated with a repositioning manoeuvre, and ongoing dizziness after an inner-ear illness often responds to vestibular exercises. Other causes need medical care. Your assessment helps work out which applies to you.
How many sessions will I need?
It depends on the cause and how long you've had symptoms. Many people with BPPV notice improvement after one or a few treatments, while rehabilitation for longer-standing dizziness usually runs over several weeks with home exercises between sessions. Ned will talk you through what to expect after your assessment.
Will the assessment make me dizzy?
Some tests can briefly bring on your symptoms. That's expected and helps identify the cause. Ned will explain each test first and make sure you're feeling okay before you leave.
Can I drive to my appointment?
If your symptoms make driving unsafe, please arrange a lift. You may also feel briefly unsteady after testing or a repositioning manoeuvre, so some people prefer not to drive home.
What should I bring?
A list of your medications, any test results or letters from your doctor or specialist, and notes on when your symptoms started and what triggers them. Wear comfortable clothes, as you may lie down during testing.
Can I claim on private health insurance?
If your extras cover includes physiotherapy, you can usually claim a rebate. The clinic has HICAPS for on-the-spot claims. Rebates depend on your fund and level of cover.
What if my dizziness isn't vestibular?
Dizziness has many causes, including blood pressure, medications, heart problems and anxiety. If your assessment suggests your symptoms aren't coming from the balance system, or need medical investigation, we'll tell you and recommend you see your GP.
Learn more
Guides to dizziness, vertigo and balance
Conditions
Your appointment
Treatment
Vestibular exercises: gaze stabilisation, habituation and balance
Headaches
Safety
Related services at Physio Focus: headache physiotherapy · neck and back pain · Pilates
Book a vestibular assessment in the Sutherland Shire
Book online with Ned Coleman, or call the clinic if you'd like to check whether vestibular rehabilitation is right for you.
This page is general information and isn't a substitute for individual medical advice. In an emergency, call 000.