Vestibular Rehabilitation: Improving My Balance to Improve My Brain
My daily routine a few months back was way different from that of anyone I know. There was the usual stuff: brushing teeth, showering, eating breakfast. Then there were some very unorthodox daily exercises I was doing…like walking backward with my eyes closed, while tilting my head in an X pattern. As far as I know, those are more than a little uncommon.
Years ago, I wouldn’t have thought that this kind of awkward walking could improve both my thinking ability and my athletic ability. Now I know that there is plenty of evidence that it can do both.
On the Surface
A while ago I got diagnosed with ADHD and learning disabilities, which was a real eye-opener. But the more I learn about the brain and gradually peel back the layers of complexity involved in what is going on with my particular brain, the more I start to connect pieces of a puzzle-like in a murder mystery.
For example, from a young age, I had a funny walk reminiscent of Monty Python’s Ministry of Silly Walks. My feet pointed out to the side like a duck, and I zig-zagged when I walked. It was so pronounced, that it was really easy to bump into people on the street when walking past them. It was so comical, that a good friend of mine since childhood still makes fun of me to this day.
My athletic ability sucked. I got picked dead last or next to last every time we played any sort of sport in gym class in school. And at recess. And after school. I was lousy at everything physical, and it was obvious.
As it turns out, athletic ability and your body’s general patterns of movement are related to your ability to think properly. Not only do they both relate to your nervous system, but they both also relate to your intelligence.
The Brain and Movement
This topic could easily fill another entire blog post, but you should know that your brain’s ability to function sharply is largely connected to your body’s movement, and, in some capacity, to your eye movement as well. Half of the strange yet incredibly interesting brain interventions I’ve done—such as Integrated Listening, Brain Gym, Brain Abilities—involve some sort of movement. There’s a lot of evidence that yoga is good for your brain. And it’s very evident that exercise, in general, is good for your brain health. So it’s hard to ignore that biology and mental health/intelligence are intimately intertwined.
Specifically, the interventions I mentioned above all involve balance training and eye movement exercises. Why? Because these things are specifically related to your cognitive ability, via something called the vestibular system.
The Vestibular System In Plain English
My high school biology teacher didn’t talk much about the vestibular system—not that I recall, at least. But it’s a very important part of our biology all day long – it’s responsible for determining how balanced we are while standing still or moving. In simplest terms, our balance is determined by a combination of things: (1) fluid levels in our inner ear (2) the way the inner ear communicates with the brain and (3) visual input from our eyes.
Largely, we as humans use our eyes a whole lot for balance. If you don’t believe me, try standing on one leg with your eyes closed for 60 seconds. Make sure you stand with your back near the corner of the room, or else you may fall over. If you happen to do well at this exercise, congrats—you’ve got better balance than most.
Most people will have some trouble with it the first time. If, however, you’ve got an impaired vestibular system like I do, it’ll be very difficult every damn time.
The Neuroplastic Vestibular System
The good news is that if you’ve got lousy balance, it can be improved. The vestibular system has a significant amount of neuroplasticity. With the right training, a lot of problems related to this system—balance problems, dizziness, motion sickness—can be improved or in some cases healed completely.
The challenge is that it’s a rather finicky and complex system. You’ll get the best kind of results with a professional OT or vestibular rehabilitation provider (I went to NYU Langone’s Rusk Rehabilitation center, a whole facility with some pro-level people there). That said, I’ve certainly heard of progress happening with general vestibular exercises. As always I recommend working with a professional if you can, but trying things on your own to see if you can have results that way as well.
Enter Vestibular Rehab
This is where things get interesting. The exercises I was doing every week at NYU (and 2-3 times per day on my own) look completely weird when you’ve never seen them before. You might get funny looks if you did them in public. But after understanding a little more about this system in the brain, it makes a bit more sense about why they’re used, and how they’re effective.
Vestibular problems manifest themselves (in varying degrees) when you’re moving parts of your body in some manner that—depending on your condition’s particulars and severity—cause the wrong info to get sent to your brain, making you feel dizzy or off-balanced when you shouldn’t be. In the worst cases, this can happen when you’re staying still or just walking normally. In less severe cases, it comes from complex motions like walking while turning your head quickly.
The treatment I’ve been exposed to breaks down these movements into simple pieces, and has you practice them with gradually increasing difficulty. In simple terms, first they find the specific motions that make you dizzy or off-balanced, then have you practice variants of them daily, then increase the challenge as things get easier. Some of the exercises they had me do for example:
- Walking forward (while turning my head left and right every other step)
- Walking forward (while turning my head left and right EVERY step)
- Walking BACKWARD (while turning my head left and right every other step)
- Walking backward (while turning my head left and right EVERY step)
- Doing each of the above with my EYES CLOSED every other step
That’s just one type of exercise; there are others where you stand still (with eyes open and closed, and feet in positions that gradually make it harder to balance), those where you stare at a target and turn your head rapidly (to improve the vestibular-ocular reflex or VOR), those involving bouncing a ball off a wall while turning your head, and more.
But based on the above, you can see the difficulty progression – this approach is a big part of what is needed to make any type of training like this work. It’s adaptive to your current skill level, progressive (increases in difficulty) and measurement-based (assesses the difficulty step-by-step).
After a few months of doing this work, we saw that my ability to tolerate these different situations – moving while tilting the head, spinning, and so on – got a lot better. My walk improved, going from super wide to a lot more straight. I was able to keep my balance better, and my tendency to get dizzy while doing common activities wasn’t gone, but was noticeably reduced. Even my fiancee at the time (now my wife) noticed that my walk was visibly different when she saw me coming from afar.
Have you ever tried to improve your balance? Leave a comment or send me an email.
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Thank you so much for the info I have the same balance issues I want to go to PT because my main issue its when iam standing still and or standing still and looking down.
Definitely look into a vestibular assessment then! If your symptoms happen when moving your head in a certain direction, an assessment will be able to help you find the right treatment.
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