Balance and dizziness: the role of exercise

When you are dizzy and off balance, the motivation to do something active can be almost nonexistent. It can be challenging to fight the impulse to avoid doing anything that might provoke your symptoms. However, once the acute phase of dizziness has passed, inactivity is not the road to recovery.

Regular exercise helps you get the most out of compensating for any vestibular deficit. Compensation is the ability of your balance system to use a different pathway to channel the information required to keep you balanced.

To “train the brain” and get it used to offending stimuli, you must challenge yourself with activity that provokes your symptoms. Even though you may feel nauseated, sweaty and just awful at times, this helps the compensation process. Some people worry that  exercise will cause more damage to the balance system – this is simply not true!

As well as doing specific vestibular rehabilitation and balance exercises, other physical activity promotes recovery and overall health. Stretching and keeping your joints mobile is important, as is keeping your muscles strong and working your cardiovascular system.

Challenge yourself in safe environments, either on your own or with others in a group. Look into classes offered in your community – your health team and local public library can be of great help in tracking these down.

Tips to get active:

• Introduce any new activity gradually so your body has time to adjust - begin with the rule of "little and often”
• Start with 10 to 20 minutes of activity every other day
• Work towards the general Canadian recommendation of at least 2.5 hours a week of moderate to vigorous aerobic activity
• Spread out physical activity throughout the day into sessions of 10 minutes or more
• Do muscle and bone strengthening activities using major muscle groups at least twice weekly
• Make time throughout the day to stretch and move your joints – pay special attention to the joints that cause you problems
• Do power training to help you react more quickly if you start to trip or lose balance
• Do some type of exercise – such as tai chi – that involves gentle head movement; over time, you’ll be able to move your head more freely without feeling dizzy
• If you have significant balance issues, neuropathy, foot complications or lack mobility you can still get a good workout doing chair exercises
• And remember to check in with your health team before starting any new activity

Experiment with some of these ways to stay active

Walking

If possible, walk outside. A variety of environments and walking surfaces can help challenge the balance system.

Yoga

Stress can make the symptoms of balance and dizziness disorders worse. The meditative aspect of yoga can be helpful to reduce anxiety. Additionally, some poses help develop a strong core which helps improve balance. Look for introductory DVDs online or at the library to start practicing at home, or join a class.

Tai chi

Done slowly and smoothly, tai chi movements challenge the balance system and help prevent falls. Tai chi is a good complement to vestibular rehabilitation and has been associated with significant improvement in balance.

With its integrative approach that strengthens the body while focusing the mind, tai chi addresses a range of physical and mental health issues—including bone strength, joint stability, cardiovascular health, immunity, and emotional well-being.

Contact your community centre or library for information about other tai chi and balance classes near you. If you cannot find a local class, look for introductory books or DVDs at the library – the 24-form Yang style is particularly suitable for beginners.

Pool exercises

The decreased gravity in water is easier on muscles and joint while still improving agility, balance and cardiovascular fitness. In addition, the pool environment reduces your risk of falling compared with land-based exercise. Many pools offer aquafit classes.

Nordic walking

There is evidence that using walking poles has a number of balance benefits including increasing gait stability, reduce falls, and core strength.

Pilates

Many of the moves of this structured method of exercise will challenge your balance, core strength, stability, posture and flexibility. Pilates has been shown to improve balance in older adults.

Certified instructors can be found through the Pilates Method Alliance.

Feldenkrais Method® (FM)

The FM develops awareness through movement and challenges your brain to learn new patterns and habits. Research suggests that FM can help improve balance in older people.

Certified instructors can be found through Feldenkrais Method®.

“Goal-directed” activities

Activities that you like to do repeatedly in your everyday life help with imbalance and dizziness. There is no particular activity that is best – just do what you like and keep at it. If you like to work in the garden, do gardening. If you like ballroom dancing, go ballroom dancing. Short sessions of activities such as these repeated throughout the day have been shown to be as helpful as longer sessions.

Functional limitations

If you are not seeing improvement despite ongoing vestibular rehabilitation and balance exercises, you may have reached some limitations in terms of function. Clinical tests of vestibular function can help determine if this is the case.

Find out where you can go for formal vestibular testing.

Sources

Barker AL, Bird M,  Talevski, J. Effect of Pilates exercise for improving balance in older adults: a systematic review with meta-analysis. Archives of Physical Medicine and Rehabilitation. 2015:96:715-723. Available from: http://bit.ly/2uCDiUh

Hain TC. Tai chi for balance disorders. 1993-1994, Reference # 1R21RR09535-01. Site, Rehabilitation Institute of Chicago. Available from: http://bit.ly/2FLQk8n

Hillier S, Worley A. The effectiveness of the Feldenkrais method: a systematic review of the evidence. Evidence-Based Complementary and Alternative Medicine, vol. 2015, Article ID 752160, 12 pages, 2015. Available from: http://bit.ly/2JT2Kzl

Physical activity and your health. Government of Canada. Available from: http://bit.ly/2uDSi4c