8 Vertigo Exercises for Symptom Relief
Certain exercises, such as the Epley maneuver or Cawthorne head exercises, are common home remedies for vertigo and its symptoms. Some are so effective that they may also be practiced by your chiropractor or physical therapist.
Vertigo symptoms include dizziness, blurry vision, nausea, and balance problems. Almost 40% of U.S. adults experience vertigo within their lives, often due to head injury or migraines.
Check out these handy exercises and step-by-step instructions for each. It’s always wise to consult your physical therapist or healthcare provider before doing any of these exercises.
What exercises get rid of vertigo?
- Sémont maneuver
- Epley maneuver
- Brandt-Daroff exercise
- Foster maneuver (half somersault)
- Romberg exercise
- Standing sway exercise
- Cawthorne head exercises
- Marching in place
Disclaimer: Many of these exercises cause dizziness or a spinning sensation for a short time. Often, these maneuvers will instruct you to hold your position until your symptoms subside.
At Georgia Upper Cervical Chiropractic, we have helped countless patients with vertigo by administering chiropractic treatment, providing medical advice, and guiding self-treatment.
1. Sémont Maneuver
The Sémont maneuver is a great exercise to address the root cause of benign paroxysmal positional vertigo (BPPV). It is designed to move calcium carbonate (canalith) debris from your semicircular canal and into a specific part of your inner ear, which can eliminate all vertigo symptoms.
You may perform it by yourself, but many prefer for their physical therapist to administer the maneuver.
To perform the Sémont maneuver effectively, you must know whether your right ear or left ear is the cause of your vertigo. Canalith debris in either ear can cause vertigo.
How to do a Sémont maneuver:
- Sit on the edge of the bed or table. Your legs should hang over the side.
- Turn your head 45° away from the side affected by vertigo.
- Swiftly lie down onto the affected side. If you feel dizzy, stay lying down until you feel better.
- Sit once more, then quickly lie on your other side. If you feel dizzy, stay lying down until you feel better.
- Repeat, beginning with Step 2.
You or your physical therapist often perform the Sémont maneuver for 10-15 minutes. Because this exercise may trigger some vertigo symptoms, do not plan on driving or operating heavy machinery for 10-15 minutes afterward.
2. Epley Maneuver
The popular Epley maneuver is designed to move the canalith debris out of your semicircular canal and into the inner ear, where it won’t trigger vertigo symptoms.
You can also do this canalith repositioning procedure at home. Your chiropractor or another healthcare provider may show you how to do a modified Epley maneuver, also called a home Epley maneuver.
How to do an Epley maneuver:
- Sit on a bed or treatment table. Your legs can hang over the side.
- Turn your head 45° horizontally towards the side affected by vertigo while still in a sitting position.
- Lie down on your back.
- With your head at the 45° angle, recline your head on a pillow. Your shoulders will go on that same pillow.
- Hold that position for 30 seconds.
- Turn your head 45° away from the side affected by vertigo (90° from where you were). Don’t raise your chin. Hold for 30 seconds.
- Lie on your side by turning your body 90° away from the side affected by vertigo. Keep your head at a 45° angle compared to your body so that you’re looking at the floor or into the pillow.
- Hold for 30 seconds or until vertigo symptoms subside.
- Sit up again.
You or your physical therapist may perform the Epley maneuver for 10-15 minutes for optimal results. Because this exercise may trigger some vertigo symptoms, do not plan on driving for 10-15 minutes thereafter.
3. Brandt-Daroff Exercise
The Brandt-Daroff exercise is an easy and often effective exercise for vertigo, particularly for the treatment of benign paroxysmal positional vertigo (BPPV) and labyrinthitis.
Some research claims it is not as effective as the Sémont or Epley maneuvers, yet other research claims it is as effective.
This exercise sometimes relieves symptoms of BPPV right away, but more often relieves symptoms gradually with repetition over several weeks.
How to do the Brandt-Daroff exercise:
- Sit in an upright position.
- Lie down on one side. Your nose should point upwards at a 45° angle.
- Remain there for 30 seconds.
- Sit upright again and repeat on your other side.
You can repeat this exercise once on each side or until your vertigo symptoms disappear. Many patients do this exercise multiple times a day.
Be careful not to hit your head on the floor or furniture. There should be no side effects to this exercise if you don’t lie down or get up unreasonably quickly.
4. Foster Maneuver/Half Somersault
The Foster maneuver, also called the half somersault maneuver, is an effective exercise for many vertigo patients.
How to do the Foster maneuver (also called the half somersault):
- Kneel down and lift your chin.
- Touch the floor with your head, tucking your chin.
- Hold that position for a few seconds or until vertigo symptoms subside.
- Still touching the floor, turn your head 45° towards the side affected by vertigo.
- Hold for 30 seconds.
- Raise your head and shoulders so that they’re level with your back. You’ll be on all fours. Keep your head at that 45° angle.
- Hold for 30 seconds.
- Sit up, on your knees, fully upright. Keep your head at that 45° angle.
- Hold for 30 seconds.
- Stand up slowly.
It may take 4-5 repetitions to move the canalith debris from the semicircular canal and into a certain part of your inner ear where vertigo symptoms should cease.
5. Romberg Exercise
Instead of repositioning canalith debris in the ear canal, this Romberg exercise is designed to train your body to deal with symptoms of vertigo. As you train your body to handle vertigo, symptoms tend to improve.
How to do the Romberg exercise:
- Stand with a wall behind you and a chair in front of you. If you start to fall, use the wall or chair for support. If this test is administered by a physical therapy expert, they may provide support instead of the chair and wall.
- Put your feet together. Rest your arms at your side. Alternative versions of the Romberg exercise have patients cross their arms.
- Close your eyes if you are comfortable doing so.
- Hold this position for 30 seconds.
Many patients do this brief exercise 2-3 times a day.
One interesting modification of the Romberg exercise is raising and lowering your chin while standing.
6. Standing Sway Exercise
The standing sway exercise is a step up in difficulty from the Romberg exercise. Standing sway exercises are meant to train your body to cope with vertigo symptoms — not reposition the canalith debris that is triggering the vertigo symptoms in the first place.
Standing sway exercises can take place side-to-side or forward-backward.
How to do standing sway exercises:
- Stand with a wall behind you and a chair in front of you, just like the Romberg exercise. If you start to fall, use the wall or chair for support. If a doctor administers this test, they may provide support instead of the chair and wall.
- Your feet should be shoulder-width apart. Rest your arms at your side.
- Lean slightly forward, then backward (or right, then left). Your weight should shift, but don’t lift your heels or toes. Your hips and shoulders should move together as one, but don’t bend at the hip.
Many patients repeat this exercise about 20 times for the best results.
To push yourself further with each repetition, gradually increase how far you sway. This maneuver should improve your balance more and more over time.
7. Cawthorne Head Exercises
Also called Cawthorne-Cooksey exercises , Cawthorne head exercises are forms of balance therapy that can help reduce vertigo symptoms.
Cawthorne head movements actually refer to multiple distinct maneuvers: eye, head, shoulder, standing, and walking exercises.
How to do the Cawthorne eye exercise:
- Move your eyes from the left side to the right side. Don’t move your head at all.
- Repeat about 20 times.
- Move your eyes up, then down. Don’t move your head at all.
- Repeat about 20 times.
- Hold your finger at arm’s length. Focus on that finger. Move one foot forward, then back again.
- Repeat about 20 times.
- Start each exercise slowly, but go a little faster every time.
How to do the Cawthorne head exercise:
- Slowly move your head side to side.
- Repeat about 20 times.
- Slowly move your chin down, then up.
- Repeat about 20 times.
- Keep your eyes open for these head exercises. With each repetition, do these head exercises with eyes closed or move gradually faster to push yourself further.
How to do the Cawthorne shoulder exercise:
- Shrug your shoulders up and down while sitting or standing.
- Repeat about 20 times.
- Turn shoulders left, then right.
- Repeat about 20 times.
How to do the Cawthorne standing exercise:
- Sit upright.
- Stand up slowly.
- Repeat from Step 1. Gradually increase speed over time.
How to do the Cawthorne walking exercise:
- Walk across the room with your eyes open, then closed.
- Repeat about 10 times.
- Walk up and down a flight of stairs with your eyes open, then closed.
- Repeat about 10 times.
As you do these Cawthorne exercises, be very aware of your surroundings and consider having a buddy to help prevent a fall. The walking exercises require special caution.
8. Marching in Place
Marching in place is a basic vertigo exercise that helps you prepare for more advanced exercises. It works just like it sounds, but this simple exercise can effectively train your body to balance better.
How to do marching in place exercise:
- Stand with a wall behind you and a chair in front of you, just like the Romberg exercise. If you start to fall, use the wall or chair for support. If this test is administered by a doctor, they may provide support instead of the chair and wall.
- Stand with your feet comfortably apart, as you would typically stand.
- Rest your arms at your side.
- March in place, lifting your knees high toward the ceiling.
- Start with 20 steps, and slowly progress to 30 steps with each session.
Repeat this exercise 2-3 times a day.
To push yourself, you can increase the step count, or you could even try marching in place with your eyes shut.
Is walking good for vertigo? Yes, walking is good for vertigo, as long as you don’t push yourself too hard. Walking in place or around the house should improve your balance.
In Summary
If you’re dealing with vertigo and the balance problems that come with it, there are multiple vertigo exercises that you can do to help ease those symptoms.
The Sémont and Epley maneuvers are the most popular exercises to reposition the canalith debris that is causing vertigo in the first place. The Romberg and Cawthorne exercises are more about balance training.
What helps vertigo naturally?
- Canalith repositioning exercises
- Balance training exercises
- Hydration
- High-quality sleep
- Yoga
- Massage
- Supplements like feverfew, apple cider vinegar, and ginger
- Stress relief
Ready to get to the root of your problem with chiropractic care? We’re currently accepting new patients at our Ball Ground office.
Sources
- Gebhart, I., Götting, C., Hool, S. L., Morrison, M., Korda, A., Caversaccio, M., … & Mantokoudis, G. (2021). Sémont Maneuver for Benign Paroxysmal Positional Vertigo Treatment: Moving in the Correct Plane Matters. Otology & neurotology , 42 (3), e341.
- Nguyen, C. T., & Basso, M. (2021). Epley Maneuver. StatPearls [Internet].
- Gupta, A. K., Sharma, K. G., & Sharma, P. (2019). Effect of Epley, semont maneuvers and Brandt-Daroff exercise on quality of life in patients with posterior semicircular canalbenign paroxysmal positional vertigo (PSCBPPV). Indian Journal of Otolaryngology and Head & Neck Surgery , 71 (1), 99-103.
- Cetin, Y. S., Ozmen, O. A., Demir, U. L., Kasapoglu, F., Basut, O., & Coskun, H. (2018). Comparison of the effectiveness of Brandt-Daroff Vestibular training and Epley Canalith repositioning maneuver in benign Paroxysmal positional vertigo long term result: A randomized prospective clinical trial. Pakistan journal of medical sciences , 34 (3), 558.
- Khaftari, M. D., Ahadi, M., Maarefvand, M., & Jalaei, B. (2021). The Efficacy of the Half Somersault Maneuver in Comparison to the Epley Maneuver in Patients with Benign Paroxysmal Positional Vertigo. The Journal of International Advanced Otology , 17 (5), 417-421.
- Forbes, J., & Cronovich, H. (2021). Romberg Test. StatPearls [Internet].
- Han, B. I., Song, H. S., & Kim, J. S. (2011). Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. Journal of Clinical Neurology , 7 (4), 184-196.
- Dix, M. R. (1979). The rationale and technique of head exercises in the treatment of vertigo. Acta oto-rhino-laryngologica Belgica , 33 (3), 370-384.
- Cohen, H. S., Sangi-Haghpeykar, H., Ricci, N. A., Kampangkaew, J., & Williamson, R. A. (2014). Utility of stepping, walking, and head impulses for screening patients for vestibular impairments. Otolaryngology-Head and Neck Surgery , 151 (1), 131-136.
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