Exercises for Vertigo and Dizziness

Medically reviewed by Misty Seidenburg

Vertigo is a condition in which you feel like everything around you is spinning, even though it is not. It is quite common, affecting nearly 40% of adults at least once during their lifetime. People experiencing vertigo may feel so dizzy, nauseous, or unbalanced that they have difficulty going about their everyday activities. Fortunately, exercises for vertigo and dizziness are available to help reduce symptoms and provide immediate and often long-term relief.

What Is Vertigo?

Vertigo is not a disease. It is actually a symptom of other conditions affecting the body’s vestibular system, which regulates posture, balance, and orientation in space. Although vertigo can impact anyone, it is more prevalent in women over the age of 65.

There are two main types of vertigo. Peripheral vertigo is caused by an issue with the vestibular nerve or inner ear, which transfers sound and equilibrium information from the inner ear to the brain. Central vertigo is related to a problem in the brain caused by infection, traumatic injury, stroke, and other conditions.

Disequilibrium is a sense of veering or off-kilter, like the sensation one feels when stepping off a boat. This sense of feeling off-balance often happens when standing or walking. It differs from vertigo, which is the sensation of spinning or the world spinning around you.

Vertigo or disequilibrium episodes last from a few seconds or minutes to hours, days, or weeks. improve balance and stability.

Brandt-Daroff Exercise

The Brandt-Daroff exercise is typically prescribed for patients with benign paroxysmal positional vertigo (BPPV.) BPPV is caused by the shifting of calcium crystals or “stones” in the inner ear when a person moves their head a certain way. These stones trigger sensors in the inner ear, which cause feelings of dizziness. These episodes typically last a minute or less.

This exercise helps the brain adjust to these confusing signals to help you quickly get over the vertigo episode.

How to Do the Brandt-Daroff Exercise

1. Begin in an upright, seated position.
2. Shift to a lying position on one side. Turn your head so your nose is pointed upward at a 45-degree angle.
3. Stay in this position for 30 seconds or until the vertigo episode passes.
4. Return to a seated position.
5. Repeat on the other side.

Do 5 repetitions on each side twice daily, or follow your physical therapist’s instructions. Symptoms may ease while performing the exercise and gradually improve over weeks or months.

Epley Maneuver for Vertigo

The Epley Maneuver is also beneficial for patients with BPPV. As the head moves into various positions during the exercise, the calcium crystals that cause vertigo shift to a part of the inner ear that does not trigger vertigo. This exercise requires the assistance of a physical therapist.

How to Do the Epley Maneuver 

1. Begin in an upright, seated position on an exam table. Your legs should be extended in front of you. Hold your physical therapist’s arms for support.
2. The physical therapist turns your head 45 degrees horizontally toward the affected ear.
3. Next, the therapist tilts your body backward to a horizontal position while your head is extended to 30 degrees and remains at a 45-degree turn. At this point, you may experience vertigo symptoms. Stay in this position until vertigo subsides, usually within a minute.
4. The therapist turns your head at a 90-degree angle toward the opposite ear before rolling you onto that side. You will now be looking at the floor.
5. The calcium stones should shift into the canal again, possibly causing another vertigo episode. Remain in this position until symptoms pass, usually within a minute.
6. Return to a seated position with the aid of your physical therapist.

Your physical therapist may recommend a modified version of the Epley Maneuver for you to do at home. If you feel safe and confident to try it on your own, it can help improve vertigo symptoms over time.

Semont Maneuver for Vertigo

The Semont Maneuver is similar to the Epley exercise because it’s designed to shift the calcium crystals in the inner ear to a location that does not cause dizziness or imbalance. It involves the patient’s rapid movement from lying on one side to the other. The Semont Maneuver is also performed with the aid of your physical therapist.

How to Do the Semont Maneuver

1. Begin seated on the exam table with your legs hanging off the front.
2. The physical therapist turns your head until it is halfway between looking straight ahead and away from the side most affected by vertigo.
3. Next, the therapist gently but quickly lowers your body down toward the side, causing the worst vertigo symptoms. Once your head reaches the table, you will look up at the ceiling. Remain in this position for 30 seconds or until vertigo symptoms pass.
4. The therapist then quickly moves you to the other side of the table in a single motion. Now, when your head reaches the table, you will look downward. Remain in this position for 30 seconds or until vertigo subsides.
5. With your therapist’s assistance, return to a seated position.

The Semont Maneuver takes approximately 15 minutes. Because you may experience vertigo as the calcium stones shift their position, it’s best to wait at least 15 to 20 minutes before leaving the clinic.

Half Somersault or Foster Maneuver

The half somersault is an exercise that can quickly be done at home without the assistance of your physical therapist. These instructions are designed for someone experiencing BPPV in the left ear. Reverse them if you have BPPV in your right ear.

How to Do the Foster Maneuver

1. Start kneeling with your hands resting on the floor.
2. Tilt your head up and back. Allow any sensations of dizziness to pass.
3. Place your forehead on the floor while tucking your chin toward your knees, as if you are about to somersault.
4. Turn your head 45 degrees and look toward your left elbow. Remain in this position for 30 seconds.
5. While your head remains at a 45-degree angle, raise it until it is level with your back and shoulders. Stay here for 30 seconds.
6. Raise your head to an upright position.

Repeat this exercise 4-5 times for symptom relief, waiting 15 minutes between each exercise.

Safety Tips for Vertigo and Disequilibrium Exercises

Whether doing home exercises for vertigo or at a physical therapy clinic, always take precautions if you experience vertigo symptoms. First, you should have a formal diagnosis before attempting vertigo treatment exercises and always work under the guidance of a licensed physical therapist.

Remember that the exercises described here may trigger vertigo before relieving it. Always wait 30 seconds or until dizziness passes to move on to the next exercise. It’s best to avoid driving after balance and vestibular rehabilitation, so plan to have someone drive you home.

Ask your physical therapist about exercises to avoid with vertigo and l tips to prevent episodes. In many cases, symptoms can be reduced or resolved entirely with simple exercises to treat the underlying cause of dizziness, spinning, and balance issues. Ask your physical therapist if these maneuvers may work for you. Find a physical therapy clinic near you.

External Sources:

• Benign Paroxysmal Positional Vertigo – StatPearls – NCBI Bookshelf (nih.gov)
• Epley Maneuver – StatPearls – NCBI Bookshelf (nih.gov)
• Sémont Maneuver for Benign Paroxysmal Positional Vertigo Treatment: Moving in the Correct Plane Matters – PMC (nih.gov)