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  • Writer's picturePaula Allia

Stronger & Better Together!

Vertigo, balance, and equilibrium

Andrey_Popov | shutterstock


Equilibrium is a function that occurs from multiple sources in the body that coordinate and provide sensory information with appropriate responses. It is dependent upon multiple systems including the central nervous system (CNS), visual, somatosensory, and vestibular systems.

The body depends upon the overall CNS to take in sensory information provided by the body with the appropriate responses. Only then can the boy know if it is moving versus the outside world is moving.

The vestibular system is the system along with the visual system which provides information to tell where the head is in space, i.e. turned to the right or left. The somatosensory system is about where the body is in space. Is the body moving or is the world moving around the body? Together, these systems function properly to allow for normal balance and equilibrium.

The goal of our body to be balanced is to keep the body’s center of mass within its own base of support. For the most part, this occurs naturally unless one of the systems mentioned is not doing its part to coordinate the information properly. When the vestibular system is malfunctioning, trying to maintain balance is very difficult.

When the head turns, fluid shifts in the ears, sensory information is relayed, and the muscles in the eye properly respond. Thus, the body knows that the head is turned either right or left. This occurs by something called the vestibular ocular reflex (VOR). It is a 1:1 response whether moving slow or fast. If the 1:1 response changes and the eye movement cannot keep up, imbalance can occur which can lead to falls resulting in injury. Essentially, the eye muscles keep up with the fluid shift in the ears and the proper information allows normalcy. When this is compromised vertigo occurs. The only thing that moves the eyes is the brain so the brain needs to get the right information to provide the eyes the proper response.

When vertigo occurs, the person feels as if they are moving when they are actually not doing so. When looking at the eyes, the eyes may actually be moving when the body is staying stationary. The feedback system is not allowing the proper response. This can occur when a crystal, actually a piece of calcium phosphate, breaks off and is free-floating in the fluid in the ear, thus not allowing the fluid to flow normally with the proper pressures. This crystal breaking off can be from aging or trauma of some sort. If this crystal is moving then vertigo can occur. It is gravity-dependent so as soon as this free-floating crystal stops moving, the abnormal eye motion stops and the feeling of vertigo is abated. That is until the head moves again and the crystals again shift.

The key to this cause of vertigo is to remove the crystal from the fluid and it will be reabsorbed in most instances. It may be helpful to even take vitamin D since it helps with calcium absorption. Vertigo can certainly cause the risk of fall and the person will experience some sort of imbalance. Using caution until this problem is resolved is best.

People also experience another cause of equilibrium deficit. When there is a problem that is caused in the vestibular system other than the crystals, vestibulopathy may be present. There are many people that are walking around with an imbalance with some not even realizing it. For example, a person never recovered fully from a concussion or even a fall without hitting the head. The common thread is that they feel better but “a little off” or “not quite right.” In this instance, a person may need to go to vestibular rehabilitation. If the right rehab is done there should be lessening of the symptoms of imbalance over time. Challenging the brain in this rehab will improve the outcome!

Working through balance problems takes work and the above-mentioned systems should be addressed if you are uncertain of why balance seems to be an issue. Aging itself can add problems so keeping the body properly stimulated with the right exercises can help maintain a happy successful functional life!


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