A breakdown of how vestibular rehabilitation works – what I do and the patterns I found easiest to follow.
Brain retraining – sounds pretty daunting, right? No one can ever be prepared for this. You don’t know where to start, how long it takes or how gruelling it is. But it soon becomes your biggest and most important goal. My life and all that was familiar to me, was suddenly ripped away. Think about this: walking is like breathing; you never give much thought to it, your body just does it. Balance is natural, not forced – easy. Until it’s not anymore.
To relearn things that have always been instinctive is crushing. I was so sick. Symptoms plaguing my every day. Sheer physical and mental exhaustion draining every ounce of my energy. I couldn’t see how brain retraining could change this, could help get me better. The slow, repetitive movements I was forced to do made me feel so much worse.
I’ve been there, I know you’re suffering with vestibular disorder and how terrified you are. Being told you have to stop living life as you knew it, retrain your brain, say goodbye to parts of yourself you love and pride yourself on. Reacquainting yourself with life and the world around you – it is so hard. But you really have no choice other than to try because you want better for yourself, you need to get better.
This is what brain retraining for a vestibular disorder is, how I tackle it and make these exercises my biggest priority.
What is brain retraining?
Vestibular rehabilitation is complex. There are a lot of layers to it. It’s not just about learning how to balance and walk again. It’s also about slowly reintroducing all different types of lights, sounds, environments, and external movements into your day to day. It’s about re-learning how to function in every place you can imagine. Your brain has to try to relearn and maintain balance to stand, walk and sit; whilst competing with overbearing sounds, lights, smells and people around you. It may seem like the quietest or most normal environment to someone else, but too much new and overwhelming sensory stimulation throws off my already sensitive vestibular system. This makes it all the more difficult to stay upright and not spin out of control.
My neurologist sent me to a vestibular physiotherapist soon after my diagnosis. A vestibular physiotherapist is a balance disorder physiotherapist – someone trained to help you retrain your brain to balance, to walk and to connect with your physical body again.
My vestibular physio is an angel; she is incredibly soft-spoken, calm, sympathetic and could make me smile on the worst of days or weeks. I immediately felt at ease with her, the whole team really. I felt seen. I felt heard. She knew exactly what I was experiencing and explained how retraining a brain to balance again works. She gave me lots of information to read and research. She continuously put my improvements into perspective, based on how I was a fortnight ago and the months before that. Professional guidance on safe movements and assessment of your brain’s physical limit is so important.
When starting vestibular rehabilitation, you quickly realise that “brain retraining” itself isn’t fast or easy. It is slow and monotonous. It is also very easy to overdo and exhaust your brain. So you need to find where you can ‘comfortably’ sit in the push and pull of this part of recovery – see what your brain is capable of. Patience is crucial. Retraining will look different depending on your vestibular disorder, symptoms and severity. Again, if you are suffering from this disorder, I would suggest looking up vestibular physiotherapists to start retraining in your area as soon as possible. I can recommend my vestibular rehabilitation clinic in Melbourne if you are from here!
How do you brain retrain?
Controlled, repetitive movements of your head and body. Unfortunately, it is incredibly uncomfortable to begin with as it worsens your symptoms and takes a long time before you see positive change. The rehabilitation exercises are designed to push your brain and vestibular system to accept small movements, pick up an appropriate amount of sensory information around you and gradually help build your balance threshold to keep your body upright. For all of the discomfort and added sickness it causes, I can say that it really does help in the long run.
I alternate between 5-6 exercises regularly. Whether it’s walking up and down my hallway and turning my head left to right (which I have to admit was painfully slow at the beginning to even attempt as I bounced off the walls), or standing in one spot and trying to turn around. The exercises eventually do what they are meant to and retrain your vestibular system. The exercises force your brain to feel slow movement and try to understand where in the space your body is and how to keep yourself upright.
Brain retraining is ongoing and truly does help reconnect my vestibular system with my body. I still float and feel woozy; there are still extremely bad days and some days that are more manageable. But these sensations have vastly decreased to how severe they were at the beginning. I can admit sometimes I forget, am distracted or just don’t feel physically capable of pushing my body. But I always remind myself to do them. It is a commitment I really need to keep. It is crucial to my rehabilitation.
Graded exposure to certain settings and scenarios is a huge part of brain retraining. You need to reacquaint your balance system with every environment you can think of; someone else’s house, cafés, stores, supermarkets, parks or a car – just to name a few. Stimuli in all environments are dissimilar and test your brain and vestibular system’s ability to keep you steady. Your threshold will be different in each place and between days as well. Start by sitting in a café for 10-20 minutes – of course sunglasses and noise cancelling headphones on if needed!
Putting myself in environments where lighting and colour schemes are different, sounds change and there is motion around me has been important. This doesn’t mean it’s not excruciating and won’t wipe me out for days if I stay too long. There are days I can try to do these things, there are days where I may go into one of these places and have to leave as quickly as I went in. But it’s all about trying. Graded exposure (within reason) is going to help you and ultimately becomes part of your brain retraining. I admit I pushed this way too hard in my first year but that’s a whole other story and something I learnt from! Ultimately, any action you take that is more than you did yesterday or a week before is good progress. If you can repeat that action again and again – you are going to retrain your brain for that setting or form of movement.
Challenging environments: Don’t do retraining exercises in the same place in your house daily. Your brain will get too used to that single environment and only improves your balance system to cope in that one space. When you’re confronted with other settings you realise this more. So try to change up the places you do your exercises; inside, outside, in a small narrow room or a wide-open space. Obviously have someone with you for safety if you need…
I’ve found that brain retraining combined with medications has helped me immensely. I truly believe in the benefit it can give your overall treatment plan. I think if you have a supportive, well-equipped vestibular physiotherapist it will really aid your overall improvement. It might be hard for you to acknowledge small changes but a professional has a steadfast way of proving it. This can be a real confidence boost amongst the all-consuming symptoms!
If you want to hear more from me as I explore my rehabilitation and healing, feel free to subscribe to my email list so you will be first to know each week when a new blog post is uploaded. Leave me a comment or send a message if you’d like to chat!
Quick trivia fact!
Some of what is known about vestibular disorders and rehabilitation is actually learnt from astronauts returning from space travel. People with vestibular disorders don’t get the rocket ship or excitement of going to space, but we still feel the launch and extreme gravity pull daily!
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