Home Vestibular Exercises: Your Step-by-Step Guide to Retraining Your Balance
Evidence-based exercises you can do at home to retrain your brain after inner ear damage. Includes exact dosing, when to progress, and when to get help.
Quick Facts
- 76% show significant improvement with consistent practice
- VR/AR programs achieve 98.4% adherence rates
- Most people improve within 4-6 weeks
Feeling awful right now?
Your brain is incredibly good at adapting — 76% of people recover fully with the right exercises.
What to do right now:
- 1Sit or lie down somewhere safe — don't try to push through
- 2Focus on a single still object in the room
- 3Breathe slowly — your heart rate affects your symptoms
- 4Wait for the room to stop spinning before standing
- 5Have someone nearby if you need to move
This usually peaks within Most spinning episodes settle within 1-2 minutes, then steadily improves.
Quick Summary
- Your inner ear is damaged. Your brain needs to learn new balance tricks.
- These exercises feel uncomfortable ON PURPOSE. That's how they work.
- Most people improve significantly within 4-6 weeks of consistent practice.
VR/AR-enhanced programs hit 98% adherence rates because they actually make this bearable — and the outcomes match.
Ready when you are
When you're feeling a bit steadier, specific exercises can help your brain adapt and reduce your symptoms. We'll guide you through them step by step — no experience needed.
Start exercisesStruggling to stay consistent?
We'll send you a gentle reminder each week with exercises for home vestibular exercises: your step-by-step guide to retraining your balance — just enough to keep you on track.
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Your inner ear is broken. Your brain is confused. And every time you move your head, your body punishes you for it. Here’s the thing: your brain is smarter than this problem. It just needs the right exercises to figure out a workaround. These exercises are going to feel uncomfortable — that’s actually the point. You’re retraining your brain’s balance system, and that requires some productive discomfort. This guide gives you exactly what to do, how long to do it, when to level up, and when to admit you need more help.
Daily Target: Complete 20+ minutes of exercises per day across 2-4 sessions for best results (APTA Clinical Guidelines 2022).
How This Actually Works
Your inner ear has tiny sensors that detect head movement. When they’re damaged, they send garbled signals to your brain. Meanwhile, your eyes are saying one thing, your ears are saying another, and your brain throws up its hands (and sometimes your lunch).
Here’s the good news: your brain has backup systems. It can learn to rely more on vision and body position, and less on that broken ear. These exercises teach your brain to make that switch.
The catch? Your brain only adapts when you challenge it. You have to create that uncomfortable mismatch between what your eyes see and what your ear senses. That’s the training signal. No challenge, no adaptation.
The Core Exercises (Your Daily Non-Negotiables)
Exercise 1: VOR x1 — The Foundation
What it trains: Keeping your vision stable while your head moves
How to Do It
Hold a target at arm's length (a business card with the letter 'X' works great)
- •Focus on the target — keep it clear
- •Turn your head side to side while keeping eyes locked on target
- •The target should stay in focus the whole time
- •Start slow, increase speed over days and weeks
The Key Variable: SPEED
Start slow. Like, embarrassingly slow. Then gradually increase speed over days and weeks.
| Level | Speed | Metronome Setting |
|---|---|---|
| Beginner | Very slow | 24-48 bpm |
| Intermediate | Moderate | 60-90 bpm |
| Goal | Fast | 120 bpm (2 Hz) |
Duration: 30-90 seconds per set, 6 sets, with 10-30 second rest between sets
When to speed up: When you can do the current speed for 3 days straight without symptoms
Exercise 2: VOR x1 — Vertical Version
Same as above, but nod your head up and down instead of side to side. Your target stays still. Your head moves. Your eyes stay locked on target.
Do this in addition to the horizontal version, not instead of it.
Exercise 3: VOR x2 — The Advanced Version
Only Start This After You've Mastered VOR x1
- ⚠You should be comfortable at faster speeds (90+ bpm) before trying this
- ⚠This is significantly harder — your eyes move twice as fast as your head
- ⚠If VOR x1 still triggers significant symptoms, stick with it longer
How to do it:
- Hold target at arm’s length
- Move your arm slowly LEFT while turning your head RIGHT
- Keep the target in focus the whole time
- Reverse: arm goes RIGHT, head goes LEFT
Duration: 1-2 minutes per direction, 3-4 times daily
Exercise 4: Balance Progressions
Your balance exercises follow a clear hierarchy. Master each level before moving on.
Standing Positions
In order of difficulty
- •1. Feet shoulder-width apart
- •2. Feet together
- •3. Semi-tandem (heel beside toes)
- •4. Tandem (heel-to-toe)
- •5. Single leg
Surfaces
Progress when ready
- •1. Firm floor
- •2. Foam pad or pillow
- •Foam challenges your proprioception
- •Only progress when stable on firm
Vision
Reduce visual input gradually
- •1. Eyes open, looking at target
- •2. Eyes open, head moving
- •3. Eyes closed
- •Eyes closed is MUCH harder
Duration: Hold each position 30-60 seconds, repeat 3-5 times
The rule: If you can do it easily for 60 seconds, it’s time to make it harder.
Exercise 5: Walking Exercises
Once standing balance is solid, add movement:
- Walk forward, normal speed
- Walk forward, slow speed (harder than it sounds)
- Walk while turning head side to side
- Walk while nodding head up and down
- Walk heel-to-toe (tandem walking)
- Walk backward (with spotter!)
Duration: 1-2 minutes each, twice daily
Exercise 6: Brandt-Daroff (For BPPV/Motion Sensitivity)
This is specifically for habituation — reducing your sensitivity to movement
Brandt-Daroff Protocol
For motion sensitivity and BPPV habituation
- •1. Sit on edge of bed
- •2. Turn head 45° to the left
- •3. Quickly lie down on your RIGHT side (nose pointing up)
- •4. Wait 30 seconds or until dizziness stops
- •5. Return to sitting, wait 30 seconds
- •6. Turn head 45° to the right
- •7. Quickly lie down on your LEFT side
- •8. Wait 30 seconds or until dizziness stops
- •9. Return to sitting
That’s ONE repetition. Do 5 reps, 2-3 sets per day (morning, afternoon, evening).
Continue for 14 days after your last vertigo episode.
Note: If you have active BPPV, you might need a repositioning maneuver first. See a vestibular therapist for proper diagnosis.
The Dosing: How Much, How Often
New Problem (<3 months)
- •Gaze: 3x/day, 12+ min total
- •Balance: As tolerated
- •Length: 2-3 weeks then reassess
Ongoing Problem (>3 months)
- •Gaze: 3-5x/day, 20+ min total
- •Balance: 20+ min/day
- •Length: 4-6 weeks minimum
Bilateral (Both Ears)
- •Gaze: 3-5x/day, 20-40 min total
- •Balance: 20+ min/day
- •Length: 6-9 weeks minimum
Total daily commitment: About 40-60 minutes spread throughout the day.
Yes, that’s a lot. But this is your balance we’re talking about. It’s worth the investment.
The Intensity Sweet Spot
This is where most people mess up. Either they don’t push hard enough (no adaptation) or they push too hard (can’t recover, give up).
The 2-Point Rule
On a 0-10 dizziness scale, exercises should bump you up 2-3 points
- •Baseline 2/10 → During 4-5/10 = ✅ Perfect
- •Baseline 2/10 → During 7+/10 = ❌ Too hard
- •Baseline 2/10 → During 2/10 = ❌ Too easy
Recovery Time Check
Symptoms should return to baseline within 15 minutes
- •Still symptomatic at 20+ minutes = overdid it
- •Dial back next time
- •Goal feeling: 'subtle nausea' — not overwhelming
- •That's the neuroplasticity sweet spot
When to Level Up
You’re ready to progress when:
- Current exercise causes 0 symptoms for 3 days straight
- Recovery time after exercise is less than 5 minutes
- You can complete the exercise without losing balance
- Target stays clear the whole time (for gaze exercises)
Don’t progress just because you’re bored. Progress because you’ve mastered the current level.
Recovery Timeline
Week 1-2: The 'Why Does This Make Me Worse' Phase
Exercises trigger symptoms. That's normal. Your brain is getting the message.
- •Symptoms increase during exercises
- •Keep sessions short
- •Rest between sets
- •This is supposed to happen
Week 3-4: The First Glimmers of Progress
Same exercises feel a bit easier. You can go a little faster.
- •Recovery time shortens
- •Can handle faster speeds
- •Less nausea
- •Ready to progress difficulty
Week 5-8: Real Gains
Noticeable improvement in daily life. Can handle busier environments.
- •Grocery stores become possible
- •Less thought required for balance
- •Ready for harder exercises
- •Confidence increasing
Month 3+: Fine-Tuning
Returning to full activities. Some people are done; others continue maintenance.
- •Most activities restored
- •May continue maintenance exercises
- •Know what to do if symptoms return
- •Brain has rewired
When Home Programs Aren’t Enough
Be honest with yourself. You need professional help if:
Your Condition Is Complex
- •Both ears are affected — 31x higher fall risk
- •The problem is in your brain, not your ear
- •You have BPPV — need repositioning first
- •Anxiety is driving your symptoms (60% of PPPD patients)
You're Not Improving
- •No progress after 6 weeks of consistent effort
- •Symptoms fluctuating — suggests Meniere's or migraine
- •New symptoms appearing
- •Getting worse instead of better
Red Flags — Get Help NOW
- ⚠Call 911 for: Sudden severe headache, face drooping, arm weakness, slurred speech, loss of consciousness
- ⚠See a doctor within 24-48 hours for: Sudden hearing change, ear pain/drainage, numbness/tingling, double vision
- ⚠Sudden severe hearing loss PLUS vertigo together = possible stroke mimic — ER immediately
Why Technology Actually Helps
Here’s a stat that should get your attention: Traditional home exercise programs have about 50% dropout rates. VR/AR-enhanced programs? 98.4% adherence.
Why People Quit Traditional Programs
- •The exercises are boring
- •Can't tell if you're doing them right
- •Hard to track progress
- •No feedback
- •No accountability
What Technology Adds
- •Real-time feedback on head movement
- •Automatic difficulty adjustment
- •Progress tracking you can actually see
- •Gamification that makes it less miserable
- •Connection to therapist for remote supervision
VR/AR vestibular rehab shows a large treatment effect (SMD -1.13) compared to controls. Some studies show AR achieves the same outcomes in 4 visits that traditional rehab takes 6 visits to reach.
Keeping Yourself Safe
Environment Setup
- •Clear the floor of tripping hazards
- •Have a wall or counter within arm's reach
- •Keep a sturdy chair nearby
- •Make sure lighting is good
- •Phone accessible in case of emergency
For Higher-Risk People
- •Always have someone home with you during standing exercises
- •Start ALL exercises seated
- •Use a gait belt if available
- •Stay in a room corner (back to corner) for standing work
- •Progress more slowly than the timelines suggest
Who Should NOT Do These Exercises
- Recent neck surgery or cervical instability
- Uncontrolled high blood pressure
- Active middle ear infection
- Recent ear surgery (without clearance)
- Severe cervical arthritis (modify the range of motion)
Still Stuck? Here’s What Might Be Wrong
Not Pushing Hard Enough
Exercises feel easy. No symptoms. No progress.
- •Speed up. Make it harder.
- •Add head turns. Close your eyes.
- •Stand on foam.
- •Your brain needs challenge to adapt.
Pushing Too Hard
Wipeout symptoms. Can't recover. Skip days.
- •Back off. Slower speed. Shorter duration.
- •Get to that 2-3 point increase, not 6-7.
- •Consistency beats intensity.
Not Consistent
Exercise 3x one week, 0x the next.
- •Same time every day.
- •Link it to existing habits.
- •Set phone reminders.
- •Your brain needs repeated signals to rewire.
Wrong Diagnosis
Doing everything right but not improving.
- •Get properly evaluated by a vestibular specialist.
- •Might be BPPV needing repositioning.
- •Might be bilateral or central.
- •Exercises can't help if you're treating the wrong thing.
The Progress Markers (So You Know It’s Working)
Week 1-2: You can handle faster head speeds with the same symptom level
Week 3-4: Recovery time after exercises shortens. What took 15 minutes now takes 5.
Week 5-8: Daily life is easier. You can handle the grocery store without dying inside.
Ongoing: You catch yourself doing things you couldn’t before — looking up at a shelf while walking, turning your head in conversations without thinking about it.
Track these. Write them down. On bad days, you’ll need proof that you’re actually progressing.
Important Statistics
The Bottom Line
Your inner ear is broken. But your brain is a problem-solving machine. It just needs the right inputs to figure out a workaround.
These exercises are the right inputs. They’re not fun. They’re not comfortable. But they work — 76% of people who do them consistently see significant improvement.
The research is clear: supervised programs + home exercise is the winning combo. Technology that gives you feedback, tracks your progress, and keeps you accountable can dramatically improve your odds of sticking with it.
You’re not crazy. This is hard. And it gets better.
Start today. Small. Consistent. Build from there.
Care Team
Vestibular Physical Therapist
Areas of Expertise:
- •Exercise prescription
- •BPPV repositioning
- •Supervised progression
Otologist or Neurotologist
Areas of Expertise:
- •Complex cases
- •Bilateral involvement
- •Central issues
Psychologist (Vestibular-Aware)
Areas of Expertise:
- •PPPD treatment
- •Health anxiety
- •Fear of falling
This content is for educational purposes and doesn’t replace vestibular assessment from a qualified healthcare provider. If you haven’t been properly diagnosed, start there. These exercises assume you have peripheral vestibular hypofunction (inner ear problem) — they’re not appropriate for central vestibular disorders, undiagnosed dizziness, or acute vertigo episodes.
Common Questions
Questions we hear from people just like you
Yes, and that's exactly how they work. You're deliberately creating a small mismatch between what your eyes see and what your inner ear senses. That discomfort is your brain getting the signal it needs to adapt. Think of it like building muscle — some burn is good.