Vestibular Physiotherapy & Rehabilitation in Toronto, North York & Don Mills
If dizziness, vertigo or balance problems are interfering with your daily life, a vestibular physiotherapy assessment can help determine what may be contributing to your symptoms and whether vestibular rehabilitation is appropriate.
At Physiomobility Health Group in Don Mills, North York, our vestibular physiotherapists assess and treat people with vestibular and balance disorders, including BPPV, vestibular neuritis and hypofunction, vestibular migraine, persistent dizziness, concussion-related dizziness and balance problems.
Treatment is based on your assessment findings and may include repositioning manoeuvres for BPPV, vestibular rehabilitation exercises, gaze stabilization, habituation, balance and gait training, and an individualized home exercise program.
Book a Vestibular Physiotherapy Assessment
When Should You See a Vestibular Physiotherapist?
Consider a vestibular physiotherapy assessment if you experience:
- Dizziness or vertigo
- Spinning when rolling over or getting in and out of bed
- Dizziness with head movement
- Feeling unsteady while standing or walking
- Difficulty walking in the dark or on uneven surfaces
- Blurred or unstable vision when moving your head
- Motion sensitivity
- Difficulty in busy stores, crowds or visually stimulating environments
- Persistent dizziness after an inner-ear illness
- Dizziness or balance problems following a concussion
- Recurrent unexplained loss of balance
- Reduced confidence with walking because of dizziness or instability
Dizziness has many possible causes and is not always related to the inner ear. Your physiotherapist will assess whether your presentation appears appropriate for vestibular rehabilitation and may recommend further medical assessment when indicated.
What Conditions Can Vestibular Physiotherapy Help?
Vestibular physiotherapy may be appropriate for several conditions affecting balance and spatial orientation.
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV commonly causes brief episodes of spinning triggered by changes in head position, such as rolling over in bed, looking upward or getting out of bed.
When assessment confirms BPPV, specific repositioning manoeuvres may be used to treat the affected canal.
Learn more about BPPV and positional vertigo treatment
Vestibular Neuritis
Vestibular neuritis is a sudden inflammation of the vestibular nerve in the inner ear, often causing intense vertigo, nausea, imbalance, and difficulty walking. While the severe dizziness usually improves within days, balance problems or sensitivity to movement may persist. Vestibular physiotherapy can help the brain adapt and restore balance through targeted gaze-stabilization, balance, and movement exercises.
Learn more about Vestibular Neuritis
Vestibular Hypofunction (Weakness)
Following vestibular neuritis or other causes of reduced vestibular function, people may experience dizziness, imbalance, motion sensitivity or difficulty keeping their vision clear while moving.
Vestibular rehabilitation can help the nervous system adapt to changes in vestibular function and improve balance and visual stability.
Learn more about Vestibular Hypofunction
Vestibular Migraine
Vestibular migraine may cause dizziness, motion sensitivity, imbalance and sensitivity to visual environments, sometimes with and sometimes without headache.
Vestibular physiotherapy may form one part of a broader management plan when movement, balance or visual-motion sensitivity contributes to symptoms.
Learn more about Vestibular Migraine
Persistent Postural-Perceptual Dizziness (PPPD)
Some people continue to experience persistent dizziness, rocking or swaying sensations, imbalance, or sensitivity to movement and complex visual environments even after the original triggering event has resolved.
An individualized rehabilitation program may help address motion sensitivity, balance and functional limitations when appropriate.
Concussion-Related Dizziness
Dizziness after concussion may involve vestibular, visual, balance and/or cervical factors.
Assessment helps identify which systems may be contributing to symptoms so that rehabilitation can be targeted appropriately.
Cervicogenic Dizziness
In some people, dizziness or unsteadiness occurs together with neck pain, stiffness or altered neck movement.
When the clinical presentation supports cervical involvement, treatment may include both cervical and balance-related rehabilitation.
Balance and Gait Problems
Vestibular dysfunction can contribute to unsteadiness, difficulty walking in challenging environments and an increased risk of falls.
Balance and gait training can be incorporated into vestibular rehabilitation when appropriate.
Learn more about Balance assessments and falls prevention
What Happens During a Vestibular Physiotherapy Assessment?
Dizziness is a symptom rather than a diagnosis. A vestibular assessment therefore involves more than simply determining whether you have vertigo.
At Physiomobility, your assessment begins with a detailed history of your symptoms, triggers, medical history and functional limitations. Testing is then selected according to your individual presentation.
Your assessment may include:
Detailed Dizziness and Balance History
Your physiotherapist will ask questions such as:
- When did your symptoms begin?
- Does the sensation feel like spinning, lightheadedness, rocking or imbalance?
- How long does each episode last?
- What movements or environments trigger symptoms?
- Are there associated hearing, neurological, migraine or neck symptoms?
- Have you fallen or become less confident walking?
The pattern and timing of symptoms provide important information when determining possible causes of dizziness.
Eye Movement Examination
The vestibular system has close connections with the eyes.
Assessment of eye movements can therefore provide useful information about vestibular and neurological function. Depending on your presentation, your physiotherapist may examine eye movements at rest, during gaze, with head movement and during positional testing.
Infrared Video Goggles
Physiomobility uses infrared/video goggles when clinically appropriate to observe eye movements more closely.
Visual fixation can suppress certain types of nystagmus. Infrared goggles allow the eyes to be observed in reduced visual fixation, which can help the clinician identify eye-movement patterns that may otherwise be difficult to see.
Positional Testing for BPPV
When your symptoms suggest positional vertigo, tests such as the Dix-Hallpike test or supine roll test may be performed.
The direction and characteristics of the resulting eye movements help determine whether BPPV is present and, when possible, which semicircular canal is involved.
Vestibulo-Ocular Reflex and Visual Stability
The vestibulo-ocular reflex helps keep your vision stable while your head is moving.
Testing may examine how well your eyes remain focused during head movement and whether certain head movements reproduce symptoms.
Balance and Gait Assessment
Your physiotherapist may assess balance under different sensory conditions and observe your walking, turning and ability to perform functional movements.
This helps identify how vestibular, visual and somatosensory information may be affecting your stability.
Cervical Screening
When dizziness occurs with neck pain, stiffness, headache or a history suggesting cervical involvement, assessment of the neck may also be appropriate.
Neurological Screening and Referral
Not all dizziness originates from the vestibular system.
If your history or examination identifies findings that require further medical investigation, your physiotherapist may recommend assessment by your physician or another appropriate healthcare professional.
What Is Vestibular Rehabilitation Therapy (VRT)?
Vestibular Rehabilitation Therapy, or VRT, is a specialized form of exercise-based rehabilitation designed to reduce dizziness, improve balance and help people function more confidently when vestibular dysfunction is contributing to their symptoms.
VRT is not a standard set of exercises given to everyone with dizziness.
Your treatment program should be based on your diagnosis or clinical findings, the movements and environments that provoke symptoms, your balance abilities and the activities you need to return to.
Learn more about Vestibular Rehabilitation Therapy
How Does Vestibular Physiotherapy Work?
Depending on your assessment findings, treatment may include one or more of the following approaches.
Repositioning Manoeuvres
When BPPV is confirmed, your physiotherapist may perform a canal-specific repositioning manoeuvre designed to move displaced inner-ear particles out of the affected semicircular canal. The appropriate manoeuvre depends on the canal involved and the findings of positional testing.
BPPV is a mechanical disorder which is caused by the displacement of calcium carbonate crystals in the vestibular canals in the inner ear. This crystal displacement can occur in different canals and therefore different manoeuvers may be used to re-position the crystals. Epley or modified Epley are frequently performed successfully by our therapists. An accurate assessment determines the necessity and form of a re-positioning maneuver. Different re-positioning maneuvers such as Epley, Semont, Gufoni are only a few of the re-positioning techniques and each is indicated for a specifically involved canal and a certain form of BPPV. Not every dizziness disorder requires re-positioning or Epley.
Gaze Stabilization Exercises
The nerves from the inner ear (vestibular nerve) have a connection to visual and balance centers in the brain. When the vestibular system is conflicted, this can affect the person’s ability to maintain their gaze and focus. Majority of patients with dizziness experience this dysfunction. A series of visual and head movement exercises are given to patients to stabilize their gaze and improve head-eye movement co-ordination. Exercises are progressed according to your symptoms and abilities.
Habituation or Adaptation Exercises
Habituation involves controlled and progressive exposure to movements or visual situations that provoke symptoms when this approach is clinically appropriate.
The goal is not simply to make you dizzy repeatedly, but to help reduce unnecessary sensitivity while gradually restoring normal activity.
Patients who have experienced an acute onset of BPPV or other conditions causing dizziness and continue to be sensitive to movement require habituation which involves controlled and progressive exposure to movements or visual situations that provoke symptoms.
Adaptation exercises are specific movements in specific patterns, frequency, and range to stimulate the brain until the brain habituates the response. In simple terms, we challenge the brain and progressively improve the connection between the brain and the inner ear with specific exercises that are tailored to each patient to habituate to the movement or learn how to process the conflicting information it receives from the inner ear.
Balance and Gait Training
Balance exercises may challenge combinations of visual, vestibular and somatosensory information. Balance exercises are designed to improve muscle responses to postural changes, improve sensory-motor integration and coordinate and improve the brain’s information processing for the stimulation received from eyes, ears and joints and muscles. In addition, body weight strengthening, core, and postural muscle strengthening are included.
Treatment can progress from relatively simple standing exercises to walking, turning, uneven surfaces, reduced vision and more complex functional tasks depending on your needs.
Visual-Motion and Functional Training
Some people are particularly symptomatic in visually complex environments such as grocery stores, shopping centres, crowds or while scrolling on screens.
Treatment may gradually incorporate appropriate visual and functional challenges to reduce sensitivity to visual stimulation.
Individualized Home Exercise Program
Your physiotherapist may prescribe specific exercises to perform between appointments.
Exercises should be selected and progressed based on your assessment rather than using a generic vestibular exercise program.
How Long Does Vestibular Rehabilitation Take?
There is no single treatment timeline for vestibular rehabilitation.
Recovery depends on factors such as:
- The underlying diagnosis
- How long symptoms have been present
- Whether one or both vestibular systems are affected
- Balance and mobility
- Migraine or concussion-related factors
- Other medical or musculoskeletal conditions
- Ability to participate in a home exercise program
BPPV is different from many other vestibular conditions. Some cases of BPPV may respond to a relatively small number of repositioning treatments, while vestibular hypofunction, persistent dizziness or complex balance problems may require a longer rehabilitation program.
Following your assessment, your physiotherapist can provide a more individualized treatment plan.
Your first appointment is primarily about understanding your symptoms and determining what may be contributing to them.
What Should I Expect at My First Vestibular Physiotherapy Appointment?
Depending on your presentation, the appointment may include:
- A detailed history of your dizziness, vertigo and balance symptoms
- Eye movement and vestibular testing
- Positional testing if BPPV is suspected
- Balance and gait assessment
- Cervical or other relevant physical assessment
- An explanation of the assessment findings
- Initial treatment when appropriate
- An individualized home exercise program when indicated
- Recommendations for further medical assessment or referral if needed
If BPPV is identified, treatment may begin during the same appointment when appropriate.
Why Choose Physiomobility for Vestibular Physiotherapy?
A Team Experienced in Vestibular Rehabilitation
Physiomobility has vestibular physiotherapists with postgraduate training and a clinical focus on dizziness, vertigo, balance and vestibular rehabilitation.
Our vestibular team assesses both common and more complex presentations rather than treating every episode of dizziness as BPPV.
Comprehensive Vestibular Assessment
Treatment starts with assessment.
Depending on your symptoms, this may include positional testing, eye movement examination, vestibulo-ocular reflex assessment, balance testing, gait assessment and cervical screening.
Infrared Video Goggles
We use infrared/video goggles when clinically appropriate to improve observation of nystagmus and other eye movements during vestibular and positional testing.
More Than BPPV Treatment
Repositioning manoeuvres are highly relevant when BPPV is present, but not all dizziness is BPPV.
Our vestibular physiotherapy services also address rehabilitation needs associated with vestibular hypofunction, vestibular neuritis, persistent dizziness, vestibular migraine, concussion and balance disorders when physiotherapy is appropriate.
Multidisciplinary Rehabilitation
Because Physiomobility is a multidisciplinary rehabilitation clinic, vestibular treatment can be coordinated with care for associated neck pain, concussion-related problems, mobility limitations and balance concerns when appropriate.
Convenient Don Mills Location
Physiomobility Health Group is located at CF Shops at Don Mills in North York, Toronto, providing convenient access for people living and working in Don Mills and surrounding Toronto communities.
Dizziness vs. Vertigo: What’s the Difference?
Dizziness is a broad term that can describe sensations such as lightheadedness, unsteadiness, floating, rocking or disorientation.
Vertigo refers more specifically to an illusion of movement, such as feeling that you or your surroundings are spinning or moving when they are not.
Because dizziness can have vestibular and non-vestibular causes, determining the pattern and associated symptoms is an important part of assessment.
Learn more about dizziness, vertigo and balance problems.
Frequently Asked Questions About Vestibular Physiotherapy
Can physiotherapy help Vertigo?
Yes, certain causes of vertigo can respond well to physiotherapy. BPPV, for example, can often be treated using specific repositioning manoeuvres after positional testing confirms the diagnosis and affected canal.
Other vestibular conditions may benefit from vestibular rehabilitation rather than repositioning manoeuvres.
Is vestibular physiotherapy the same as BPPV treatment?
No.
BPPV treatment is one component of vestibular physiotherapy. Vestibular physiotherapists also assess and rehabilitate problems involving vestibular hypofunction, balance, visual stability, motion sensitivity and other causes of dizziness.
What should I wear to a vestibular assessment?
Wear comfortable clothing that allows you to move your head, neck and body easily and supportive footwear suitable for balance and walking assessment.
Will vestibular exercises make me dizzy?
Some vestibular exercises intentionally create a mild, controlled level of symptoms because the nervous system needs appropriate exposure to certain movements to adapt.
Exercises should be individualized so that the level of challenge is appropriate for your condition and stage of recovery.
Do I need a doctor’s referral for vestibular physiotherapy?
A physician’s referral is generally not required to see a physiotherapist in Ontario. However, some extended health insurance plans may require a referral for reimbursement. Check the requirements of your individual plan.
Can vestibular physiotherapy help after a concussion?
It may help when vestibular, balance or visual-motion problems are contributing to persistent symptoms following concussion. A detailed assessment is important because post-concussion dizziness can have multiple contributing factors.
How many vestibular physiotherapy sessions will I need?
The number of visits varies considerably depending on the diagnosis and individual response.
BPPV may require relatively few treatments in some cases, while vestibular hypofunction, persistent dizziness and complex balance disorders may require rehabilitation over a longer period.
Can I receive vestibular physiotherapy virtually?
Some components of vestibular rehabilitation and follow-up may be appropriate for virtual physiotherapy. However, certain vestibular and positional tests require an in-person assessment. Contact our clinic to determine which option is appropriate for you.
Vestibular Physiotherapy in Don Mills, North York
Physiomobility Health Group provides vestibular physiotherapy and rehabilitation for people experiencing dizziness, vertigo and balance problems in Don Mills, North York, Toronto and surrounding communities.
Our clinic is conveniently located at CF Shops at Don Mills.
If dizziness or imbalance is limiting your work, exercise, walking or everyday activities, the first step is determining what may be contributing to your symptoms.
Book a Vestibular Physiotherapy Assessment
Related Vestibular Resources
Learn more about:
- BPPV & Positional Vertigo Treatment
- Vestibular Migraine
- Vestibular Neuritis
- Dizziness & Vertigo Exercise Video Library
Clinical Review
Clinically reviewed by Gita Mikal, Registered Senior Vestibular Physiotherapist
Gita Mikal is a physiotherapist at Physiomobility Health Group with advanced training in vestibular disorders and has a clinical focus on vestibular rehabilitation, dizziness, balance disorders as well as concussion management.
Last clinically reviewed: August 2026
This information is provided for educational purposes and does not replace individualized medical assessment. Sudden or severe dizziness accompanied by new neurological symptoms, severe headache, chest pain, fainting or other concerning symptoms requires appropriate urgent medical assessment.
