top of page

Dizziness and Balance Therapy

My Approach

What our patients say...

I can’t say enough good things about Liz’s work. First time when she treated me was more than 2 years ago, I went to her for a random and sporadic vertigo issue. I felt dizziness, spinning, loss of balance, and nausea. She diagnosed me with BPPV (benign paroxysmal positional vertigo) and treated me with her expertise. Liz is very knowledgeable, attentive, and asked the right questions. She did an awesome job to explain to me what my issue was by using an inner ear model. After two treatments back in 2018 I was dizziness free for 2 years. This year March I had the same issue again, my fiance is a family medicine resident. He tried to treat me first, and it went badly. I felt even dizzier and off-balance after his treatment. Immediately I contacted Liz and she helped me right away. I have been dizzy free since then. Cannot thank her enough, her work is magic.


After reading the information on the Engage website, I took the big step of making an appointment for an evaluation. For 40 years, I have had issues with dizziness being diagnosed with meniere’s disease and positional vertigo. It’s been tolerated because I’ve figured out how to adapt and just live with it. As I have aged, my balance has been significantly impacted with a fear of falling always present.

I had an evaluation appointment with Christina. In the conversation, I felt that I was listened to, that my condition was real and, most importantly, that there are ways in which it could be dealt with immediately and in the long term. She knew exactly how to start treatment and what would need to be done each step of the way. She stressed the importance of adhering to the process which contributed to my confidence in her expertise and in my being able ultimately to improve my quality of life. Most of the daily dizziness has already subsided!


I recommend Engage PT, OT, SLP highly based on my excellent experience working with Liz Yates Horton on Vestibular Therapy for vertigo. It was easy to make an appointment, the location was convenient with free parking, the receptionist was very personable and helpful, the facility was clean and attractive and the COVID precautions reassuring. Liz was wonderful to work with. She took time to thoroughly explain the cause of my vertigo and the course of treatment she would be providing with a 3D model. She executed my therapy with great care and competence. If the need arises, I’ll definitely be back.


What is balance?

Balance is the ability to maintain an upright position at rest or during movement. There are three main systems that work to keep us balanced:

  • Visual system (eyes)

  • Vestibular system (inner ear)

  • Somatosensory system (touch/sensation)

These three systems receive information about body position in relation to gravity and our surroundings, allowing us to react and move freely without falling. Illness, injury, medication interactions or aging can affect these systems and lead to decreased balance and a higher risk for falls.  Balance and vestibular therapy is a safe and effective treatment option to improve balance and decrease your fall risk.


What is the vestibular system?

The vestibular system consists of the inner ear and its connections to the brain. This system assists in keeping us balanced as well as coordinates head and eye movements. Vertigo and dizziness are common symptoms that occur when a person experiences vestibular dysfunction. Other symptoms include:

  • Blurred or shaky vision with head movements (oscillopsia)

  • Difficulty concentrating or feeling foggy-headed

  • Fluctuating ear pressure, fullness or ringing (tinnitus)

  • Hearing changes

  • Imbalance, falls or lack of coordination

  • Nausea or vomiting

How can physical therapy help with balance and vestibular issues?

The goal of balance and vestibular therapy is to improve your ability to safely participate in daily activities.  Specialized balance physical therapy can be used to address vestibular and balance problems that are the result of a variety of diagnoses. Such therapy is recommended for treating the following symptoms:

  • Dizziness or vertigo

  • Motion sickness that occurs when walking in crowds or busy environments

  • Spinning sensation when looking up, bending over or lying down in bed

  • Unsteadiness or frequent falls

  • Concussion

What to expect at your first visit?

  • A comprehensive evaluation including a medical history, medication review and a physical examination. 

  • Your initial visit gives your therapist the information they need to assess your problem, determine a prognosis, and create an individualized treatment plan.

  • Your therapist will discuss this plan with you at your initial evaluation.

  • You may attend therapy sessions 1-2 visits per week, depending on your condition.

We offer a team approach to helping those with:

What is Benign Paroxysmal Positional Vertigo (BPPV)?

  • Benign: Not malignant or damaging

  • Paroxysmal: Sudden onset or episodic

  • Positional: Triggered by movement or changes in head position

  • Vertigo: True rotational dizziness described as if you and the room are spinning

BPPV is episodic vertigo that typically lasts for short periods of time. It occurs with certain head movements or position changes such as looking up, bending over, lying down or turning from side to side in bed. Some individuals may also experience nausea or unsteadiness between episodes.  This is one of the main reasons people experience vertigo.

Can BPPV be treated with balance & vestibular therapy?

BPPV should be diagnosed and treated by a trained healthcare provider. During the initial assessment, your provider will move your head through a series of testing positions to observe all eye movements and determine which positions provoke vertigo. The assessment will involve the use of video goggles to record eye movements.

An effective and noninvasive treatment for BPPV is called a canalith repositioning maneuver. The treatment works by moving the ear crystals out of the semicircular canals and back to their normal position within the inner ear.

bottom of page