Balance. I love how Sally Goddard Blythe refers to balance - ‘the art of not moving’.

The primary controller of your balance is your vestibular system. Often, when I mention the vestibular system in a consult, people think of things such as tinnitus, dizziness, motion sickness, or vestibular migraines. But the reality is you can have a vestibular imbalance without having any of these symptoms. Our brains are so clever at compensating for ‘weak parts’ that it isn’t until we fix any underlying imbalances that we notice a shift in our body.

The importance of the vestibular system

There are two significant reasons I focus on the vestibular / balance systems of the body at the beginning of many care plans.

The biggest stimulation into the stress response of the body is through the vestibular system.

This means that if there is an imbalance in your balance systems, it will send messages directly to your stress systems to elicit a stress response. So if you’ve had any kind of chronic stress issue for a long time and can’t quite get a hold on it, it might be a vestibular issue. Chronic stress has a huge impact on the rest of the body - brain health, gut health, hormonal health - by focusing on the vestibular system initially it allows the stress response to reduce, and the flow on effect into the rest of the body can be life changing for some.

For those who experience vestibular migraines, this stress response due to excessive imbalanced vestibular input is a big trigger for their migraines. Plus stress tolerance of the nervous system is much lower because the system is already so stressed, so it doesn’t take much to tip them over the edge into vestibular migraine (or regular migraine) territory.

The vestibular system plays a big part in your postural control.

The muscles that support your spinal column are called postural muscles. They are meant to be able to hold your body up against gravity for as long as you need. When you have a vestibular imbalance, these muscles don’t get sufficient stimulation from the brain and tend to fatigue quickly. You might notice that you struggle to hold yourself up, maybe you notice yourself hunching after sitting for a while, or if standing for a period of time you feel you need to lean onto something to hold yourself up. For others, this imbalance can be severe enough that you feel like gravity is too strong for your body and you need to lay down to rest (one of the symptoms of chronic fatigue syndrome or fibromyalgia).

What is the vestibular system?

Now that you know the most important functions of the vestibular system, let’s look at what it does and how it functions in a healthy, integrated nervous system.

The task of the vestibular system is to facilitate orientation and postural control. The vestibular system uses gravity to work out where your body is in space. Once your vestibular system has told the rest of your brain where your body is, the rest of the brain uses this information to direct movement, spatial awareness, and feelings of safety vs stress.

Messages enter the brain from the vestibular system and combine with visual input to interpret the information. Often if the vestibular system is weak, or not integrating messages with the visual system, the visual system will take over and make up for deficits in balance. In these cases, you’ll find you need your eyes to watch everything your body is doing, and if something is done with closed eyes, the vestibular weakness becomes apparent.

The vestibular system sits within the inner ear, and uses head movement relative to gravity as its biggest source of information. A vestibular imbalance does not mean there is an inner ear pathology, and actually refers to a lack of integration of its messages into the rest of the brain.

Restoring the vestibular system

The most exciting thing for me in practice is that the vestibular system (and the rest of the brain) is very plastic, and in most cases responds to care very quickly.

Finding the source of imbalance is my biggest goal during vestibular consultations, and often you will go home with some exercises to do to stimulate the weaker part of your system.