Guest Post written by Jimmy Pang (PT/DPT, AIB-VRC, ITPT, CCRT)
Swaying ropes, tall heights, and constant visual motion are part of what makes climbing so engaging. Most climbers adapt to these demands without issue. Occasionally though, dizziness or vertigo can creep in and start to affect confidence or performance on the wall — especially after a fall or head impact.
What many people do not realize is that there is a targeted form of physical therapy designed specifically to address dizziness and vertigo called vestibular rehabilitation.
What Is Vestibular Rehabilitation?
Vestibular rehabilitation is a specialized form of physical therapy focused on balance and a person’s sense of equilibrium. It works by addressing how the brain integrates information from three main systems: the inner ears, the eyes, and the body. When those systems are not communicating efficiently, dizziness and vertigo can occur.
Although many people have never heard of it, vestibular rehabilitation is well established in research. It’s commonly used after concussion, inner ear disorders, and certain neck-related injuries. Some high-level athletes even incorporate vestibular training to enhance performance — faster reaction times, better motion tolerance, better hand-eye coordination.
Concussion and Head Injury
Concussions and head injuries are more common in climbing than many people realize, even when helmets are worn. Helmets are designed to prevent skull fractures and serious blunt trauma, but they do not reliably prevent concussions — which occur due to rapid acceleration and deceleration of the head and neck.
Common concussion symptoms include:
- Headache or head pressure
- Dizziness or vertigo
- Sensitivity to movement or visual motion
- Difficulty focusing or tracking
Standard advice to “cocoon” in a dark room until symptoms resolve is largely outdated beyond the first 24–48 hours. Research now shows that active rehabilitation leads to better outcomes and reduces the risk of developing post-concussion syndrome. Vestibular rehabilitation and concussion recovery go hand in hand.
Cervicogenic Dizziness
Neck pain is common in climbers given the demands placed on the shoulders, upper back, and cervical spine. Beyond movement, the neck also provides the brain with information about head position through proprioception. If this information becomes unreliable, a sense of dizziness or disorientation can occur — known as cervicogenic dizziness.
Most commonly seen after whiplash-type injuries, it can also occur with neck strain or overuse. Vestibular rehabilitation effectively addresses this by integrating neck, visual, and balance retraining.
Persistent Dizziness or Visual Motion Sensitivity
Ongoing symptoms are usually related to how the brain processes sensory information rather than a simple mechanical problem. Vestibular rehabilitation for persistent symptoms often includes:
- Gradual exposure to head and body movement
- Visual motion tolerance training
- Targeted balance interventions
With appropriate guidance, even long-standing symptoms can improve. The brain remains remarkably adaptable with the right approach.
About the Author
Jimmy Pang (PT/DPT, AIB-VRC, ITPT, CCRT) is a physical therapist who specializes in treating dizziness, vertigo, and headaches based in San Diego. He works with both injured athletes and those suffering from more serious vestibular conditions.