Evidence-Based Treatment

Physical Therapy Exercises for Post-Concussion Dizziness

Dizziness affects 50-60% of concussion patients. These evidence-based vestibular exercises—used by physical therapists—can significantly reduce symptoms and speed recovery.

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50-60%

of Patients Affected

2-4

Weeks to Improve

Daily Sessions

*Per Hall CD, et al., JNPT 2022 Clinical Practice Guideline for Vestibular Rehabilitation.

Why Concussions Cause Dizziness

Concussions disrupt the vestibular system—your brain's balance and orientation center. This causes a mismatch between what your eyes see, what your inner ear feels, and what your brain expects.

Vestibulo-Ocular Reflex (VOR) Dysfunction

The reflex that keeps your vision stable during head movement gets disrupted, causing blurred vision and dizziness with motion.

Visual Motion Sensitivity

Your brain becomes overly sensitive to visual motion—grocery stores, scrolling phones, and busy environments trigger dizziness.

Balance Impairment

Disrupted sensory integration makes you feel unsteady, especially on uneven surfaces or in the dark when visual cues are limited.

Good News

Vestibular physical therapy exercises work by retraining your brain to process balance information correctly. Most people see significant improvement within 2-4 weeks of consistent daily practice.

Three Types of PT Exercises for Concussion Dizziness

A complete physical therapy program addresses all aspects of vestibular dysfunction

VOR (Gaze Stabilization) Exercises

The foundation of concussion dizziness treatment

VOR exercises retrain the vestibulo-ocular reflex—the system that keeps your vision stable during head movement. This is THE most important exercise category for concussion-related dizziness.

VOR x1 Exercise

Hold a target (like your thumb or a business card with a letter on it) at arm's length. Keep your eyes focused on the target while moving your head side-to-side or up-and-down. The target stays still—only your head moves.

Duration: 1 minute per direction (horizontal, vertical)
Frequency: 2-3 times daily
Goal: Keep the target clear (not blurry)

VOR x2 Exercise (Advanced)

Move your head and the target in opposite directions. For example, move your head right while moving the target left. This doubles the challenge to your VOR.

When: Only after VOR x1 becomes easy
Duration: 30-60 seconds per direction
Note: More challenging; expect mild symptoms initially

Complete VOR exercise guide with videos

Habituation Exercises

Reduce motion sensitivity and visual triggers

Habituation exercises desensitize your vestibular system through repeated, controlled exposure to movements and visual stimuli that trigger mild symptoms. Your brain learns to filter out false signals.

Head Movement Habituation

• Quick head turns left-right-left
• Nodding "yes" quickly 10 times
• Head tilts ear-to-shoulder
• Looking up and down rapidly

Repeat until mild symptoms appear, rest briefly, repeat 3-5 times

Visual Motion Habituation

• Walk through busy environments (malls, stores)
• Watch moving patterns or scrolling content
• Practice in visually complex spaces
• Move eyes rapidly side-to-side

Start with 5-10 minutes, gradually increase exposure

Important

Habituation exercises should provoke mild symptoms that resolve within 15-30 minutes. If symptoms are severe or last hours, reduce intensity.

Balance and Postural Training

Restore stability and reduce fall risk

Balance exercises challenge your postural control system by manipulating visual input, surface stability, and head position. Progressive difficulty is key.

LEVEL 1 Basic Balance

• Stand on firm surface, eyes open (30-60 seconds)
• Stand on firm surface, eyes closed (30 seconds)
• Tandem stance (heel-to-toe) eyes open

LEVEL 2 Intermediate Balance

• Stand on foam pad, eyes open then closed
• Single-leg stance (30 seconds each leg)
• Walk heel-to-toe (tandem walking) for 10 feet
• Standing with head turns side-to-side

LEVEL 3 Advanced Balance

• Single-leg stance on foam, eyes closed
• Walking with head turns (gaze shifts)
• Backward walking, tandem backward walking
• Throwing/catching ball while standing on foam

Progression rule: Master each level before advancing. "Mastery" = hold position for full duration without wobbling or stepping.

Sample Daily Exercise Program

Week 1-2: Foundation Phase

Morning Session (10 minutes)

→ VOR x1 horizontal (1 min)
→ VOR x1 vertical (1 min)
→ Static balance on firm surface, eyes open then closed (2 min)

Afternoon Session (10 minutes)

→ VOR x1 horizontal + vertical (2 min total)
→ Head movement habituation: quick turns, nods (5 min)
→ Tandem stance (heel-to-toe) practice (2 min)

EVE

Evening Session (Optional, 5 minutes)

→ Light VOR x1 review (1 min each direction)
→ Visual habituation: scrolling, busy patterns (3-5 min)

Progression

After 2 weeks, advance exercises (add VOR x2, progress to foam balance, increase habituation exposure). Most people need 4-6 weeks of daily practice for full recovery. VOR Eye Rehab handles automatic progression for you.

When to See a Physical Therapist

Home Exercises May Be Enough

Mild to moderate symptoms
Clear concussion diagnosis
Symptoms improving (even slowly)
No significant balance problems
Motivated to practice daily

See a Vestibular PT If...

Severe or worsening symptoms after 2 weeks
No improvement with home exercises after 3-4 weeks
Severe neck pain or headaches (may need cervical PT)
History of multiple concussions
Balance so poor you're at risk of falling

Hybrid Approach

Many patients benefit from an initial in-person assessment with a vestibular PT, followed by app-guided home exercises. The PT can rule out complications (like BPPV or cervical issues) and prescribe the right exercises, while VOR Eye Rehab provides daily structure, tracking, and progression.

Frequently Asked Questions

Common questions about post-concussion dizziness exercises

How long does post-concussion dizziness last?

Post-concussion dizziness typically improves within 2-4 weeks with proper treatment. However, about 10-15% of concussion patients develop persistent symptoms lasting months or longer. Early intervention with vestibular physical therapy exercises significantly reduces the duration of dizziness and prevents chronic symptoms. Most patients who start exercises within the first few weeks recover faster than those who wait.

What type of dizziness is common after a concussion?

Post-concussion dizziness often presents as: visual motion sensitivity (worse in busy environments like grocery stores), positional dizziness with quick head movements, balance problems and feeling 'off', lightheadedness or brain fog, and nausea with motion. Unlike BPPV (benign positional vertigo), concussion dizziness is usually not a spinning sensation, but rather an unsteady or disoriented feeling.

Can I do vestibular exercises too soon after a concussion?

Current concussion guidelines recommend starting light physical activity and vestibular exercises within 24-48 hours after a concussion, as long as symptoms don't significantly worsen. The old advice of 'complete rest' is now considered outdated. Gentle vestibular exercises (like basic VOR x1) can actually speed recovery. However, if an exercise dramatically worsens symptoms for more than an hour, dial back the intensity or consult a concussion specialist.

Do I need a physical therapist or can I do concussion dizziness exercises at home?

For mild to moderate post-concussion dizziness, home exercises guided by a digital program like VOR Eye Rehab are often effective. See a vestibular physical therapist if: symptoms are severe or worsening after 2 weeks, you also have neck pain or headaches (may need cervical PT), you have a history of multiple concussions, balance is so poor you're at risk of falling, or home exercises aren't helping after 3-4 weeks. Many people benefit from an initial PT assessment followed by app-guided home exercises.

What's the difference between concussion dizziness and BPPV?

BPPV causes sudden, intense spinning vertigo triggered by specific head positions (rolling over in bed, looking up). It's caused by displaced crystals in the inner ear and is treated with repositioning maneuvers (Epley). Post-concussion dizziness is usually a general unsteadiness, visual sensitivity, or imbalance that's present with any movement. It's caused by disrupted vestibular processing in the brain and is treated with VOR exercises, habituation, and balance training. You can have both conditions simultaneously after a head injury.

How often should I do physical therapy exercises for concussion dizziness?

For optimal recovery, perform vestibular exercises 2-3 times daily, about 10-15 minutes per session. Consistency is critical—daily practice yields faster results than sporadic long sessions. You should provoke mild symptoms during exercises (a sign the exercises are working), but symptoms should resolve within 15-30 minutes. If dizziness lasts hours or significantly worsens, reduce intensity or frequency. Use a digital tracker to maintain consistency and monitor symptom trends.

Key Takeaways: PT Exercises for Post-Concussion Dizziness

Three exercise pillars treat concussion dizziness: VOR gaze stabilization (retrains the reflex), habituation (reduces motion sensitivity), and balance training (restores postural stability).
50-60% of concussion patients experience dizziness. It is the single most common vestibular complaint after head injury and responds well to targeted exercises.
Start VOR exercises within the first 2 weeks after concussion for fastest recovery. Early intervention reduces the risk of developing chronic vestibular symptoms.
Mild symptom provocation is therapeutic. Exercises should trigger mild dizziness (1-2 points) that resolves in 15-30 minutes. This drives brain adaptation.
Home exercises can be effective for mild-moderate symptoms. See a vestibular PT if symptoms are severe, worsening, or not improving after 3-4 weeks.

About This Guide

This content was created by the VOR Eye Rehab team, founded by a post-concussion syndrome survivor who spent years searching for answers before focused vestibular and vision rehabilitation gave recovery structure. Exercise protocols are based on the 2022 APTA Clinical Practice Guidelines for Vestibular Rehabilitation.

Medical Disclaimer: This guide is for informational purposes. Always consult a healthcare provider before starting vestibular exercises after concussion.

Published: February 2025 • Last Updated: February 2026

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