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How Does Balance Work?

Imbalance and Falls Physical Therapy in New Jersey

Our balance system is often taken for granted.

On a day to day basis when you are feeling well, you might not sit to ponder or research the complexities that go into balance.

However, when a component of your balance system is not functioning optimally, you may be left with dizziness, imbalance, and fatigue and seeking answers for the cause of your condition.

And if you are feeling motion sensitive or dizzy you may be thinking, “I’m not afraid of my balance because I know I’m not going to fall… so balance is NOT my problem”.

But symptoms of motion sensitivity, dizziness, vertigo and even some headaches and migraines can all be rooted in problems with your balance system.

So, let’s clear the air, clarify a few terms, educate you, and talk to you about your next best steps so that you can finally get the right help.

What is dizziness?

There are a few different words that my clients will use to describe their symptoms.Here a few I have heard...

"I feel like my head is swimming"

"My eye are bouncing"

"I feel like I'm in a fog"

"I feel light-headed and woozy"

"I keep getting these sinus headaches and pressure"

"I feel unsteady"

"The room is spinning something awful and I feel like I am going to die!"

So let's just make sure we are all on the same page. We are going to use 3 different words when it comes to these symptoms:


If you’ve ever felt that the room (or the world!) was spinning, you know you’ve had vertigo. This sensation can last for seconds, minutes, or hours depending on the condition. Dizziness:

this is a feeling of "foggy" "woozy" or "light-headed" or “motion sickness”. This happens on "inside" Imbalance:

feeling unsteady, which may lead to falls

Any and all of these 3 symptoms all have to deal with your balance, even if imbalance is not a symptom you struggle with.

So let’s dive in…

How does balance work?

How Does Balance Work

  1. Sensory Information

  2. Central Nervous System

  3. Executing Muscles

  4. Postural Changes

Let's take a closer look at Sensory Information

There are 3 components...

1. Inner Ear (vestibular system)

Vestibular System

The anatomy of the inner ear is complex but can be divided into two parts: hearing (the snail looking end) and balance.

We will discuss the balance part—called the labyrinth.

The labyrinth contains a bony outside, and a membranous/jelly inside. All of our motion is detected through a change in fluid inside the components of this jelly system. It helps tell us how our head is moving in relation to gravity and speed.

2. Visual System

Our visual system has direct connections to our vestibular system called Vestibular Ocular Reflex, or VOR for short.

We will keep this one simple.

What we see gives our brain and body information about our environment and how to navigate it.

Our visual system is amazing because it responds to these signals from our vestibular system by rotating the eyes at equal and opposite directions of our head motion, this is called the vestibular ocular reflex, or VOR for short.

3. Joint Sense: proprioception & somatosensation

This system provides have information about where your body is in space because your feet sense you are on the ground when you stand. The joints in your feet send signals to your inner ear and brain that says you are standing on solid ground.

Vestibular Specialist NJ

Do you notice that it's harder to walk on sand at the beach versus walking on the hardwood floor in your house?

That's because your joint sense/proprioception is working harder to keep your body upright posture neutral so you don't topple over!

Tying it all together:

How Does Balance Work

  1. Sensory Information (Vision/Eyes, Vestibular/Inner Ear, Joint Sense/Proprioception)

  2. All this sensory information goes to our brain (central nervous system) for it to be processed

  3. The brain sends signals to our muscles to tell them how to execute movement

  4. When we move, our posture changes– our muscles send this motor information to our sensory system (eyes, inner ear and joint sense) to make adjustments and maintain and restore our balance

So why does this all matter?

This information from this process allows our brain to view the environment in three dimensions, maintain balance, and coordinate our movements.

When there is a problem in how these systems are talking to each other, it can lead to a variety of symptoms and problems.

Dizziness, nausea, headache, and vertigo symptoms can happen to people when there is a problem any part of this cycle.

People who rely too heavily on their visual system for balance or orientation to the world may find the following areas to be extra difficult to navigate:

  • Escalators

  • Busy carpets, repetitive tile, repetitive cobblestone patterns

  • Driving & Traveling (trains, boats, airplanes).

  • Computer, screen time

  • Sun glaring off the trees/objects and casting shadows that move

  • Wind blowing and shaking the trees and leaves

  • Crowded environments (supermarket, tourist areas).

It's important to keep the following things in mind when it comes to imbalance, vertigo, and dizziness:

  1. No individual system can provide all the necessary information for sensing motion of the whole body

  2. Each system may contribute unique and essential information to our brain which allows for motor output (motion and action!)

  3. Damage, injury, or weakness along any part of these systems has the potential of causing symptoms of dizziness, imbalance, headaches, and/or falls. But, the brain and body are always adapting and recovery is possible!

Call or text us at 732-691-4681 or email us at for your free dizzy analysis!


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