Don’t Fall for It – Inner Ear Mysteries Revealed!


One of the three sensory systems that our bodies use to maintain balance is located in your inner ear, called the vestibular system.  When you turn your head, a fluid sloshes against tiny (microscopic!) sized hair cells in your inner ear.   As we get older, the density of these hair cells decreases, and this decline reduces our sensitivity to head movements, which increases our sway.  These wobbles are more apparent when vision is no longer available (like in a dark movie theater) and when the somatosensory information is distorted (like standing on an unstable surface).

Our vestibular system is also responsible for helping us stabilize our vision when we turn our heads rapidly with something called the vestibulo-ocular reflex – VOR.   The VOR tells your eyes how much to move in their sockets to the left when you turn your head to the right in order to stay focused on the object ahead of you.

If someone is sedentary (like being confined to bed rest after surgery) and they aren’t turning their heads at all, the VOR gets a little out of shape from disuse.  This puts the person at a high risk for falling when they do stand up and turn their head.  I always suspect a weak VOR when someone tells me “All I did was turn my head and the next thing I knew I was on the ground!”

Another common cause of dizziness is BPPV (Benign Positional Paroxysmal Vertigo).  This condition develops when teeny tiny crystals called otoconia fall into one of the wrong canals in your inner ear, causing dizziness with certain movements of your head. I had a severe case of BPPV this year – it’s nasty!  The good news is that this disorder is very treatable.

Many older adults have been living with this disorder for years and have never been treated for it.

There are techniques available to improve your VOR and cure your BPPV, but they are too complicated to describe in this blog.  If you experience dizziness, I highly recommend that you talk to your doctor or see a vestibular specialist.  Check out the Vestibular Disorders Association (VEDA) at for more information.

I had a 93 year old class participant tell me this week that her doctor just laughed at her when she said she was feeling dizzy, telling her that this was just a function of her age. No way!  Dizziness is not something you have to meekly just live with!  I referred her to a wonderful vestibular specialist  – which I hope you will consider as well if your inner ear is making you woozy!

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