Concussion Dizziness & Vertigo — Vancouver
Dizziness is the second most common post-concussion symptom after headache — and the symptom most likely to keep someone away from work, driving, sport and screens. Post-concussion dizziness is almost always vestibular in origin: the inner-ear, brainstem and visual-vestibular integration are sensitive to the same forces that injure the brain.
Targeted vestibular rehabilitation at Envision Physiotherapy resolves the dysfunction at its source. We are a Complete Concussions Management (CCMI)-certified clinic and have vestibular-trained physiotherapists at both Vancouver locations.
No referral required. Direct billing to most extended health, ICBC.
What's actually causing the dizziness
Vestibulo-ocular reflex (VOR) dysfunction. Your inner-ear normally moves your eyes in perfect counter-rotation to your head. After concussion, this reflex is impaired — quick head turns blur vision, busy environments overwhelm, and you feel like the world keeps moving after you stop. Gaze-stabilisation exercises retrain the VOR in 4–8 weeks.
BPPV (Benign Paroxysmal Positional Vertigo). Concussion can dislodge calcium crystals in the inner ear, causing brief, intense spinning when rolling over in bed or looking up. BPPV is the most common single cause of post-concussion dizziness and is treated with positional manoeuvres (Epley, Semont) — typically resolved in 1–3 sessions.
Visual-vestibular mismatch. When the inner-ear and visual systems disagree, you feel dizzy in busy visual environments — grocery stores, traffic, fluorescent lighting. Habituation exercises gradually reduce the system's sensitivity.
Cervicogenic dizziness. Less common but real — upper-cervical dysfunction can produce a non-spinning, unsteady dizziness. Manual therapy and cervical proprioceptive retraining address it.
How we assess and treat it
Your initial vestibular assessment includes oculomotor testing (smooth pursuit, saccades, convergence, VOR cancellation), dynamic visual acuity, the Dix-Hallpike and supine roll tests for BPPV, balance testing (static, dynamic, sensory organisation), and cervical screening.
Treatment is matched to your specific dysfunction — gaze stabilisation, BPPV repositioning manoeuvres, habituation exercises, balance retraining and Buffalo Concussion Treadmill Test–guided aerobic reconditioning. Most patients see substantial reduction in dizziness within 6–12 sessions.
When dizziness needs urgent attention
Sudden severe dizziness, double vision, slurred speech, facial weakness, or hearing loss require emergency assessment — these are not typical post-concussion symptoms. For ongoing post-concussion dizziness without these red flags, book a vestibular assessment.
Common Questions
How long does post-concussion dizziness last?
Most post-concussion dizziness resolves within 4–6 weeks with appropriate vestibular rehabilitation. Without targeted treatment, dizziness can persist for months — and is one of the strongest predictors of chronic post-concussion syndrome.
Will my dizziness go away on its own?
Some cases resolve spontaneously, but research consistently shows that early vestibular rehabilitation produces faster and more complete recovery than waiting. If dizziness persists beyond two weeks, assessment is recommended.
Is my dizziness coming from my neck or my inner ear?
Both are possible — and often both contribute. A vestibular assessment isolates each driver and quantifies the contribution. Treatment is then matched specifically to what is dysfunctional.
Can I drive while I have post-concussion dizziness?
Avoid driving until your dizziness has substantially resolved or your physiotherapist clears you. Driving requires intact gaze stabilisation, visual processing and reaction time — all commonly impaired after concussion.
Connected services
Book in this week
Same-week assessments at South Granville and False Creek. No referral required.
Book Now