Why Dizziness and Imbalance Happens – Even When You’re Not Moving?

Dizziness and imbalance are among the most common, and most frustrating, symptoms people experience after illness, injury, or neurological change. They can make everyday life feel uncertain: walking in the supermarket feels overwhelming, turning your head too quickly sparks a spin, or standing still brings a sense of swaying, like you’re on a boat.

These sensations often arise because your brain and body’s balance systems are struggling to work together – and neurological physiotherapy is specifically focused on retraining that connection.

Understanding How Balance Works

To stay upright, your brain constantly gathers information from 3 key systems:

1. The vestibular system (inner ear):
   Deep inside your ear are tiny organs filled with fluid and microscopic hair cells. These detect movement and position changes; whether you’re turning your head, tilting, or accelerating.

2. The visual system (eyes):
   Your eyes help stabilise your world. They track motion and provide a frame of reference for balance; that’s why closing your eyes can make standing on one leg harder.

3. The proprioceptive system (muscles and joints):
   Sensors in your feet, legs, and spine tell your brain where your body is in space, even without looking.

The deeper areas of the brain – brainstem and cerebellum then integrate these signals to create a sense of stability. When one system sends confusing or weaker messages e.g. due to illness, injury, or de-conditioning, your brain gets ‘mixed messages’. This results in dizziness, unsteadiness, or that vague floating sensation.

Common Causes of Dizziness and Imbalance

 

Vestibular dysfunction

Conditions like vestibular neuritis, labyrinthitis, or benign paroxysmal positional vertigo (BPPV) affect the inner ear’s ability to detect movement. You might feel spinning, nausea, or imbalance that worsens with head turns.

Post-concussion and mild traumatic brain injury

After a concussion, the brain can have difficulty processing sensory information. The result is often a feeling of disconnection – moving your head or eyes makes the world feel ‘unstable’. Visual motion in crowds or on screens can often trigger symptoms too.

Neurological conditions

People living with conditions such as Parkinson’s disease, Multiple Sclerosis, Stroke, or Peripheral Neuropathy often experience balance challenges. These may come from changes in muscle tone, sensory loss, coordination deficits, or slower postural reflexes.

Age-related and de-conditioning changes

As we age, our vestibular hair cells reduce in number and effectiveness; vision can change and reaction time slows down. If you have been less active or had a long hospital stay, the muscles and balance systems can become less responsive, increasing the risk of falls.

Neck-related dizziness (Cervicogenic dizziness)

Tension or stiffness in the neck can disrupt signals from the neck’s position sensors to the brain, creating a mismatch between what your eyes and body sense.

Other contributors

Anxiety, medication side effects, dehydration, or blood pressure fluctuations can also cause dizziness or the fear of movement, reinforcing the cycle of unsteadiness.

What’s Actually Happening in Your Brain

Balance relies on integration. Your brain must make a clear decision from the information being passed to it from the eyes, ears and body. If one of these functions starts to work inefficiently, the brain can’t process information in the same way.

This sensory mismatch means your brain can’t predict how your body will respond to movement. It reacts with protective mechanisms; e.g. stiffening muscles, freezing posture, or dizziness as a “warning signal.”

Over time, this creates a learned pattern of imbalance. The less you move, the more your balance reflexes fade. Your brain loses the feedback it needs to recalibrate and you start to feel dizzy or unsteady more often, even in calm situations.

How Neurological Physiotherapy Can Help (help you feel grounded again)

A neurological physiotherapist is trained to assess how your sensory and motor systems interact. Through a tailored rehabilitation program, they help retrain your brain’s ability to integrate balance information effectively.

Assessment and diagnosis

Your physiotherapist will:

• Review your history of dizziness, triggers, and other symptoms.
• Test eye–head coordination and gaze stability.
• Assess balance reactions, postural alignment, and strength.
• Identify whether your dizziness is vestibular (inner ear), neurological, or functional in nature.

This detailed picture from assessment ensures that treatment is targeted, not generic:

1) Gaze Stabilisation Training

If you feel dizzy when turning your head or moving your eyes, this often means your vestibulo-ocular reflex (VOR) needs retraining.

Exercises might involve:

• Focusing on a target while moving your head side to side.
• Progressing from slow to faster speeds, and then to dynamic balance tasks.

These exercises strengthen your brain’s ability to keep your vision steady as you move. This is crucial for walking safely and regaining confidence.

2) Balance Retraining

Balance isn’t just standing still; it is your body’s ability to react to movement.

Therapy may include:

• Controlled balance exercises on different surfaces (foam, pillow, wobble cushion).
• Reaching or turning while maintaining upright posture.
• Dynamic balance challenges such as stepping or walking tasks
• Gradually, your brain learns to anticipate and correct balance shifts more efficiently.

3) Strength, Posture & Coordination

Weak calf or hip muscles, stiff ankles, or poor posture all reduce your ability to stabilise quickly. A personalised strengthening and mobility plan supports your balance work and helps to restore fluid, coordinated movement.

4) Habituation & Real-Life Integration

If motion or busy environments trigger symptoms, gradual exposure training helps desensitise your brain. This might mean practising head turns, looking between moving objects, or walking through a supermarket simulation under guidance.

We also address confidence and fear of falling, which are powerful barriers to recovery.

What Recovery Looks Like

Recovery time depends on the cause, but many people notice improvement within a few weeks of consistent, guided exercise. Neuroplasticity is the term used to explain your brain’s ability to adapt and form new pathways. It means that with the right stimulus, balance pathways can strengthen again.

Some people completely resolve their dizziness. Others may still have occasional mild symptoms but gain much greater control and confidence in managing them.

Your therapist will teach you how to monitor progress and safely increase daily activity, such as walking outdoors, turning quickly, or exercising again without fear.

When to Seek Help

Seek professional assessment if:

• Dizziness lasts more than a few days or keeps returning.
• You feel unsteady even when standing still.
• Head turns or looking up/down make symptoms worse.
• You avoid certain movements or situations due to fear of falling.

These can all be signs that your balance systems need retraining, and early intervention leads to better outcomes.

Ready to Find Your Balance Again?

If you’ve been living with dizziness, light-headedness, or imbalance, book a balance and vestibular assessment with one of our neurological physiotherapists.

Together, we’ll help you restore stability and feel grounded in your movement once more.