Posted by: seattledizzygroup | February 28, 2018

Getting Through Difficult Days With Chronic Illness


Ways To Make It Through Tough Times With Chronic Illness

Living with chronic illness is challenging especially on days when symptoms and circumstances are at their worst.

These articles offer strategies to get through difficult days while living with chronic illness:

The First Step to Take When You’re Having a Rough Day

A Secret to Surviving a Rough Day

Finding the Strength to Get Through Bad Days

  How to Have a Bad Day Gracefully and Avoid Guilt with Chronic Illness

Balancing Good and Bad Days with Chronic Illness

Pushing Through Brain Fog on Difficult Days

10 Strategies to Try When You’re Sick of Being Sick

101 Self-Care Suggestions for When It All Feels Like Too Much

Practicing Self Care for Coping with Chronic Illness

Turning Negatives Into Positives When You’re Chronically Ill

Things to Do When You’re Mostly Housebound

Coping with the Isolation and Loneliness of Chronic Illness


© Copyright 2018, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | January 31, 2018

Help Make a Difference in 2018

We Grew Stronger Together in 2017! Help Us Continue to Make a Difference in 2018!

Seattle Dizzy Group is a respected leader in the vestibular and balance disorders patient support community with increasing national and global reach. (Read about our 2017 Highlights below). We hope you will join us in 2018 and help us continue to grow, provide community, and offer support to people living with chronic dizziness and imbalance–in Seattle and beyond.  With your help, we can continue to make a difference by expanding community outreach and involvement (including hosting professional speakers on various vestibular/balance topics and connecting with local health providers/resources) and also increasing our advocacy efforts to raise awareness about vestibular and balance disorders (including participating in Balance Awareness Week with our annual Walk for Balance Event, see Making a Difference for Balance Awareness).

Get Involved!

Seattle Dizzy Group is organized entirely by volunteers (the majority who are personally impacted by chronic dizziness and imbalance). With your help, we can continue to make a difference in 2018! We invite you to contribute to our group however you are able. Spread the word about Seattle Dizzy Group and invite others to join us. Share Seattle Dizzy Group information and resources with others. Participate in online discussions. Help with hosting in-person meetings and activities (be a greeter, assist with room set-up and take-down, bring snacks, provide transportation, etc.). For more info, email:

We are an independent, not-for-profit group funded through donations. As we continue to grow and expand our outreach efforts, we are naturally incurring more expenses. Our goal is to continue to offer no-cost support and resources to those in need in the vestibular community–in Seattle and beyond. Please consider supporting Seattle Dizzy Group with a financial gift to help us keep growing and thriving in 2018!  (Any donation amount is greatly appreciated!).

Ways your financial gift helps support Seattle Dizzy Group:

  • Providing materials, supplies, and hosting for monthly support group meetings.  (Each meeting costs about $25, or about $300 annually).
  • Providing thank you gifts for guest speakers. (As funds allow, we strive to honor speakers with about $25 value gift, or about $100 annually).
  • Providing administrative support, online services/resources, and website hosting, etc.  (Administrative costs are about $500 annually).
  • Providing funding for Balance Awareness Week event(s) and other group activities.  (Costs may be about $50-$100 or more per activity).
To give Seattle Dizzy Group a donation of any amount by credit card or PayPal, click the “Donate” button below.

PayPal Donate

(Gifts to Seattle Dizzy Group are not tax deductible at this time)

THANK YOU for your support!

2017 Highlights

  • In September, we hosted our Seventh Annual Walk for Balance Event in celebration of Balance Awareness Week and Falls Prevention Awareness Day/Week with a goal of raising awareness for vestibular and balance disorders and showing our support for people living with chronic dizziness and imbalance. We started the event with a Tai Chi warm-up activity led by Cascade Dizziness & Balance PT and then invited others to “Walk a Mile in Dizzy Shoes” with us at Green Lake.  We increased our impact during our walk by wearing blue, Seattle Dizzy Group gear, and Walk for Balance badge stickers as well as carrying balloons and balance awareness signs. After walking together, we honored event participants with our third annual Dizzy Spirit Awards. As a part of the celebration, we enjoyed food and giveaways (including free visit coupons from Move Beyond Limits Feldenkrais, North Seattle Community Acupuncture, and Bastyr Center for Natural Health). We also had a balance awareness Information Fair  throughout the event. It was a fun day that hopefully helped lift spirits and build momentum for the cause. We received wonderfully positive feedback from participants, and we are excited to continue to grow the event in 2018!
  • In October, we celebrated 11 years together as a support group!

  • In 2017, we continued to expand the Seattle Dizzy Group website/blog and online services/resources and reached thousands of people around the globe. (For example, our website/blog was viewed over 10,000 times in 2017 by visitors from about 100 different countries worldwide!). Additionally, we gained followers on Facebook and  Twitter, and increased membership of our MeetUp Group.  We appreciate everyone who connected online with Seattle Dizzy Group in 2017 and are especially grateful for all those who helped get the word out about our group and shared our posts/resources with others.

See also: Past Annual Highlights

© Copyright 2018, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | December 24, 2017

Surviving the Holidays with Chronic Illness

Ways to Survive the Holidays with a Chronic Illness

Living with a vestibular or balance disorder can be especially challenging during the holidays.  These articles offer ways to survive and enjoy the holiday season with a chronic illness:

Everything You Ever Wanted to Know about Surviving the Holidays with Chronic Illness

Surviving the Holidays When You’re Chronically Ill

Tips for Getting Through the Holidays with Chronic Illness

Finding Joy During the Holidays with a Chronic Illness

6 Things You Don’t Have to Do During the “Most Wonderful Time of the Year”

Holiday Tips for Vestibular Patients

   How to Survive the Holidays with Meniere’s Disease

How to Handle the Holidays with Hearing Loss

Holiday Migraine Avoidance Tips

Tips for Loved Ones:

A Holiday Letter to Loved Ones from the Chronically Ill

5 Holiday Wishes from Someone with an “Unseen” Illness

6 Things I Wish People Knew about Being Chronically Ill During the Holidays

8 Ways to Support the Chronically Ill During the Holidays

See also:

Holiday Tips

Tips for Surviving the Holidays with Joy and Peace

Living with a “New Normal” in the New Year

Ways to Survive Winter with a Chronic Illness


© Copyright 2017, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | November 30, 2017

Managing Hearing Loss and Tinnitus

Strategies for Improving Communication with Hearing Loss & Tips for Managing Tinnitus

by Mary Henry, AuD

of Swedish Balance Center

 (Presented to Seattle Dizzy Group on 11/4/17)

This presentation discusses hearing loss/impairment and offers strategies for improving communication with others as well as tips for managing tinnitus.

The majority of people with hearing loss have loss in the high pitches of speech (“f, s, th, k”), which tends to cut out the clarity of speech. This is why a common complaint for a person with hearing loss is “I can hear fine – people speak loudly enough, but they mumble!”  However there are many different configurations of hearing loss, particularly for those who experience balance problems.

If you have ever had a hearing test (or plan to have one), feel free to draw your right (O) and left (X) hearing scores on this graph and see which letters you might be missing! The letters you have difficulty hearing are the ones which fall above your scores (as they are softer than the softest sound you can hear). Talk with your audiologist if you have questions about this.

Communication  Strategies for the Individual

Advocate for Your Listening Needs

Hearing loss is “invisible.” This means it is difficult for others to determine when you are having difficulty hearing. Acknowledging your hearing loss and educating others about your listening needs will facilitate successful communication. Many are unaware of strategies that can improve communication. Education and gentle reminders to use strategies are helpful to improve communication.

Strategies to Share for Improving Communication

  • “Please get my attention before speaking to me. It is helpful if you say my name or tap me on the shoulder to ensure you have my attention before beginning to speak.”
  • “Please look at me when speaking. I benefit from seeing your mouth for speechreading cues.”
  • “Please speak slowly and clearly. It is difficult for me to hear some speech sounds when speech is spoken quickly.”
  • “Please reduce the background noise. I will hear you better if the television/radio/dishwasher/fan is turned off.”
  • “Please don’t cover your mouth while speaking to me. I benefit from seeing your mouth for speechreading cues.”
  • If you only hear part of a sentence, repeat the part of speech that you did hear, for the other person to fill it the part you missed. (“You want to go to the movies when?”)
  • “Please let me know if the topic of conversation changes. Please give me a clue such as: Movie. What movie would you like to see?”
  • “May I sit at the center of the table? Sitting in the center allows me to clearly see everyone, which will provide me with visual cues about the conversation.”
  • “May I sit with the noise to my back? It will help my hearing aids reduce those sounds” (if you wear hearing aids with directional microphones).

Communication Strategies for Friends and Family

Hearing loss is “invisible.” The nature of hearing loss makes it difficult for communication partners to realize when a communication breakdown has occurred. People with normal hearing may be unaware of the additional concentration those living with hearing loss exert to communicate. As a communication partner to someone with hearing loss, you can take the following steps to facilitate communication and understanding:

  • Always speak from within the same room.
    • A person with hearing loss will not hear your message when you speak from one room into another.
  • Face the listener when speaking.
    • The listener with hearing loss utilizes visual cues in addition to hearing. Clearly seeing the mouth is essential.
    • Do not cover your mouth with your hand or an object as this muffles your speech and removes visual cues
    • Take advantage of well-lit areas to increase facial visibility.
  • Get the listener’s attention before speaking.
    • Tap the listener on the shoulder before talking, if mutually agreeable by both individuals.
    • Say the listener’s name before talking. This simple step focuses the listener’s attention and a head turn provides acknowledgement to the speaker that the listener is prepared for conversation.
  • Reduce background noise when conversing.
    • Turn off the television, radio or noisy equipment when possible.
    • Select quiet establishments or dine during off-peak hours when visiting restaurants.
    • Conversations in the car may be challenging. Assistive devices may be helpful in reducing these challenges. Talk to your audiologist to determine if these are appropriate.
  • Visit in smaller groups when possible.
    • Many hard of hearing people have difficulty following and participating in rapid conversations between many speakers. Reducing group size to a smaller group of three or four versus a larger group of eight or more speakers can result in easier participation.
    • Cue the listener with hearing loss when the topic of conversation changes.
  • Speak slowly and clearly.
    • Rapid speech is often difficult to understand for those with hearing loss. But don’t slow down too much — that can also reduce understanding!
    • Enunciate clearly.
  • Do not shout.
    • While speaking loudly and clearly are appreciated, shouting is not necessary.
    • Shouting distorts facial features and may hinder lip reading cues.


What is tinnitus?  Tinnitus (pronounced TIN-it-us or tin-NIGHT-us) is the perception of a sound or noise in the ear or head that occurs in the absence of a sound.  Some people perceive tinnitus as a ringing sound while others report it as a clicking, roaring, hissing or static noise.  It is also common for tinnitus to become louder and change in severity from time to time.   The exact cause of tinnitus is unknown, however it is often associated with hearing loss and is sometimes a symptom of it.  It should be noted that tinnitus can occur independently of hearing loss, and sometimes people with normal hearing will also experience it.

What causes tinnitus?  The exact physiological causes of tinnitus are not known.  It may be associated with many factors, including the following:

  • Noise exposure
  • Cerumen (ear wax) impaction
  • Side effects of medications (particularly anti-inflammatory medications and medications in the aspirin family
  • Fatigue
  • Stress
  • Vascular abnormalities
  • Ear conditions, including hearing loss, Meniere’s Disease and ear infections
  • Ear, head and neck traumas and jaw misalignment
  • Other possible factors that are less conclusive include alcohol, caffeine and smoking
  • Other unknown factors

Can it be cured?  Though it is the subject of extensive research, there is currently no known cure for tinnitus.  The nature of tinnitus is unpredictable.  For some it may spontaneously resolve over time.  Others learn to live with tinnitus as a chronic condition.  Coping strategies are recommended to manage tinnitus symptoms.

What can I do to manage my tinnitus?  Different strategies work for different people.  Below are some suggestions:

  • Remain positive. It can be easy to become discouraged by limited tinnitus treatment options.  Tinnitus is an area of extensive research.  We may have insights and answers tomorrow that are not available today.
  • Redirect your attention. Many report that focusing on the tinnitus can exacerbate the symptoms.  Pursuing a hobby or favorite activity can be an effective refocusing tool.  Many report that they are unaware of the tinnitus when reading an interesting story, watching a favorite television program or having a conversation with others.
  • Explore masking noises. Tinnitus is often most noticeable when trying to fall asleep or early in the morning.  Some find that the use of noise machines or a radio playing at a low level mask the noise of tinnitus while falling asleep.
  • Wear hearing aids if appropriate for your hearing. Many report that tinnitus is less noticeable when hearing aids are worn.  Hearing aids do not cure or prevent tinnitus.  The increased volume provided by hearing aids can sometimes mask tinnitus sounds.
  • Avoid loud noises. Always wear hearing protection when operating machinery and lawn equipment and when attending concerts or playing an instrument.
  • Reduce stress. Many report that tinnitus is more prominent during periods of stress.  Consider breathing exercises, yoga or taking a walk to reduce stress.
  • Rest. Get adequate sleep at night.  Fatigue has been associated with increased tinnitus.

Where can I find other tinnitus resources?  Tinnitus information, management strategies and support groups can be found through the following sources:

American Tinnitus Association:

American Academy of Audiology:

American Speech-Language and Hearing Association:

Mayo Clinic:

TM Soft: Downloadable white noise maskers:


Mary Henry, AuD

of Swedish Balance Center





Presentation information is not meant to be taken as medical advice.

Presentations posted online may include discussion notes, links, images, and other information added by Seattle Dizzy Group.


© Copyright 2017, Seattle Dizzy Group. All rights reserved.


Posted by: seattledizzygroup | October 31, 2017

Treating Dizziness and Imbalance with Physical Therapy

October is National Physical Therapy Month!

Every October, the American Physical Therapy Association (APTA) celebrates National Physical Therapy Month (NPTM) which is a great opportunity to learn about the many benefits of physical therapy and recognize the impact of physical therapists.

Maximize your movement. Participate in your recovery. Choose physical therapy!  

Find out more:

How Can Physical Therapy Help with Dizziness and Imbalance?

Dizziness is a common problem, especially among older adults. In fact, for people over the age of 65, dizziness is one of the most common reasons for physician visits and hospitalizations. Regardless of the cause of dizziness, the sooner you get help, the better.

The good news: most dizziness and balance disorders can be successfully treated—and they are not an “inevitable” part of aging.

Your physical therapist can perform tests to determine the causes and also to assess your risk of falling. Often, there is more than one reason for dizziness and falls in the same person. Based on your physical therapist’s evaluation and your goals for recovery, the therapist will customize a treatment plan for you. Your therapist’s main focus is to help you get moving again and manage the dizziness at the same time. Exercise and new ways to perform daily activities are the primary treatments.

During your recovery, your physical therapist will teach you strategies to help you cope with your symptoms:

  • Do certain activities or chores around the house cause you to become dizzy? Your therapist will show you how to do those activities in a different way to help reduce the dizziness.
  • Have simple activities become difficult and cause fatigue and more dizziness? Your therapist will help you work through these symptoms right away so you can get moving again and return to your roles at home and at work more quickly.

Physical therapy treatments for dizziness can take many forms. The type of exercise that your therapist designs for you will depend on your unique problems and might include exercises to improve your balance, to improve your ability to focus your eyes and vision, and to “correct” differences between your brain and your inner ears. The inner ears tell the brain how the body is moving in relation to gravity. They also communicate information about head motion, which is used to coordinate eye motion.

In addition to those exercises, your physical therapist might prescribe exercises to improve your strength, your flexibility, and your heart health—with the goal of improving your overall physical health and well-being.

(Information from Move Forward PT)

Evidence has shown that vestibular rehabilitation (a specific type of physical therapy) can be effective in improving symptoms related to many vestibular (inner ear/balance) disorders. People with vestibular disorders often experience problems with vertigo, dizziness, visual disturbance, and/or imbalance. These are the problems that rehabilitation aims to address. Other problems can also arise that are secondary to vestibular disorders, such as nausea and/or vomiting, reduced ability to focus or concentrate, and fatigue.

Symptoms due to vestibular disorders can diminish quality of life and impact all aspects of daily living. They also contribute to emotional problems such as anxiety and depression. Additionally, one of the consequences of having a vestibular disorder is that symptoms frequently cause people to adopt a sedentary lifestyle in order to avoid bringing on, or worsening, dizziness and imbalance. As a result, decreased muscle strength and flexibility, increased joint stiffness, and reduced stamina can occur.

Treatment strategies used in rehabilitation can also be beneficial for these secondary problems.

(Information from Vestibular Disorders Association)


Vestibular Rehabilitation Therapy Promotes Compensation

Vestibular rehabilitation (VR), or vestibular rehabilitation therapy (VRT) is a specialized form of therapy intended to alleviate both the primary and secondary problems caused by vestibular disorders. It is an exercise-based program primarily designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and falls.

For most people with a vestibular disorder the deficit is permanent because the amount of restoration of vestibular function is very small. However, after vestibular system damage, people can feel better and function can return through compensation. This occurs because the brain learns to use other senses (vision and somatosensory, i.e. body sense) to substitute for the deficient vestibular system. The health of particular parts of the nervous system (brainstem and cerebellum, visual, and somatosensory sensations) is important in determining the extent of recovery that can be gained through compensation.

For many, compensation occurs naturally over time, but for people whose symptoms do not reduce and who continue to have difficulty returning to daily activities, VRT can help with recovery by promoting compensation.

The goal of VRT is to use a problem-oriented approach to promote compensation. This is achieved by customizing exercises to address each person’s specific problem(s). Therefore, before an exercise program can be designed, a comprehensive clinical examination is needed to identify problems related to the vestibular disorder.

Depending on the vestibular-related problem(s) identified, three principal methods of exercise can be prescribed: 1) Habituation, 2) Gaze Stabilization, and/or 3) Balance Training.

For patients with Benign Paroxysmal Positional Vertigo (BPPV) the exercise methods described above are not appropriate. First a clinician needs to identify the type of BPPV the patient is suffering from, and then different repositioning exercises can be performed. After BPPV has been successfully treated and spinning symptoms resolved, some patients will continue to report non-specific dizziness (symptoms other than spinning) and/or imbalance. In these cases, treatment using habituation exercise and/or balance training may be indicated.

(Information from Vestibular Disorders Association)


More Information about Vestibular Rehabilitation:

VEDA Article “Vestibular Rehabilitation Therapy (VRT)”

Overview of Vestibular Rehabilitation

Vestibular Testing

Treating and Managing Vestibular Disorders

Calm, Cool, and Compensated

Vestibular Rehabilitation from a Pilates Point of View


© Copyright 2017, Seattle Dizzy Group. All rights reserved.


Posted by: seattledizzygroup | September 22, 2017

Balance and Falls Prevention Awareness

September 18-24, 2017 is Balance Awareness Week!

The goal of Balance Awareness Week is to “Defeat Dizziness” by reducing the time it takes to diagnose a vestibular disorder.

Through Balance Awareness Week, the Vestibular Disorders Association (VEDA) hopes to raise public awareness about vestibular disorders and encourage people who have experienced symptoms like dizziness or vertigo to become informed about their condition and seek help from a vestibular specialist.  Increased awareness can reduce the time it takes patients to receive a diagnosis and put them on the road to recovery.

Find out how you can get involved at

The human balance system is complex, involving the inner ear, eyes, joints & muscles, and brain. When one part of the system is damaged by disease or injury debilitating dizziness and imbalance can result.

To learn more about vestibular and balance disorders, visit:

Balance Awareness Articles:

Raise Balance Awareness

Balance Awareness Facts, Figures & Trivia

A Balancing Act: Improving Balance and Preventing Falls

Exercise & Tai Chi Moving for Better Balance 


September 22-28, 2017 is Falls Prevention Awareness Week!

Among older adults, falls are the leading cause of injury deaths, unintentional injuries, and hospital admissions for trauma. Falls can take a serious toll on older adults’ quality of life and independence. The first week of Fall each year is Falls Prevention Awareness Week with the goal of spreading the message that falls are preventable.

More information about Falls Prevention Awareness Week:

September 22, 2017 is Falls Prevention Awareness Day!

This year is the tenth annual Falls Prevention Awareness Day which is celebrated on the first day of fall.  In honor of this notable milestone, the National Council on Aging (NCOA) has chosen the theme 10 Years Standing Together to Prevent Falls. This event raises awareness about how to prevent fall-related injuries among older adults.

More information about Falls Prevention Awareness Day:

Falls Prevention Resources:

Falls Prevention Fact Sheet

NCOA List of Falls Prevention Articles

Help Raise Awareness with Seattle Dizzy Group!


In celebration of Balance Awareness Week and Falls Prevention Awareness Day/Week, Seattle Dizzy Group will host our Seventh Annual Walk for Balance Event on Saturday, September 23, 2017 (12-2:30 pm at Green Lake).  Join us for this fun community event where we will “Walk a Mile in Dizzy Shoes” together to help create greater awareness for vestibular and balance disorders and show our support for people living with chronic dizziness and imbalance–in Seattle and beyond.

Event details:

(Also, find out how Seattle Dizzy Group is Making a Difference for Balance Awareness) 


Walk for Balance TM

© Copyright 2017, Seattle Dizzy Group. All rights reserved.


Posted by: seattledizzygroup | August 31, 2017

Coping with the Isolation and Loneliness of Chronic Illness


Strategies to Overcome Feeling Alone with Chronic Illness

Chronic illness may cause or increase isolation and feelings of loneliness. Adjusting to a “new normal” includes finding ways to cope with feeling alone and maintain social connections while living with chronic illness.

These articles discuss the isolation of chronic illness and offer strategies to overcome feelings of loneliness:

The Isolating Loneliness of Chronic Pain & Invisible Illness

Isolation Risk of Chronic Illness

Handling Isolation that Comes from Chronic Illness

Curing the Loneliness of Illness

6 Ways to Cope with Loneliness

8 Ways to Cope with Loneliness and Isolation When You Have a Chronic Illness

10 Things to Try When You’re Feeling Lonely

Things to Do When You’re Mostly Housebound

Ways to Maintain Healthy Relationships & Social Activity Despite the Challenges of Living with Chronic Illness


Post Updated February 2018

© Copyright 2017, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | July 31, 2017

Caregiver Tips

Helpful Suggestions for Caregivers & Supporters of the Chronically Ill

Adjusting to a “new normal” can be as challenging for those in a caregiving or support role as it is for a chronically ill loved one. It is important to find ways to maintain healthy relationships in spite of chronic illness.

These articles offer advice for caregivers and supporters as well as loved ones with chronic illness:

A Not-To-Do List for Caregivers of the Chronically Ill

How to Help Your Caregiver

The 5 Caregiver Commandments: How to Support a Loved One with Invisible Illness

7 Ways to Keep Your Relationship Strong Despite a Chronic Illness

Supporting Relationships Through Chronic Illness



© Copyright 2017, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | June 30, 2017

Balancing Activity and Rest

Importance of Resting with a Chronic Illness

It can be challenging to balance activity and rest with a chronic illness. Every activity costs energy and too quickly brings on fatigue. For the chronically ill, “making the most of each day” includes getting adequate rest.

This infographic illustrates The Spoon Theory which is a helpful tool for explaining the energy impacts of activity while living with a chronic illness:


These articles discuss energy limitations and offer strategies for increasing activity level and managing fatigue while living with a chronic illness:

The Spoon Theory

With Chronic Illness, I Will Always Pay Tomorrow for What I Do Today

When Our Chronically Ill Bodes Say “Rest” Why Don’t We? 

Tips on Increasing Your Activity Level & Managing Fatigue

Fatigue, Stress and Responsibility



© Copyright 2017, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | May 31, 2017

Exercise and Tai Chi Moving for Better Balance

How to Exercise with a Vestibular Disorder

by Myra Emami, PT, NCS

of Cascade Dizziness and Balance PT

(Presented to Seattle Dizzy Group on 4/8/17)

This presentation discusses the health benefits of exercise and offers exercise strategies to improve balance including modifications for overcoming the challenges of chronic vestibular impairment as well as an overview of Tai Chi Moving for Better Balance which is a research-based exercise program that has effectively demonstrated reduced falls, risk of falls, and fear of falling.

Presentation Objectives:

  • Discuss how to incorporate exercise when you have a dizziness or balance disorder
  • Different types of exercises: strengthening, balance, aerobic, community based
  • How to modify the exercises based on balance impairment or dizziness issues
  • Tai Ji Quan Moving for Better Balance
  • Practice a few Tai Chi exercises


  • Strengthen functionally: Sit to stands, walking lunges
  • Functionally strengthen with balance exercises
  • Core exercises: Reverse crunches seated, standing cross knee crunches, medicine ball lifts in standing. Upright core exercises tend to work best for patients with dizziness issues.

Aerobic Exercises Benefits

  • Improved cardiovascular pulmonary health, lower blood pressure
  • Increases endorphins to combat depression
  • Burn cortisol to combat stress
  • Improves stress
  • Improves GI system
  • Improves memory and overall brain function, increased brain volume
  • Improves immune system
  • Increased energy level, combats fatigue
  • Decreases weight

Aerobic Exercise

  • Sustained activity that increases your heart rate
  • AHA (American Heart Association) recommended guidelines: 5x/week 30 minutes moderately intense exercise or 3x/week 25 minutes intense exercise
  • Target Heart Rate: 220 – age x 0.7 (Example: 60 year old = 112)
  • BORG Scale goal 13-15 (light to somewhat hard)

Borg Scale

  • 6 No exertion
  • 7 Extremely light
  • 8 Extremely light
  • 9 Very light
  • 10
  • 11 Light
  • 12
  • 13 Somewhat hard
  • 14
  • 15 Hard
  • 16
  • 17 Very hard
  • 18
  • 19 Extremely hard
  • 20 Maximal exertion

Type of Aerobic Exercises

  • Walking, power walking, walking with poles
  • Jogging, running
  • Equipment: biking, treadmills, ellipticals
  • Swimming

Aerobic Exercise with Balance Issues

  • Recumbent biking
  • Nustep
  • Power walking with 2 poles
  • Swimming: laps with resistance boards

Aerobic Exercise with Dizziness Issues

  • MRD, dysautonomia, vestibular disorder, motion sensitivity
  • Start with short sessions and gradually build up. Short duration and decreased frequency. 2-3x/week
  • Dizziness will be the limiting factor instead of Target Heart Rate.
  • Warm up and cool down especially important.
  • Staying hydrated especially important, consider electrolytes.
  • Low sensory environment
  • Use midline visual target.
  • Limit exercise that causes head movement.
  • Recommended: recumbent biking, Nustep, slow progressive walking program with hiking poles

Balance Exercises

  • Balance: ability to control the COM (trunk) over the BOS (Base of Support = feet) in a given environment or task without taking a step.
  • Vestibular
  • Anticipatory postural control
  • Limits of stability
  • Reactive postural control

Vestibular Exercises

  • Vestibular: One of 3 main balance systems (eyes, ears, sense of touch in feet) which is located in the inner ear and orients you to where you are in space and is responsible for righting reactions that keep you upright.
  • Static: Static standing with or without head turns eyes closed standing in an unstable position.
  • Dynamic: Walking with head turns
  • Modifications for balance: Feet position
  • Modifications for dizziness: Slow reps with midline sensory orientation

Reactive Postural Control

  • Automatic shifting in COG (Center of Gravity) in response to external and unexpected disturbances. (Example: Stepping reaction when you are about to fall).
  • Ankle/hip/stepping strategies
  • Tai Chi exercise

Limits of Stability

  • How far can you move over your base of support before you fall. The boundaries within which the body can maintain stability and not change the BOS (Base of Support) without step or reach.
  • Expanding the LOS (Limits of Stability) is critical for fall prevention.
  • Tai Chi LOS exercise

Anticipatory Control

  • Ability to proactively shift your COG (Center of Gravity) over your BOS (Base of Support) to successfully achieve a motor task such as stepping over an object.
  • Single leg stand: Inability to stand greater than 5 seconds indicates a high fall risk.
  • Key is ability to shift your weight over your BOS
  • Tai Chi anticipatory control exercise

Tips for Success

  • Find an exercise buddy
  • Make it easy – exercise at home or gym close by
  • Make it successful – start out slowly and gradually build up
  • Make it safe – practice in a corner for safety
  • Make it a habit – same time (for example, first thing in the morning)
  • Make it fun – use upbeat music
  • Cognitive behavioral approach: make your brain want it by thinking about the benefits of exercise

Other Recommended Exercise: Tai Chi

  • Lowers stress, improves sense of well being
  • Calms your mind, reduces anxiety
  • Grounding – reduces dizziness
  • Increases leg strength and core muscles
  • Improves bone density
  • Turns off the sympathetic nervous system
  • Better sleep
  • Better immune system
  • Thickens brain’s cortex – improved cognitive function
  • Improves balance and reduces fear of falling

Tai Ji Quan: Moving for Better Balance


  • Designed by Fuzhong Li, a research scientist and tai chi master, published multiple research studies on Tai Ji and balance
  • 6 month program 2x/week: Significant reduction in falls with this program (55% decreased fall risk)
  • Different than traditional Tai Chi programs: Evidence and research based exercise protocol that has been shown to reduce fall risk. Designed for balance training to improve functional mobility. Fall prevention focus. Maximizes excursion of COG (Center of Gravity) around edge of BOS (Base of Support) to optimize motor control.
  • Traditional Tai Chi: Health promotion focus, designed for self defense so that the COG is constrained within the BOS to optimize force and stability for combat.

Tai Chi Balance Exercises

  • Reactionary postural control: ankle/hip/stepping strategy
  • Limits of stability training: Butterfly
  • Form one: Hold the ball. Anticipatory postural control. Active movement.

Limits of Stability Training

  • Goal: Shift your center of gravity further and further outside your base of support to improve your balance.
  • Stay safe working in a corner, in front of a chair, or countertop so you can catch yourself if you lose your balance.
  • 10x each direction 1-2x/day
  • Keep trunk straight, don’t bend at your hips!
  • Keep it challenging by working at the limits of your stability!

Forward and Backward Weight Shift

  • Stand with feet shoulder width apart.
  • Shift weight forward so that your weight is on your toes.
  • Return to center. Repeat 10x
  • Shift weight backward so that your weight is on your heels.
  • Return to center. Repeat 10x

Side to Side Weight Shift

  • Stand with feet should width apart.
  • Shift weight to the right so that all your weight is on your right outer foot.
  • Return to center. Repeat 10x
  • Shift weight to the left so that your weight is on your left outer foot.
  • Return to center. Repeat 10x
  • Hold an imaginary Tai Chi ball when you weight shift (right hand on top when you shift to the right, left hand on top with left weight shift).

Clock Turns

  • Move from center to 1:00
  • Move from center to 7:00
  • Move from center to 11:00
  • Move from center to 5:00


  • Hold an imaginary Tai Chi ball at center, right hand on top.
  • Weight shift forward and backward for the body.
  • Move left hand in a big circle to make the left upper wing.
  • Left hand on top to reform the ball.
  • Move the right hand to make a big circle for the right upper wing.
  • Right hand on top to reform the ball.
  • Left hand backwards to the left back wing.
  • Left hand back on top.
  • Right hand backwards to make the right back wing.
  • Remember to work at the limits of your stability!

Anticipatory Control Exercises

  • Goal: Be able to stand on one foot to step over obstacles, be more stable walking, be safer going up and down stairs, transferring into a tub, stepping on or off a curb, etc.
  • Practice each exercise for 5-10 minutes, 1-2x/day

Side to Side

  • Stand with feet shoulder width apart.
  • Hold a Tai Chi ball with right hand on top.
  • Weight shift all the way to the right.
  • Move the Tai Chi ball to the right.
  • Lift your left heel up.
  • Lightly balance on your left big toe.
  • See if your can lift your left foot completely off the ground.
  • Try lifting your foot off for a few seconds.
  • Move the ball out further to the right if you keep losing your balance to the left.
  • Repeat on the left side with the Tai Chi ball to the left, lifting your right foot.


  • Stand with one foot forward and one foot back, a few inches apart.
  • Hold a Tai Chi ball forward.
  • Shift your weight to your front foot so that all your weight is there.
  • Lift your back heel off the ground.
  • Lightly balance on your back toe.
  • See if you can lift your entire foot off the ground for a few seconds.
  • Move the ball further forward if you feel falling backwards.
  • Shift your weight backwards so that all your weight is on your back foot. 
  • Lift your front toe off the ground.
  • Lightly balance on your front heel.
  • See if you can lift your entire foot off the ground for a few seconds.
  • If you keep falling forward, move your hands backwards to help you weight shift.
  • Repeat with the opposite leg.

Walking with Single Leg Standing

  • Take a step.
  • Weight shift forward.
  • Single leg stand for a few seconds.
  • Take another step and repeat.
  • Move slowly and deliberately, focusing on your comlete weight shift.

Exercise and Tai Chi Handout

Additional Health & Wellness Blog Posts:


Myra Emami, PT, NCS

of Cascade Dizziness and Balance PT

Myra Emami is a graduate of the University of Washington and has been practicing physical therapy for over 15 years. She specializes in vestibular rehabilitation and balance/fall prevention and obtained her Herdman Certification in Vestibular Competency in 2012.

Myra’s passion in vestibular rehab started after a personal experience with dizziness and vertigo, which helps her understand what her patients are going through. When patients talk about their dizziness, I can relate to how they feel. It’s important for patients to understand they can get better with the right strategy. Myra utilizes the latest evidence-based research in vestibular rehab in order to develop effective treatment strategies.

Myra also specializes in neurological disorders such as strokes and Parkinson’s Disease and obtained her APTA Neurological Clinical Specialist Certification in 2013. In her clinical practice, she applies her neurological background to emphasize the concept of neuroplasticity: The brain’s remarkable ability to change and build new connections to improve function. Neuroplasticity has far-reaching implications and amazing possibilities for almost every aspect of human life including balance disorders, movement dysfunction, and for reducing symptoms such as dizziness. She believes in a holistic healing approach delivered with care and compassion, with a focus on education and self-empowerment.

Myra’s accomplishments include the development of an acoustic neuroma post-surgical inpatient physical therapy protocol and Return-to-Play concussion protocol to facilitate safe return of young athletes to sports after a concussion. She organized and leads a multi-campus vestibular study group.

More information about Myra Emami



Presentation information is not meant to be taken as medical advice.

Presentations posted online may include discussion notes, links, images, and other information added by Seattle Dizzy Group.


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