When you start physical therapy school you know you want to work as a physical therapist, but maybe you don’t know how many specialist options are available. You can specialize in anything from acute care to pediatric care, or specialize in nothing at all. One much needed and under-specialized area is Vestibular Physical Therapy. Vestibular Physical Therapy is a very niche practice within neurologic physical therapy focused on treating the inner ear. The vestibular system and your cochlea are situated within the inner ear controlling your hearing, balance, equilibrium, and spatial awareness. Once a patient is diagnosed with a vestibular disorder, a healthcare team works together to treat their symptoms. Vestibular Physical Therapists work with their patient’s entire healthcare team, usually consisting of a neurologist, an otolaryngologist, a primary care provider, and sometimes more. All of these providers work together closely to ensure each patient’s individual needs are being met.
Physical therapists who focus strictly on vestibular rehabilitation are rare, but focusing on this specialty makes you very employable and will help you stand out within your colleagues. The job of a Vestibular Physical Therapist is focused on how to get rid of symptoms related to dizziness, lightheadedness, and vertigo. It combines orthopedic and neurologic physical therapy to meet each patient’s functional goals and help them feel like themselves again.
Becoming a Vestibular Physical Therapist does not have a directly set path, and typically requires some continuing education after graduation. There are many routes you can take to become a Vestibular Physical Therapist, so let’s talk about the many ways you can get there!
The first step to becoming a physical therapist, vestibular or otherwise, is to graduate from college with an undergraduate degree. There is no major that you “should” work toward, but some are more recommended than others. The typical degrees that are achieved by future physical therapists are Kinesiology & Exercise Science, Biology, and Biomechanics. These are endlessly helpful for understanding the basics of human movement and function. However, many other majors can help you be incredibly successful as a PT. Other majors include Business, Neuroscience, Psychology, or Public Health. Any major that interests you and leaves you time to complete the prerequisites for graduate school is a great choice. Weigh all your options and interests before choosing your major, but most importantly, check the list of prerequisite courses your future school will require.
Physical Therapy School
Physical therapy school is a two and a half to three year doctorate program in which you achieve the title of Doctor of Physical Therapy. According to the board who determines the credentials necessary to become a physical therapist, you are required to graduate as a generalist. This is different from other medical professions as many other programs require specialization within their profession. However, just because physical therapists don’t have to specialize, doesn’t mean you cannot. There are many options between residency and continuing education that can help further your knowledge in a specific topic. Additionally, choosing a specialty does not mean you need to only see that population.
During physical therapy school, the best thing you can do is try and figure out what you do and do not like. There are so many people who need physical therapy, and being a Jack-of-All-Trades is not necessary, you will usually have an opportunity to choose who you want to treat. Figuring out exactly in which area you’d like to specialize is not necessary, but realizing if you prefer orthopedics or neurology is a good start. When you take your courses in neurology, pay extra attention to the inner ear and its function. Focus on the intricacies of balance, functional tests, and measures related to dizziness and balance, and be diligent about learning exercise prescription for those with dizziness and balance deficits. Then, when it comes time to choose your clinical rotations, if you are able, try to find clinics and clinical instructors who see patients with vestibular disorders. Your clinical rotations will be your first opportunity to dive into the diagnosis and treatment of vestibular disorders.
Your clinical rotations are where you learn the most about being a physical therapist. This is the place where you can find out if you love a specialty, don’t like a specialty, or if you just want to do it all for a while. You will have the opportunity to try a few different areas of practice including, inpatient rehabilitation, vestibular therapy, acute care, outpatient neurology and orthopedics, and pediatrics. Because there are so many options, it’s unlikely that you will be able to see everything. Using your clinical director as a resource, and doing research about your likes, dislikes, and options will give you a great idea of where you might want to end up.
Finding a clinical rotation that is completely vestibular rehabilitation based can be difficult, but they do exist. However, most are a mix between outpatient orthopedics and vestibular care. This is actually a great option for most as it provides an opportunity to practice two sets of skills that overlap in the clinical world. No matter which option you choose, complete vestibular care, or a mix, practicing your vestibular skills during a clinical rotation is vital to becoming an excellent Vestibular Physical Therapist.
Continuing education, or CE courses, are required to maintain your license and a great way to learn new skills and practice techniques. CE courses are the most likely option for PT’s who would like to start practicing Vestibular Physical Therapy.
After you know that you like the world of vestibular care, or even if you’d just like to dip your toe into the pool, there are many courses you can take. Some are weekend courses, and some are months long, it just depends on what you’re looking for.
Introductory Vestibular Rehabilitation Courses
- MedBridge, an online therapy continuing education and home exercise program website, has multiple courses for those interested in vestibular rehabilitation. Here, you can take many courses about the oculomotor exam, concussion, balance testing, and vestibular deficit testing.
- The American Institute of Balance is another excellent option for introductory vestibular rehabilitation education. They have both a vestibular course and a vestibular & concussion course offered with competency exams for the online and in-person portions of the course.
- Great Lakes Seminars’ Introduction to Vestibular Rehabilitation is an introductory course worth 16 Continuing Education Units and can be taken without a lot of previous Vestibular Rehabilitation practice, making it perfect for beginning your journey into vestibular care.
- Vestibular Today’s Vestibular Rehabilitation: Evaluation and Treatment of Dizziness and Balance is a great choice for those who have some experience with vestibular disorders but don’t see complex cases often. This two day course will help guide you toward being able to differentially diagnose vestibular and balance disorders as well as provide treatment solutions for those who are dizzy.
- Therapy Network Seminars’ The NeuroVestibular Complex course is designed to “bridge the gap” between evaluation and treatment of those with vestibular disorders, and is approved for 15 CE Units. It is a two day, hands-on, course that can be taken by those who have just some vestibular therapy experience.
Advanced Vestibular Rehabilitation Courses
- 360 NeuroHealth’s Vestibular Rehabilitation course (CCVR) is an excellent choice for those who have some vestibular therapy education and practice who are looking to further their skills and be certified in their competency. Lasting for many weeks, it is approved for over 39 CE Units, and provides both in person and online learning experiences.
- Emory’s Competency Based Vestibular Rehabilitation course also focuses on all aspects of vestibular therapy in a clinical setting. This course is offered annually and is both in person and online.
- APTA’s Vestibular Rehabilitation: An Advanced Course and Update through the University of Pittsburgh and the APTA is a shorter, complex, course (2 days) on everything from the basics to the practice to rare and difficult cases.
The above coursework options are just a few of the many courses offered in vestibular rehabilitation. Because there are so many, it is important to research which may be the best course for you. There are many avenues to becoming a Vestibular Physical Therapist that exist at any step of your education. Whether you realize it during school, after you graduate, or after you’re a seasoned clinician, taking the relevant course material is the most important part! Vestibular therapy is a complex and demanding field of physical therapy that is frequently evolving with increasing evidence. Taking the time to gain the knowledge and skills to provide excellent care is difficult, but the incredibly rewarding nature of the job is reason enough to take on the task.
Dr. Madison Oak is a Vestibular Physical Therapist based in Manhattan, New York who specializes in treating dizziness and vertigo of all kinds. She graduated with a clinical Doctorate in Physical Therapy from the University of Wisconsin and has been treating patients with dizziness ever since. Dr. Madison Oak understands that dizziness comes in many forms, from vertigo to lightheadedness, and knows that finding the source of your dizziness is the best way to treat it. Finding the root of your problem, and treating the whole person, instead of just the symptoms, is very important to her. That’s why she started TheVertigoDoctor.com; to provide easy to read, accessible, resources to patients who are dizzy and struggling to find a diagnosis, prognosis, and treatment. She strives to help her patients reach functional goals to return to a dizzy-free way of life.