Understanding Vestibular Rehabilitation Therapy (VRT): What Every Massage and Manual Therapist Should Know

If you’ve ever worked with a client who complained of dizziness, imbalance, or that frustrating “room spinning” sensation, you’ve brushed up against an area of practice that’s both fascinating and deeply rewarding to understand: Vestibular Rehabilitation Therapy, or VRT.

As massage and manual therapists, we often focus on muscles, joints, and soft tissue — but the vestibular system plays a critical role in how our clients feel and function every single day. It’s the system that helps us know which way is up, keeps us balanced while we walk, and allows us to move our eyes smoothly as our head turns. When it’s not working properly, the ripple effects can be profound.

In this blog, I want to walk you through what VRT actually is, why it matters, and how aspects of this therapy can fit within our scope of practice as massage and manual therapists.

What Is the Vestibular System?

Think of the vestibular system as your body’s internal gyroscope. It’s made up of tiny structures inside the inner ear, including the semicircular canals and the otolith organs, that detect motion and position. These structures send signals to the brain about where your head and body are in space.

When the vestibular system works properly, we don’t even think about it. But when there’s dysfunction — from injury, illness, or even aging — clients may experience:

• Dizziness or vertigo

• Loss of balance or frequent falls

• Nausea

• Difficulty focusing visually

• A sense of “disconnection” from their environment

So What Is Vestibular Rehabilitation Therapy?

Vestibular Rehabilitation Therapy (VRT) is an exercise-based approach designed to retrain the brain and body to compensate for vestibular dysfunction. Instead of relying on medication to mask symptoms, VRT uses carefully structured movements to encourage adaptation, improve balance, and reduce dizziness.

Common components of VRT include:

• Gaze stabilization exercises – training the eyes to stay focused while the head moves.

• Balance training – challenging the body in safe ways to improve steadiness.

• Habituation exercises – repeated exposure to movements or positions that trigger dizziness, gradually reducing sensitivity.

Where Massage and Manual Therapists Fit In

Now, here’s where it gets exciting for us as massage and manual therapists. While the diagnosis of vestibular disorders is outside our scope, many aspects of VRT can safely and effectively be included in our practices:

• Postural awareness and proprioceptive training: We already work with alignment and body awareness. Guiding a client through gentle balance challenges is very much within scope.

• Neck and shoulder work: Tension in the cervical region often aggravates dizziness. Manual therapy here can complement VRT beautifully.

• Breath and relaxation techniques: The nervous system is tightly linked with vestibular health. Helping clients regulate their breathing and reduce anxiety is a natural extension of our role.

• Guided movement: Teaching safe, simple movement patterns or stretches that encourage vestibular adaptation can be part of our therapeutic toolkit.

The key is knowing which tools belong to us and when to collaborate or refer out to a vestibular specialist, PT, or physician.

Why VRT Matters for Your Clients

If you’ve ever had a client tell you, “I feel off balance” or “The room spins when I lie down,” you know how disruptive vestibular issues can be. These aren’t just physical complaints — they affect confidence, independence, and overall quality of life.

By understanding the principles of VRT, you’re able to:

• Recognize when symptoms may benefit from vestibular-focused exercises.

• Offer supportive treatments within your scope.

• Collaborate more effectively with healthcare providers.

• Expand your skill set in a way that directly improves your clients’ lives.

Ready to Go Deeper?

We’ve seen an incredible response from therapists worldwide to our Online Vestibular Rehabilitation Therapy Course (7 CE’s). It’s one of our most popular offerings — and for good reason.

In this course, you’ll get a clear, practical breakdown of VRT, taught in a way that’s relevant to massage and manual therapists. You’ll learn what you can apply immediately in your practice, how to stay within your scope, and how to support clients dealing with vestibular dysfunction.

Final Thoughts

Vestibular Rehabilitation Therapy might sound like something reserved for specialists, but the truth is, many of its principles are right at home in our work as massage and manual therapists. By integrating these ideas, we don’t just relieve tension — we help restore balance, confidence, and quality of life.

If you’ve ever had a client who complained of dizziness or instability, this is knowledge that will serve both you and them well.

👉 Click here to explore the VRT course and earn 7 CE credits