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Enter The Vestibular System

Your vestibular system is the background operating system connecting your brain and nervous system to your joint and muscular system. When operating efficiently your vestibular system helps you seamlessly and effortlessly combine primal movement patterns through space to accomplish known and novels tasks. In other words, it helps you be the Power Athlete you’ve trained to become.

Within the nervous system, the vestibular system (a series of structures connecting the eyes, inner ear, and brain) will provide information regarding movement, head position, and spatial orientation. With this information, we can stay balanced and stable while moving. In simple terms, this system provides us with a map of our body and guides most of our movement-based decisions.

When your vestibular system is injured, either through a traumatic injury like a concussion or through a lesser insult like imbalanced training, sub-concussive impacts like falls or a punch taken, a myriad of downstream symptoms and limiting factors start emerging. You may start feeling anxious for no apparent reason. You might notice that driving a car, shopping in a busy store, or reading for an extended period of time on your laptop, tablet, or phone starts to make your head hurt or your eyes fatigue or make staying focused a monumental challenge.

An athlete dealing with vestibular system problems can feel like they’re losing their mind. The external problems like performance in the gym or on the field may be obvious, but the inability to stay focused in the classroom or on the job, an increase in anxiety or irritability, or a feeling of constant fatigue and an increased need for sleep can make them feel like they’re falling apart on the inside with no obvious fix for the problem.

In the world of strength and conditioning, we often times stop at the level of the joints, tendons, ligaments, and muscles. Doing so ignores one of the most important systems in the body-the nervous system. Centrally, the brain and the spinal cord, and peripherally, the nerves that extend into the upper and lower extremities act as a master regulator to performance on and off the field.


How do you quickly assess whether your vestibular system is functioning properly? And if it’s not, what do you do about it?

There are two methods to go about assessing vestibular function.

The first is a simple self-assessment that you can perform daily at the end of your training sessions.

The second requires a trained professional and is primarily used when you’ve experienced a concussion or taken a hard shot to the head without a concussion and noticed a deficit like those I described earlier (headaches, anxiety, eye pain or pressure, difficulty focusing or concentrating, increased fatigue and increased need for sleep).

Method one for assessing your vestibular function involves a quick self-assessment called the Fukuda Step Test. To perform this assessment, apply the following technique after training.

  1. Find a quiet and clear floor space.

  2. Standing with your feet directly under your hips, raise your arms in front of your body to shoulder level.

  3. Once your arms are raised, close your eyes and begin marching in place. Your feet should pick up to a level slightly above your ankles with each marching step.

  4. Count 50 steps total (25 right and 25 left) then open your eyes and assess: are you facing the same direction that you were when you started? Is your body turned to the right or to the left more than 15 degrees?

  5. If you didn’t turn or turned less than 15 degrees, congratulations! Your vestibular system is functioning properly!

  6. If you turned more than 15 degrees, your vestibular system is not functioning properly and in need of a “Reset”. How do you “Reset”? It depends on which way you turned.

For a right turn, here are the corrections to follow:

For a left turn, here are the corrections to follow:

I recommend my athletes perform this test on a daily basis after their training and before their cool-down routines. A properly functioning vestibular system actually enhances your body’s ability to switch from the “Fight or Flight” mode you need train like a savage to the “Rest and Digest” mode you have to enter to allow the training stress to have its intended effect and elicit the appropriate training adaptations.

If you have suffered a concussion or are experiencing concussion-like symptoms (again, headaches, anxiety, eye pain or pressure, difficulty focusing or concentrating, increased fatigue, and need for sleep), you are a good candidate for a Vestibular-Ocular assessment. This is a more in-depth assessment that will determine the root cause and limiting factors in your vestibular system function.


Do you need help returning to the weight room or getting back on the field after a concussion, a vestibular injury? Don’t wait another day to take the first step on your road to recovery and getting back to the physical life you want to live. Click the "Inquire Now" button above to set up a call and see if you’re a good fit for our vestibular rehab program.


Blog: Treating Concussions by Dr. Tim Cummings


Dr. Tim Cummings is a strength coach, physical therapist, writer, speaker, and, along with his wife, Jess, the founder of Restore/Thrive. Tim splits his time between helping athletes, parents, and coaches fix acute and long-standing orthopedic injuries and programming post-rehab training programs for individuals looking to get back to their active lifestyles after an injury.

He received his Bachelor of Arts in Exercise Science from the University of Missouri-Kansas City in 2004, and his Doctorate of Physical Therapy from Southwest Baptist University in 2010. He was certified as a Titleist Performance Institute Certified Trainer in 2011. He was certified as an IMPACT Concussion Management Provider in 2012 he was the first physical therapist in Kansas City to earn recognition as a MovNat certified trainer in 2014. He was the first physical therapist in Kansas City designated as The Ready State Certified Practitioner in 2015. He earned the Power Athlete Block One Coach certification in 2020.

Tim’s background as an athlete includes a history of competitive baseball, basketball, cross-country running, and performance weightlifting. In his free time, he enjoys spending time with his wife Jess and their three children, Aiden, Evelyn, and Connor, their Cavachon puppy Coco, weightlifting, golfing, obstacle course racing, competitive eating, and wrestling with his kids.

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