Our team has extensive experience and knowledge on treating patients with vestibular deficits, like dizziness and BPPV, in addition to treating patients who have sustained a concussion. Physical therapy can be a very valuable treatment, and our team will help you to understand your symptoms and condition. 

Dr. Valentine Ngo, PT, DPT is a certified vestibular and concussion rehabilitation specialist with the American Institute of Balance, which is the world's largest network of neurodiagnostic & rehabilitation balance specialists. 

Valor Physical Therapy provides concussion and vestibular rehab for patients in Carlsbad and surrounding communities, including student athletes returning to Encinitas and Carlsbad youth sports programs.

Treatment at Valor Physical Therapy may be the right fit for you if you experience:

  • Vertigo/dizziness
  • Lightheadedness or unsteadiness on your feet
  • Motion sickness
  • Acute concussion symptoms (<3 mo ago)
  • Post-concussion syndrome symptoms (>3 mo ago)
  • Symptoms from multiple concussions
  • Difficulty concentrating or focusing
  • Short term memory issues
  • History of head trauma or whiplash resulting in neck/head pain
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What is vestibular rehab?

Your vestibular system is the balance apparatus tucked inside your inner ear. It works together with your eyes, neck, and brain to tell your body where it is in space, how you stay upright, keep your gaze steady while your head moves, and walk through a crowded room without feeling like the floor is tilting.

Vestibular rehab is a specialized type of physical therapy that retrains that system when it's not working right. Using targeted exercises, a vestibular-trained PT helps your brain and inner ear recalibrate, reducing dizziness, vertigo, and imbalance so you can move through daily life without constantly compensating for it.

Common vestibular diagnoses we treat

  • BPPV (Benign Paroxysmal Positional Vertigo) — brief, intense vertigo triggered by specific head positions, caused by displaced crystals in the inner ear
  • Vestibular hypofunction — reduced function in one or both inner ears, causing imbalance and visual instability with movement
  • Vestibular neuritis / labyrinthitis — inner ear inflammation, often following a viral illness
  • Post-concussion vestibular dysfunction — dizziness and imbalance persisting after a head injury
  • Cervicogenic dizziness — dizziness driven by neck dysfunction rather than the inner ear itself

Vestibular symptoms and Common Causes

 Common symptoms:

  • Dizziness or a spinning sensation (vertigo)
  • Feeling unsteady or off-balance
  • Blurred or jumpy vision when moving your head
  • Nausea tied to movement or position changes
  • Difficulty in visually busy environments such as grocery stores, traffic, crowds

Common causes:

  • Concussion or head injury
  • BPPV- small crystals in the inner ear becoming dislodged
  • Vestibular neuritis or labyrinthitis (inner ear inflammation, often after a virus)
  • Migraines
  • Whiplash or neck injury
  • Age-related decline in inner ear function

What is concussion rehab?

A concussion is a mild traumatic brain injury caused by a direct or indirect force to the head or neck. It doesn't require losing consciousness to count, and symptoms can show up immediately or develop over the following days or weeks.

Concussion rehab is physical therapy that specifically targets the systems a concussion disrupts, most often the neck, the eyes, and the vestibular system. Rather than just "resting it out," it uses hands-on treatment and progressive exercise to address the actual source of ongoing symptoms like headaches, dizziness, and trouble concentrating.

Signs you may have a concussion

  • Headache or pressure in the head
  • Dizziness, fogginess, or feeling "off"
  • Sensitivity to light or noise
  • Nausea or vomiting
  • Confusion or trouble concentrating
  • Balance problems or clumsiness
  • Memory issues or feeling slowed down
  • Symptoms that don't show up right away, sometimes appearing hours or even days after the initial hit

If any of these are lingering more than a week or two after a head injury, that's a signal it's worth getting evaluated rather than waiting it out.

How Can Physical Therapy Help

Getting evaluated early matters. Research on concussion recovery consistently points to better outcomes when vestibular-focused PT starts within the first one to two weeks, rather than waiting for symptoms to resolve on their own.

From there, treatment is built around what's actually driving your symptoms not a one-size-fits-all protocol. That might mean addressing neck stiffness contributing to your headaches, retraining the reflex that keeps your vision steady, or gradually exposing your system to the exact movements that trigger dizziness until your brain stops overreacting to them. Progress is paced carefully but enough of a challenge to drive adaptation, never so much that it sets you back.

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Types of exercises we use

Gaze stabilization exercises — retraining the reflex that keeps your vision steady while your head is moving

Habituation exercises — controlled, repeated exposure to the specific movements that trigger your dizziness, so your brain adapts instead of overreacting

Balance and postural training — standing and moving on varied surfaces, with added visual or cognitive challenges, to rebuild real-world stability

Canalith repositioning maneuvers — like the Epley maneuver, used to treat BPPV by moving displaced inner-ear crystals back where they belong

Cervical (neck) treatment — manual therapy and exercise, since neck dysfunction is one of the most common drivers of post-concussion headaches and dizziness

Graded return-to-activity progressions — for returning to work, school, driving, or sport at the right pace

Frequently Asked Questions

Concussion rehab addresses the full picture after a head injury — often the neck, eyes, and vestibular system together. Vestibular rehab is more specifically focused on the inner ear balance system, and it treats dizziness and imbalance whether or not a concussion was the original cause.

Common signs include headache, dizziness, fogginess, sensitivity to light or noise, and trouble concentrating after a hit or jolt to the head. Symptoms don't always appear right away — they can develop over the following days.

Many people improve within one to two weeks, but symptoms lasting longer than that are a signal to get evaluated rather than wait, since early intervention is linked to faster, more complete recovery.

No. Vestibular rehab treats dizziness and balance issues from many causes — BPPV, inner ear infections, migraines, or age-related changes — not just concussions.

We assess your specific symptoms, triggers, and how your neck, eyes, and inner ear are functioning together, then build a treatment plan around what's actually driving your symptoms rather than a generic protocol.

For most people, no. With the right vestibular-focused treatment, symptoms improve substantially. Waiting it out without treatment is what tends to allow symptoms to linger.