total-balance-ptThe Total Balance Physical Therapy team at Virginia Ear Nose & Throat was created to fill a community void for the prompt and accurate diagnosis and treatment of balance and dizziness disorders. Many patients with chronic or acute dizziness, gait disturbances or frequent falls have been told that they have an unexplainable situation. Many patients falsely feel, or are told that, their dizziness and balance loss is a direct relation to their advancing age or that they will be stuck feeling off balance for the rest of their lives. Our team has assembled an evaluation process and the clinical expertise to accurately assess what is causing the problems that people have experienced episodically or on a daily basis.

Our balance is a system of sensors and motor output. Like any machine, if you look hard enough into the problem, the reasons for the problem come to light. Our balance sensory system is comprised of our sense of vision, sense of head position from the vestibular system and what we feel in our body during movement.  

People new to being dizzy frequently are experiencing a mechanical issue of the vestibular systems such as BPPV which is a calcium crystal out of place or inflammation of the nerves around the inner ear organs. We test for this using goggles to assess what the eyes do during head movement and in certain positions since the vestibular system is responsible for the position of the eyes. 


These are common issues that, if left unaddressed, can lead to compensations that will lead to other issues of over-utilizing the eyes for vision or the hands on furniture or walkers and canes. We test this via certain walking patterns to see if they recreate symptoms or via the use of a Balance Manager, which can score your sensory system in each category versus the average person your age. Very often, the patient just needs to be asked the right questions to determine when and why the balance or dizziness problem started and what may be the reason the problem didn’t resolve with time.

Our motor system as it pertains to balance, involves the coordination of the hips, ankles and trunk to maintain a center of gravity or to correct the loss of it. We have seen many people with motor deficits that have seen neurologists and other specialists with no diagnosis. Often times the balance problems that happen in the motor realm involve a coordination issue between the segments of the body.  


This is a functional issue and not a medical one. Sometimes it is a matter of the speed with which you coordinate. Other times it could be related to a specific group of muscles or just a single muscle that isn’t fully able to help with balance. With a proper assessment, patient’s with these sorts of issues leave with a home regimen that can be advanced as their problems improve. 

Commonly people who say that they are fearful of falls are very rigid in their movement patterns. Over time, this will feel normal to them. This is often a source of balance loss as balance is not a matter of staying rigid at all times, but keeping the ability to respond to mistakes. Everyone loses their balance. We need to preserve the ability to correct it or else we restrict the activities we do and further lose balance. This can be a vicious cycle that can be broken.


Each patient will be given adequate time to discuss what symptoms they have been experiencing. Every patient is different but there are trends and specific triggers for many diagnoses. When the interview suggests a basket of symptoms that fits a vestibular diagnosis, this can be tested and is quite accurate.  The same is true for balance and gait disorders. Total Balance frequently sees patients willing to drive from all over the state of Virginia due to the excellent results the therapists and patients achieve together.