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Why New Grads are Falling for Vestibular

by Nidhi Sharma

When I graduated from PT school, I started practicing in an outpatient setting. Like many of my peers, my focus was orthopedics. This was familiar territory that I found both exciting and rewarding. But soon, I was required to receive training in Vestibular Rehabilitation Therapy (VRT). I was working in a tight knit hospital based outpatient setting which started getting referrals from in-house ENTs and audiologists. Even though orthopedics was my primary interest, I found myself treating vestibular patients frequently and surprisingly, successfully. While orthopedics remained challenging and competitive, vestibular rehabilitation became basic, yet gratifying.

I was trained in vestibular rehab 6 years ago and have never worked in an exclusive balance center (nor do I plan to), but I have always maintained a partial caseload of vestibular patients. It's refreshing to take a break from orthopedics and manual therapy every now and then and my hands thank me for the much needed rest. It keeps my options open for the future and sometimes helps me tease out the nuances of gait abnormalities that may be caused by an underlying vestibular dysfunction.

5 reasons new grads should consider practicing vestibular rehab

1. Unique skill set

After 7 years of clinical practice, I am still surprised by a dearth of PTs trained in vestibular rehabilitation in outpatient settings.

Even if your practice is primarily orthopedic or neuro based, this is an easy addition to expand your referrals, as well as your client base.

This unique skill set will set your resume apart from piles of others. Although manual therapy certifications are "sexy", they are much more common than vestibular ones. For companies not actively looking for a vestibular therapist, you can propose to build a new caseload and attract more referrals.

2. Professionally rewarding

Some of the most grateful patients in my years of practice have been patients with benign paroxysmal positional vertigo (BPPV). This very common condition can be significantly disabling to patients. Fortunately, it has an easy fix using a simple canalith repositioning maneuver. Despite the minimal amount of time required to treat these patients, which averages 5 minutes, the results are quite dramatic. Symptoms are often completely resolved in 1-2 sessions, leaving you as the patient's “hero”.  It can help you build your brand and fosters confidence as a new grad PT.

3. Modest training

As complicated as vestibular rehab looks and sounds, a one weekend training course is usually enough to start treating most vestibular cases. While many school curriculums prepare students to treat patients with vestibular disorders, training is usually not satisfactory. New grad PTs often do not feel comfortable dealing with these patients. Having a clinical rotation or internship in a clinic which offers vestibular rehabilitation can be of great help with this.

4. Geriatrics physical therapist

If you’re practicing in or are interested in geriatric physical therapy, then understanding vestibular rehabilitation is even more important to your clinical practice.

With a high prevalence of general vestibular degeneration in the geriatric population, assessing and treating this component of the balance system is imperative for successful outcomes of many balance programs.

5. Cost Effective

“All I need to treat a patient is a piece of foam and 10 square ft space.”

How often do you get to say that? How much easier is it for you to see a cash based patient when you don’t have to bring a table? There is no electrotherapy equipment, no exercise equipment and no need for hour long sessions. With your knowledge and expertise as the only true requirements to treat vestibular patients, it is probably the most cost, time and space effective sub-specialty of physical therapy.

If vestibular rehabilitation sounds interesting to you or if you're considering taking a course or a job in this field, I recommend that you take the step toward owning this skill and making a difference in people’s lives.


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