As a personal trainer, it’s important to realize that every client is different, each requiring their own program and modifications in order to help them reach their goals in a safe and effective manner.

Having worked with a wide variety of clients, many with challenging conditions to work around, I must say working with a client who deals with vertigo can be one of the most challenging of all. Why? Well, because any sudden movement can trigger their vertigo. Movements such as a quick turn of the head, bending over, jumping, and lying down on their back just to name a few. Having said that, you’re probably wondering what you CAN do with a client who deals with vertigo issues, we’ll get to that a bit later in the article. First, let’s discuss what vertigo actually is.

What is Vertigo?

Remember spinning in circles as a kid and then the room spinning around? In contrasts, that’s similar to what vertigo feels like. However, you’re not spinning on purpose and the sensation can last for hours at a time. You may simply be sitting down or bending over to tie your shoe and the next thing you know the room has flipped upside down and you’re experiencing nausea and vomiting.

Now, it’s important to understand what causes vertigo before we jump into what exercises you can perform to help keep you fit and strong!

What Causes Vertigo?

Vertigo is usually caused by an inner ear problem caused by some of the following conditions:

• Benign Paroxysmal Positional Vertigo, otherwise known as BPPV, is when tiny calcium particles (canaliths) can be displaced in the canals of the inner ear causing irritation which can lead to vertigo.
• Meniere’s Disease. According to WebMD, this is an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It can cause episodes of vertigo along with ringing in the ears (tinnitus) and hearing loss.
• Vestibular neuritis or labyrinthitis. According to WebMD, this is an inner ear problem usually related to infection (usually viral). The infection causes inflammation in the inner ear around nerves that are important for helping the body sense balance

Now that you have a better idea of what vertigo is and what causes it, let’s dive into exercising with vertigo.

Symptoms of Vertigo

Things to Avoid

As I mentioned earlier, it’s important to keep a couple things in mind when prescribing exercises to a client with vertigo.

Avoid tilting the head.

No exercises lying down.

Avoid sudden head movements.

These three things will automatically diminish many exercises that you can perform with the client. No bent-over rows, no push-ups, no mat exercises.

Well, WHAT CAN WE DO? First, understand that every client will have different triggers for their vertigo. From there, talk to the client, listen, ask questions, understand what does and does not bother them. What kind of intensity level do they want? How are they feeling that day? Are they dealing with any nausea? From there, keep things light to start.

Exercises

Start the workout at a light intensity and see how the client reacts. Furthermore, below is a list of exercises to target each major muscle group that may work when working with a client with vertigo.

• Chest: Chest press, machine/cable pec fly
• Back: Lat pull-downs, seated cable rows, machine rows, face pulls, straight-arm pull-downs, rear delt fly
• Quads: Knee raises, some leg press machines, leg extensions
• Glutes/Hams: Hip abduction machine, donkey kick machine, cable hamstring curl, cable hip abduction, cable hip extension, leg press machines (sometimes)
• Shoulders: Military press, dumbbell lateral raises, upright rows, cable internal/external rotation
• Biceps: Seated/standing bicep curls, high pulley curls
• Triceps: Cable push-downs, seated overhead triceps press
• Core: Cable anti-rotation, Pallof press

Now, in terms of intensity level, start light and get some feedback from the client. Most importantly, ask If they feel comfortable increasing the intensity level, then slowly do so. Besides that, in order to safely get their heart rate up without including plyometric movements, avoid breaks in between exercises and increase the weight they’re using. Now, having mentioned plyometric movements, this is when things can get tricky.

So, perhaps a client isn’t too interested in strength training and would like to focus more on plyometric exercises. These typically include quick and jerky movements, which as we know by now will trigger dizziness and nausea. Therefore, the best protocol in this situation is to talk to your client and help them understand that these types of movements are not in their best interest until they’re cleared by their doctor or physical therapist. At that point, when they are finally cleared, it is a good idea to ease them back into their usual workload.

Reflection 

First, look back at the session with your client and find out what worked and what didn’t work. Most importantly, ask your client how they feel and if any particular movements or exercises bothered them. Therefore you have an opportunity to take any notes and make necessary changes for the next session together.

Check out these resources to find out more about Vertigo or Benign Paroxysmal Positional Vertigo for  more information.