Testing and Rehabilitation
Should vestibular therapy make me feel worse?
By Dr. Ryan Worley
Published July 31, 2026 · 2 min read
Direct answer
Feeling tired after rehabilitation is one thing. Feeling consistently more dizzy, more unsteady, or more symptomatic is another. In my practice, a temporary increase in fatigue is completely understandable because your brain is working hard during rehabilitation. However, if an exercise consistently makes the symptoms you're trying to improve significantly worse, I don't simply assume that means it's working. I see that as information. Your nervous system is constantly communicating with you, and sometimes increased symptoms are telling us that the current approach isn't the right one for your system.
Want to understand why? Keep reading.
Isn't it normal to push through symptoms?
One of the most common things I hear is:
"I was told it's supposed to make me feel worse."
I think that's worth questioning.
Imagine you broke your arm and started physical therapy.
If every time you performed a particular exercise your arm hurt more and functioned worse afterward, would your physical therapist say,
"Good. That means it's working."
Probably not.
More likely, they would adjust the exercise, change the dosage, or choose a different approach.
I believe the nervous system deserves that same level of respect.
What I look for
My goal isn't to make your symptoms worse.
My goal is to identify the specific dysfunction contributing to those symptoms and choose exercises that help your nervous system function more efficiently.
In many cases, people actually notice a reduction in symptoms during the visit.
Sometimes that improvement happens within minutes.
Other times it takes longer.
Every nervous system is different.
That is why I continually reassess how someone responds instead of assuming every exercise is appropriate for every person.
Does that mean rehabilitation should never be challenging?
Not at all.
Rehabilitation should challenge your nervous system.
It just shouldn't blindly aggravate it.
There is an important difference between asking your brain to do meaningful work and repeatedly provoking symptoms without seeing measurable improvement.
That is one reason I rely on objective testing throughout the rehabilitation process.
If an intervention improves objective findings and the nervous system is functioning more efficiently, we continue moving in that direction.
If it makes those findings worse, we change course.
The goal isn't to push through symptoms.
The goal is to find the approach your nervous system responds to best.
Related questions
Related education
- Why Am I Dizzy?
Dizziness can feel like spinning, rocking, imbalance, lightheadedness, or feeling disconnected. Learn why understanding the pattern behind your symptoms is often more important than the label itself.
When you are ready for individualized assessment
Persistent or complex symptoms often need findings specific to you, not a generic exercise list. When you are ready, we can help you decide on an appropriate next step.