How the Inner Ear Plays a Vital Role in Balance

If you think your ears are just for hearing, it might surprise you to know that they aid in balance too. Several structures in the inner ear, together called the vestibular system, relay messages to the brain that help you orient to your surroundings and aid in balance.
“We know that falls impact our seniors,” says Geoff Fraser, partner of Clear Choice Health Care. Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among the ederly, according to the National Council on Aging. Here are a few tips about how the body maintains balance, and what happens when these systems don’t work properly.
Our inner ears contain three fluid-filled tubes called “semicircular canals,” says Paul DiZio, a neuroscientist at Brandeis University who studies balance, motion, and dizziness. Because they each have a different axis of motion, they detect three movements: up and down, left, and right, and side to side.
“When your head moves, the fluid inside the tubes kind of flows a little bit,” reports DiZio online at Live Science. “And there are sensors — sensors that are like little pieces of seaweed inside the tubes — that float with the fluid and sense what’s going on.”
The movement of your head dictates which canal activates. A nod of yes, a headshake no, or an ear-to-shoulder movement creates a chain reaction that coordinates all the necessary structures to operate normally within the vestibular system.
This coordination relies on and interacts with our eyes, our somatosensory system – our sense of touch, and our proprioception sensors within our joints. When all systems react correctly, we have normal equilibrium. However, conflicting messages can be sent, and their harmony could stop.
For example: If you’ve ever sat at a stop sign in your car, looked out the window and suddenly felt like your car was still moving when it wasn’t, blame this on the eyes. Because maybe what you saw was another car moving, this made you feel like your car was moving in the opposite direction.
The eyes conflicted with your body’s sensory receptors. And your somatosensory system didn’t receive messages of gravity and vibrations to alert us we were moving, but our eyes tricked our vestibular system.
Sometimes loss of balance is due to inconsistent messages. For example, a spinning carnival ride will cause the inner ear to tell you correctly that you’re turning. The eyes agree because they see the landscape is moving as well. Proprioception sensors in our joints say you’re spinning. All systems agree, until you abruptly stop.
Your inner ear may tell you that you’re still moving. The eyes say that you’re not moving and give conflicting information to the brain. As you try to stand still, you stagger and leave your proprioception testing solid ground.
After a long spin, the inner ear is reflexively driving the eyes in a way that’s going to disrupt vision. It will make your eyes track with the supposed turning; your eyes will rapidly move side-to-side. Your brain is confused, and your proprioception can’t figure it out. So, you reachfor something for stability or succumb to a fall.
The spinning sensation after a amusement park ride and moments in a car are normal reactions. Abnormal happens when the vestibular system is besieged by a common vestibular problem known as Benign Paroxysmal Positional Vertigo (BPPV).
Of all falls suffered by the elderly, 50 percent are a result of BPPV. At any time, your balance system can be derailed. One tiny ear crystal that comes loose and slowly rolls, much like a coffee bean in syrup, can trigger intense vertigo when the crystal excites the inner ear canal, telling your brain that you are moving even though you are not.
Lack of balance, for some people, could be caused with a simple sinus infection. Or a cold or flu could impact the inner ear. For others, a fall or car accident could trigger an inner ear disorder. There are many reasons why the inner ear gets blamed for falls.
“The good news is, most balance disorders can be cured or at least improved,” writes Dr. William Wright, a neurotologist and vertigo specialist in his book “Dizziness and Vertigo: A simple guide to figuring it out.” “In general, the worse the dizziness, the better the chance for improvement,” says Dr. Wright.
“The good news is, there’s help for vertigo,” says Geoff Fraser. “A physical therapist with training and certification in vestibular dysfunctions can provide care and solutions.”
There are a lot of to treat balance issues and 80 to 90 percent of patients can solve their vertigo with balance retraining exercises.
If you fear that dizzy spells are starting to limit your outings or if you’re experiencing one or more falls per month, Fraser advised to consult with a doctor. “Ask if therapy can put you on the right track,” says Fraser

Geoff Fraser is a partner at Clear Choice Health Care in Melbourne FL