Dizziness After a Concussion: Causes and Treatment in Burlington

The room spins when you roll over in bed. You feel off-balance turning your head to check a blind spot. Standing up too fast makes everything tilt sideways. If you've searched "why am I still dizzy after my concussion," you're not imagining it, and you're not alone.

Dizziness shows up in a large majority of people after a head injury, and it's one of the strongest predictors of symptoms lingering longer than expected. The frustrating part is that "dizziness" isn't one thing. It can come from at least three different places in the body, and each one needs a different fix.

Why does a concussion cause dizziness in the first place?

Your brain figures out where your body is in space by combining three sources of information: your inner ear (vestibular system), your eyes, and sensors in your neck. A concussion — especially one from a car accident or a fall where the neck whips around — can disrupt any or all three of these systems at once.

That's why two people with "concussion dizziness" can need completely different treatments. Getting the right diagnosis first is what makes the exercises actually work, instead of guessing.

BPPV: dizziness triggered by moving your head

Benign paroxysmal positional vertigo (BPPV) is the most common inner-ear cause of dizziness after a head injury. It happens when tiny calcium crystals inside the inner ear get knocked loose and end up somewhere they shouldn't be.

The signature pattern: a brief, intense spinning sensation — usually under a minute — triggered by specific position changes. Rolling over in bed, looking up to a high shelf, or tipping your head back in the shower are classic triggers.

Post-traumatic BPPV tends to be stubborn compared to the kind that shows up out of nowhere in older adults. It's more likely to affect both ears, more likely to need several treatment sessions, and more likely to come back. The good news is that it responds well to specific repositioning maneuvers — guided movements that coax those crystals back where they belong — rather than general balance exercises.

Vestibular hypofunction: the inner ear's "volume" is turned down

Instead of false signals (like BPPV), vestibular hypofunction is a loss of signal. The balance organs or the nerve carrying their information to the brain have been affected, so the brain gets less input than it needs when your head moves.

This tends to feel less like spinning and more like a general sense of imbalance, a feeling that your vision "jumps" or blurs when you turn your head (oscillopsia), or that busy environments like grocery stores and traffic feel overwhelming.

Treatment here isn't about repositioning anything — it's about retraining the brain. Gaze stabilization exercises (moving your head while keeping your eyes locked on a fixed point) and balance training help the brain compensate for the reduced signal through a process called central compensation. One trial in youth athletes found this kind of targeted therapy reduced dizziness symptoms by about 31%.

Cervicogenic dizziness: when the neck is the problem

The neck is loaded with sensors that tell your brain where your head is relative to your body. After whiplash or a concussion with significant neck involvement, those signals can become unreliable or conflict with what your eyes and inner ear are reporting.

The result is cervicogenic dizziness: a vague unsteadiness or lightheadedness, often alongside neck pain or stiffness, that's triggered by turning or extending the neck or by holding a position too long — think working at a screen or driving. Unlike BPPV, it isn't tied to lying down or sitting up specifically, and the spinning quality is usually absent.

This matters because cervical issues are a major, and often overlooked, contributor to persistent post-concussion dizziness — particularly after a car accident. Treatment focuses on restoring deep neck muscle control and joint awareness, often paired with gaze stabilization work for best results.

Can these causes overlap?

Often, yes. It's common for inner-ear dizziness and cervicogenic dizziness to coexist after a concussion or whiplash, which is exactly why a thorough exam matters more than a quick symptom checklist. A proper assessment looks at your vestibular system, your eyes, your neck, and how all three work together — and asks detailed questions about what specifically triggers your dizziness and how long it lasts.

What does treatment actually look like?

• BPPV: specific repositioning maneuvers performed by a trained clinician, sometimes needing more than one session
• Vestibular hypofunction: gaze stabilization and balance exercises, typically at least 20 minutes daily for several weeks
• Cervicogenic dizziness: deep neck muscle retraining and joint position exercises, often combined with gaze stabilization
• Across all three: gradual return to activity, allowing mild, short-lived symptom increases rather than avoiding all triggers

Research supports an active approach here: after a brief initial rest period, easing back into activities that cause only minor, short-lived symptom increases tends to support recovery better than waiting for dizziness to disappear completely before moving. If dizziness and imbalance are still around at the four-to-six week mark, combining vestibular therapy, neck-focused treatment, and graded aerobic activity becomes especially important.

If your dizziness started after a motor vehicle collision, it's worth knowing that neck injuries and concussions are frequently missed together in the early days — you can read more in Concussion After a Car Accident: Why Symptoms Get Missed. And if you're curious what a structured concussion recovery plan actually involves session by session, see What Concussion Physiotherapy Looks Like, Visit by Visit.

Getting assessed in Burlington

At OMNI Health and Rehab, our Burlington Concussion Clinic team starts every dizziness assessment by figuring out which system — or systems — are involved. That includes testing for BPPV with positional maneuvers, evaluating the vestibulo-ocular reflex, and a hands-on cervical spine exam to rule in or out neck involvement. From there, your treatment plan targets the actual cause, not just the symptom.

If your injury was from a car accident, our clinic also works within motor vehicle accident rehab funding, and we direct bill most extended health plans so you're not stuck managing receipts on top of recovery.

This article is for educational purposes and doesn't replace an assessment by a qualified health professional.

Ready to get a clear answer on what's driving your dizziness? Book a concussion assessment at our Burlington clinic.