Practicing Yoga with Benign Positional Vertigo

A bout of vertigo can put the brakes on a lot of daily activity. Can you still practice yoga? Will it help? Will it make it worse?

As with most questions in life, the answer is, when in doubt, go to yoga.

I have suffered from motion sickness and periodic bouts of vertigo throughout my life. It wasn’t until my early thirties that an ear exam revealed I have Meniere’s disease, a genetic condition shared by my father and sister, and an explanation for vertigo at such a young age.

Practicing yoga has been a life-saver.

I cannot say classes with vertigo are easy or fun, but they are a path to feeling better for the rest of the day. To understand how to use your practice to help your vertigo, it’s critical to understand the main causes of Benign Positional Vertigo (BPV).

The otolith organs (utrical and sacculus) in your ear monitor your position in relation to gravity with a combination of fine hairs and tiny crystals. For different reasons, the crystals can occasionally get dislodged from these organs and find their way into semicircular canals that make up the vestibular labrynth. It is the out-of-bounds crystals in the vestibular canals that cause the nystagmus, nausea and dizziness that make up vertigo.

To get on track to feeling better, we must first get those crystals back where they belong. There are several techniques out there to counter BPV. The most popular for years was the Epley Maneuver, which I found effective about 50% of the time and works better if it is done to you by a professional.

In recent years, I discovered the Foster’s Maneuver designed by Dr. Carol Foster. This technique is simple to use and can be repeated until you feel better. It is easily assimilated right in the middle of class if you notice the vertigo returning. Please watch the technique in the video below.

What to do in class?

First, perform the Foster’s maneuver prior to class. Because it is ideally done in 15-minute intervals, it is best to do it about 5-10 minutes prior to the start of class. Before you do the technique, lie on your back and roll over to one side and sit up. Repeat on the other side. Note which side made you feel worse. This is the side you will turn your head to during the exercise.

When the class begins Prayanama, it may feel a little bit gross the first few times you drop your head back. If there are still free crystals, they are moving around. That’s why you may feel nauseated or a little dizzy. The exhale breath actually helps to bring the crystals to the back of the vestibular canals where you want them for the maneuver. Go slowly, but don’t skip over it. It will make you feel better in the long run.

Half Moon Pose is helpful in loosening all of the muscles you’ve been tensing since you woke up with vertigo. It’s good for your overall health, so participate. I often find I don’t have a lot of strength when I have vertigo, so don’t be surprised if it looks very different from your usual posture. Complete the lateral flexion (side bends) and the back bend, but skip the forward bend, Hands to Feet, for this class.

The backward bend of Half Moon is the same as the prep phase of the Foster’s Technique. Since the first forward bend in class is about 15 minutes after you did the first set of Foster’s, now is a great time to repeat it. From the back bend, keep looking up and come down to your knees and execute the rest of the maneuver from there while the class completes hands to feet.In the second set, do not repeat the Foster’s Technique, but skip the forward bend.

Awkward, Eagle, Standing Head-to-knee and Standing Bow can be executed as usual, with one exception. If you have the ability to put your forehead on your knee in SH2K, don’t do that today. Keep your face parallel to the mirror.

Balancing Stick should be done to tolerance. Most people find they cannot come all of the way down to parallel. If you woke up with a full-fledged vertigo this morning, I’d recommend keeping your face parallel to the mirror for this class. This means you will only come down about halfway into the stick pose.

By the time we get to Standing Separate-leg Stretching, if has been about 15 minutes since your last Foster’s Technique. If you are still experiencing a little of that shaky-eye nystagmus, this is a good time to repeat it.

If you are feeling okay at this point, feel free to perform the posture, but keep your face up, above the horizontal plane. For flexible students, you may be able to achieve this by placing your hands on the floor and doing the posture with a flat back. If you are a little less loose in the hamstrings, do this with your hands on your thighs for support.