Vertigo and Vestibular Disorders – a quick overview

What is the Vestibular System?

It is the system which essentially links the brain and the inner ear, allowing people to maintain proper balance, eye movements and orientation and giving important information about body position when responding to external movement or self-induced movement.

What are symptoms of vestibular disorders?

Common symptoms of disorders include:

  • vertigo and/or dizziness
  • problems with balance or unsteadiness
  • vomiting and/or nausea
  • headaches, vestibular related fatigue
  • blurriness, or “jumpy vision” while moving

What are causes of vestibular disorders?

Problems with the vestibular system may be caused by numerous factors, including: aging, viral infections, head injuries and even environmental or genetic factors.

How are vestibular disorders diagnosed?

Vestibular disorders are diagnosed using various tests, to assess all aspects of the vestibular system, including inner ear, vision, hearing, and balance function. At Avita Health we also use specialized infrared Vestibular Goggles for conditions that cannot be assessed at room light.

How do Avita’s Vestibular Goggles work?

These specialized goggles require a specifically trained Practitioner (Physiotherapist Dimitri Naef, at Avita). The goggles test in darkness and this allows certain eye behaviours (ie. tracking) to highlight an underlying issue. Not every vestibular case requires goggles, however, they are an invaluable tool in many cases for determining location, diagnosis and severity of a condition. The goggles can also record eye movements, allowing our Practitioner to replay the video, to aid with accurate assessment, or as an educational too for clients.

How are vestibular disorders treated?

Treatments include rehabilitation, lifestyle changes and sometimes medications. At Avita we focus on rehabilitation and lifestyle changes. Leaving vestibular disorders untreated and unmanaged, can result in a significant reduction in quality of life, reduced function, and the risk of falls. Our goal at Avita is to accurately diagnose the issue, treat accordingly and suggest proper homecare strategies. The net goal is to minimize or eliminate symptoms and to improve the patients’ function and quality of life.

Our Vertigo/Vestibular Care Team

Dimitri Naef
Registered Physiotherapist

Dimitri Naef

M.Sc.PT, B.Sc.Kin, IMS, Concussion

Originally from Nelson, BC, Dimitri left the Kootenays to pursue his goal of becoming a Physiotherapist by attaining a Bachelors degree in Kinesiology and a Masters Degree in Physical Therapy at UBC.

Since completing his formal education, Dimitri has been dedicated to helping people recover from injuries from head to toe. In addition to more common conditions, Dimitri also has significant experience in concussion management and vestibular disorders. Having worked in specialized concussion clinics Dimitri is uniquely positioned to help individuals recover from concussions and all of the associated symptoms.

No matter the condition, Dimitri brings a laid back, empathetic, and honest approach to his practice, where he believes strongly in patient centered, evidence based care, continually working with patients to identify the actions they can take for their personal well-being.

Dimitri is certified in IMS, and has also completed the following continuing education courses:

– Concussion Management Workshop levels 1 & 2 with Shannon McGuire

– National Academy of Neuropsychology Symposium on Concussion Management

– Vestibular Therapy Training with Bernard Tonks

– Chronic Pain Management Certification with Bahram Jam

– Lynn Watson Shoulder Course level 1 & 2

– Adam Meakins Shoulder Rehab

– Jill Cook course on Tendinopathy Management

– Orthopaedic Manual Therapy Level 1

– Mulligan Technique

– Active Release Techniques

In his spare time, Dimitri is an avid soccer player and outdoor enthusiast (isn’t everyone in North Vancouver!?), spending time camping, hiking and snowboarding.

Sarah Hearne
Registered Physiotherapist

Sarah Hearne

Sarah grew up on the beautiful North Shore, where her passion for helping people and her interest in holistic health care led her to pursue a career in physiotherapy. She completed her undergraduate degree in Kinesiology at Simon Fraser University and went on to earn her Master’s in Physiotherapy from the University of British Columbia.

Sarah holds post-graduate certifications in acupuncture, vestibular therapy, concussion management, facial neuromuscular retraining, yoga for pain management, and advanced orthopaedic manual and manipulative therapy (Level 2). In addition, she has attended numerous courses and conferences focused on pain management and is currently pursuing a graduate certificate in pain management through the University of Alberta.

With experience in various areas of physiotherapy, Sarah has worked with clients dealing with complex pain (including CRPS and fibromyalgia), geriatrics, orthopaedic injuries, pre- and post-surgical care, vestibular disorders (dizziness), concussion management, and facial palsy. Her treatment philosophy is rooted in a client-centered approach, incorporating her training in motivational interviewing and trauma-informed care. Sarah is dedicated to treating each client as an individual, tailoring her care to meet their specific needs and goals.

As a clinical faculty member at UBC, Sarah is actively involved in teaching within the Master’s of Physical Therapy Program, contributing to the education of future physiotherapists.

Outside the clinic, Sarah enjoys running, practicing yoga, and exploring the great outdoors on the North Shore with her husband and young son.

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