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Health and Ear Balance Problems try the Cawthorne-Cooksey Exercises

Updated on November 21, 2016
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Trudy otherwise know as tlcs has a lot of ideas about different things that she loves to share with others and is not afraid of the response

Feeling run down!
Feeling run down! | Source

The Cawthorne-Cooksey Exercises

This exercise program was given to me by my doctor as a result of damage to the balance organ of the inner ear, in my case it has caused dizziness and loss of balance also known as vertigo and can make you feel very ill.

Wow! Looking at them makes me feel dizzy!
Wow! Looking at them makes me feel dizzy! | Source

The ears and the control of balance

Apparently, the two balance organs, one located in each of the inner ears, send information about head movement and position to the balance centre's in the brain. This information is essential fro the maintenance of balance. The two ears work together: the information from them must normally agree in order for the brain to make sense of it.

When either ear is damaged, the sensory inputs to the brain do not agree. This results in dizziness and imbalance and it feels like sea-sickness and in the case of vertigo the sensation feels like your surroundings are moving and you can also sometimes feel sick and want to be sick.

Believe me it is very unpleasant.

Now that is balanced!
Now that is balanced! | Source

How does vertigo get better?

Damage to the inner ear, whatever the cause, is often permanent. The resultant vertigo and imbalance, however, usually improve rapidly. Eventually the sense of balance should return to normal, even after the complete loss of an inner ear. This recovery occurs because the balance centres in the brain learn to compensate for the loss of sensory input.

The brain compensation process is faster in young people and may sometimes be incomplete in the elderly. It is also affected by stress and will be slower if you are too anxious about your balance.

Stress, that awful word again!

The most important factor, however is movement. The sensation of vertigo and imbalance is usually made worse by movement, and your or mine in this case natural tendency when dizzy is (at least initially) to remain as still as possible. Paradoxically, this lack of movement will seriously delay the recovery process. The Cawthorne-Cooksey Exercises introduce you or me in this case to a carefully graded programme of gentle mobilisation and stimulation of the balance system, speeding up the restoration of a sense of balance, by provoking mild, brief and easily tolerated dizziness which is under my own control..

Full recovery is likely to take two to three months (noway!). During the recovery period, it is advised you return to normal activity, including work and sports as soon as possible.

It is also important, during the recovery period, to make as much use as possible of vision, the other main sensory input to the balance centres in the brain. Good vision can over-ride poor inner ear function. In order to make best use of eyesight at all times, you should ensure that lighting is good if you have to get up at night, (that explains why I bumped into the door last night!) and that you wear effective glasses if needed. If possible, avoid bifocal or multifocal lenses during this period, not helpful if you do actually wear this type of glasses!


This video looks at exercises for balance and dizziness

Lets move on to how to practice the Cawthorne-Cooksey Exercises

I was told that the sooner and more regularly the exercise programe is carried out, the faster and more complete will be the recovery of balance and the return to normal activity.

All of the exercises are graded into "levels". My doctor told me to start at the top of the list and progress down as I improve and that I must do enough to induce (bring on) mild dizziness or imbalance, but it is counter-productive to overdo them and that I must not make myself feel sick.

It was recommended to me to do the Exercises for ten minutes three times a day

My doctor also advised me that I would only be able to carry out a few of the exercises in the course of each session: which ones I choose can be varied a little from session to session and that I must not try to work right through the list in one go! He said to time the sessions as the exercises are boring and that I may find it helpful to listen to music or the radio while I exercise.

Even if you are very dizzy, you may safely start with level 1 (eye movements). Ideally, I should aim to begin with a combination of exercises from levels 1 to 3. It can be helpful, when you first start, to mark on a chart (on a scale of 0-3) how dizzy each exercise makes me feel (or if your intending to do these exercises) It is possible then to measure progress by repeating this assessment on a weekly or monthly basis. (See chart later on in hub.)

Lets get balanced!
Lets get balanced! | Source

Perform each set of movements just fast enough to produce a slight sense of dizziness or imbalance at the completion of the set of 10 or 20. (If you feel dizzy before completing the set, (and believe me you will!) do the next set a little more quickly, and so on. As your balance improves, you should speed up. If any exercise does not make you dizzy no matter how fast you do it, then you should drop that particular exercise from the program and move on down the list. This means that eventually you are tailoring the exercise programme to your own precise needs by seeking out those movements that induce slight dizziness, and performing them at the appropriate speed.

It can be helpful to combine in each session an exercise from each level when the exercises have been carried out for a few weeks

When you have been doing the exercises for a few weeks, it can be helpful to combine in each session an exercise from each level. Once you feel that your balance is back to normal, you can stop doing the exercises (even if they still make you dizzy). He said I could always go back to them again in the event of my dizziness returning and that they would be just as effective a second time.

The Level 6 exercises are designed more to boost confidence in your balance than to make you dizzy. They can usefully be introduced at an earlier stage, depending on how you feel.

My doctor went on to say not to exhaust or hurt myself. Some of the exercises are quite strenuous. If I suffer excessive tiredness, breathlessness, joint or back pains, to miss out the exercises that are likely to bring on those problems, or to do them more gently.

Let's go through the Cawthorne-Cooksey Exercises

Level 1

Eye movements (SITTING, KEEPING HEAD STILL)

Carry out each movement 20 times in each direction.

LEVEL 1

1a
Look from left to right and back again, as far to each side as you can
1b
Look up and then down as far each way as you can
1c
Focuse on your finger at arm's length, then move it to within about 6 inches of your nose, making yourself cross-eyed, and back out again
Remember carry out each movement 20 times in each direction in the sitting position and keeping head still

Level 2

Head movements (SITTING)

The aim is to move and stimulate your inner ears, not to exercise your neck. Move as far as you comfortably can in each direction, without jerking, 20 times. Start slowly, with your eyes open. As you improve, speed up and close your eyes.

LEVEL 2

2a
Turn your head from left to right and back again
2b
Bend your head right forwards and then backwards
Remember, the aim is to move and stimulate your inner ears, not to exercise your neck.Start slowly, as you improve, speed up, and close your eyes, do 20 times.

Level 3

Shoulder and bending movements (SITTING)

Do each movement 20 times, eyes open to begin with. As you improve, speed the movements up, and do them with eyes closed.

LEVEL 3

3a
Shrug and circle your shoulders
3b
Bend right forward, with your head down, then sit up again
3c
Drop shoulder and head sideways, to left and then to right
Remember, Do each movement 20 times, eyes open to begin with. As you improve, speed the movements up, and do them with eyes closed

Lying down, head and body movements

Lie flat on your back, without using a pillow, if possible. Do each movement 20 times, eyes open to begin with, then eyes closed.

3d
Roll head from side to side
3e
Roll whole body from side to side
3f
Sit up straight forwards, then lie flat again
3g
Roll onto your side, sit up with your legs over the edge of the bed, lie down on the opposite side and roll onto your back
Remember, for d,e,f ang g you are lying down flat on your back. Do each movement 20 times, eyes open to begin with, then eyes closed

Level 4

Standing and bending, eyes open

When placing or throwing an object, head and eyes must follow the object. Repeat each movement 10 times in each direction. If you suffer severe back problems, omit 4a and 4d.

4a
From standing, bend forwards to pick up an object from the floor, then stand up again. Bend and replace object on floor
4b
Turn right round once, first to the right, then to the left
4c
Place an object on your chair, bending your head as you do so. Turn right round and bend to pick it up again. Repeat, turning in the reverse direction
4d
From standing, bend forwards to place an object on the floor. Turn right round and bend to pick it up agin. Repeat, turning in the reverse direction.
4e
Bend to pick up an object from the floor. Stand and reach up, keeping eyes on the object, first to left, then to right, then straight up. Place object back on the floor and stand up again
4f
Throw a ball from hand to hand above eye level (This involves eye and head movement, as wel as general co-ordination)
Remember, Repeat each movement 10 times in each direction. If you suffer sever back problems, omit 4a and 4d

Moving sitting to standing, eyes open

Repeat each movement 10 times, Omit these exercises if you find them too tiring.

4g
Move from sitting to standing and back again
4h
Move from sitting to standing, turn right round once, and sit down again. Repeat in reverse direction
 
 
Remember, don't do these exercises if you find them to tiring

Level 5

Standing and bending, eyes closed

Repeat each movement 10 times in each direction. Open your eyes briefly after each movement, to check on your position. If you suffer sever back problems, omit 5a and 5d.

LEVEL5

5a
From standing, bend forwards to touch the floor, then stand up again
5b
Turn right round once, first to the right, then to the left.
5c
Bend forwards to touch your chair. Stand up, turn right round and again bend to touch your chair. Repeat, turning in the reverse direction.
5d
Bend forwards to touch the floor. Stand up, turn right round and bend to touch it again. Repeat, turning in the reverse directio
5e
From standing, bend to touch the floor. Stand and reach up, first to left, then right, then straight up
Remember, repeat each movement 10 times in each direction.

Moving sitting to standing, eyes closed

Repeat each movement 10 times. Omit these exercises if you find them too tiring

5f
Move from sitting to standing and back again
5g
Move from sitting to standing, turn right round once, and sit down again. Repeat in reverse direction
Remember, repeat each movement 10 times

LEVEL 6

These may be introduced at an earlier stage

Moving around

These exercises are designed to boost your confidence and improve your general sense ofbalance, rather than to induce dizziness. At least to begin with, you should have someone else present when you do those with eyes closed. Repeat each movement 10 times

LEVEL6

6a
Walk across the room with your eyes open
6b
Walk across the room with your eyes closed
6c
Circle around a companion who will throw you a large ball and to whom you should return it
6d
Walk up and down steps with your eyes open
6e
Walk up and down steps with your eyes closed
Remember, at least to begin with, you should have someone else present when you do those with eyes closed

Finally, any game or activity involving stooping or turning

Any game or activity involving stooping or turning is useful in improving balance. For the young, any ball game is ideal. Bowls, skittles, croquet or golf are good for all ages.

Would you pass this exercise programme on to others with the same symptoms

Would you pass the Cawthorne-Cooksey Exercise Program onto others suffering with the same symptoms?

See results

This lady explains how she felt with an inner ear inbalance

To summarise for the benefit of those of you who may try the Cawthorne and Cooksey Exercise Program

I have been working through this program for the past two weeks. My belief is that it does work. However, that said I do believe you need to keep up these exercises for sometime to gain the best results.

(These exercises are based on originally described by Cawthorne and Cooksey, with recent additions from the National Hospital, Queen Square, adapted for use at home without supervision by a physiotherapist)

That' more like it! Balance back in line!
That' more like it! Balance back in line! | Source

When your feeling better you may want to look at the following link for normal exercises and I hope with all my heart that these exercises help you like they are helping me!

Cawthorne-Cooksey exercises

PERSONAL SYMPTOM RATING CHART (Scale 0-3)

Rating Scale:

0 = no symptoms

1 = mild symptoms

2 = moderate symptoms

3 = severe symptoms

(Leave a blank if any particular exercise not attempted)

Personal Symptom Rating Chart

Date:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level1: Eye Movements
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1a
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1b
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1c
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 2: Head movements
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2a
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2b
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 3: Shoulder and bending movements
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3a
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3b
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3c
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 3: Lying down, head and body movements
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3d
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3e
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3f
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3g
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 4: Standing and bending, eyes open
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4a
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4b
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4c
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4d
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4e
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4f
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 4: Moving sitting to standing, eyes open
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4g
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4h
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 5: Moving sitting to standing, eyes closed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5a
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5b
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5c
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5d
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5e
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 5: Moving sitting to standing, eyes closed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5f
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5g
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 6: Moving around
 
 
 
 
 
 
 
 
 
 
 
 
 
 
6a
 
 
 
 
 
 
 
 
 
 
 
 
 
 
6b
 
 
 
 
 
 
 
 
 
 
 
 
 
 
6c
 
 
 
 
 
 
 
 
 
 
 
 
 
 
6d
 
 
 
 
 
 
 
 
 
 
 
 
 
 
6e
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Read through the notes again about completing this chart

What has the out come of using the exercises been for you?

If you suffer with dizziness, vertigo and loss of balance and try the Cawthorne-Cooksey Exercises, what were the results for you?

See results

Please leave a comment I would love to hear your thoughts

I really would!

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    • tlcs profile image
      Author

      Trudy Cooper 2 years ago from Hampshire, UK

      Thank you lisapikey, I can recommend you try them if you ever get these symptoms, it plays havoc with balance! I am still suffering now :(

    • tlcs profile image
      Author

      Trudy Cooper 2 years ago from Hampshire, UK

      Tai Chi, I hadn't thought of that! I need to see if there are any local classes in my area, this has really knocked me for six. The computer causes me really big problems, I find myself going dizzy. The exercises have really helped however and that is why I wanted to share the information. Thanks aesta1 I will be looking into Tai chi for the future.

    • lisapikey profile image

      Lisa Pikey 2 years ago from Liverpool

      Great hub some useful tips here!

    • aesta1 profile image

      Mary Norton 2 years ago from Ontario, Canada

      I will definitely try this. We do some of these exercises before we start tai chi. I suppose tai chi is also to promote balance.

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