Post-COVID Dizziness: How Physical Therapy Can Help
About 25 to 30 percent of people are experiencing long-haul symptoms after recovering from COVID. Even after COVID runs its course, the body continues to have lingering symptoms.
Long-haul symptoms include:
- Chronic fatigue
- Shortness of breath
- Body aches
- Chest pain
- Cough
In some cases, symptoms of post-COVID dizziness may be a sign of postural orthostatic tachycardia syndrome, or POTS. As a result of blood circulation issues, POTs impair cognitive processes which causes fatigue and dizziness.
What are the symptoms of Post-COVID dizziness?
While dizziness is itself a major symptom of post-COVID dizziness, it comes with other signs related to cognitive impairments:
- Brain fog
- Trouble concentrating
- Fatigue
- Memory loss
- Balance issues
Post-COVID dizziness seems to be sudden, repetitive, and no clear cause or explanation. Along with other accompanying symptoms, post-COVID dizziness can have an impact on daily functioning.
However, what can you do with symptoms of a condition from which you have already recovered? Because there is currently no treatment for COVID long-haul symptoms, all we can do is manage the symptoms as best as we can.
What can physical therapists do to evaluate dizziness?
While the direct cause of post-COVID dizziness is unclear, physical therapists can make a detailed assessment.
Every case of post-COVID dizziness may be different, so a physical therapist will want to know about the following.
- Inner ear condition
- Balance or vertigo
- Strength of various body areas (legs, arms, neck)
- How you walk
- Cases of vertigo or other symptoms
Since post-COVID dizziness can vary from person to person, physical therapy helps identify main concerns and tailor treatment to the person. Then, they can help you improve your dizziness by way of physical maneuvers, breathing patterns, balance, and overall mobility.
What can physical therapists do to treat dizziness?
Since there are physical therapy treatments that help with benign paroxysmal positional vertigo (BPPV), they may also assist with post-COVID dizziness. With BPPV, certain crystals in the inner ear may be displaced, leading to vertigo and dizziness with sudden head movements. So the aim of treatment is to allow the inner area to reintegrate those crystals, putting them back in the right place.

The following treatments may alleviate dizziness.
- Epley maneuver
- Sermont maneuver
- Vestibular Ocular Reflex exercise
Both the Epley and Sermont maneuver aims to improve vertigo, but they may help with post-COVID dizziness. With the Epley maneuver, the physical therapist will turn the head in certain ways depending on what they assess about your ear condition.
First, you will start off sitting upright before the therapist pulls you back. All the while, your head will maintain its turned position towards the ear with the condition. Here, you will gauge your dizziness or vertigo levels, waiting for any to pass. Next, the physical therapist will tilt your head in the opposite direction, before turning your entire body to the side.
The Sermont maneuver involves a physical therapist first holding your head midway between facing forward and the affected side as you sit in an upright position. Then the therapist will quickly move the head all the way to the side that experiences the most dizziness or vertigo, holding it in place as you maintain your gaze straight up at the ceiling.
Additionally, physical therapists can guide you through vestibular ocular reflex exercises to relieve dizziness and related symptoms. VOR exercise helps people with balance difficultly, headaches, and lightheadedness by stabilizing one’s vision. As a part of a larger vestibular rehab program, you can improve your posture via stretching, retrain your balance, and other modes of improving functioning despite dizziness.
How long is therapy? How many therapy sessions?
Both the Epley and Sermont maneuvers take only about 10 to 15 minutes per session. Usually, depending on the cause of the issue, about 1 to 3 visits is enough to improve or even relieve dizziness.
What is the effectiveness of the treatment?
Considering that the Epley maneuver has approximately an 80 percent success rate for benign positional vertigo, it may help with post-COVID dizziness. As for the Sermont maneuver, patients with BPPV tend to have over 90 percent success rate, depending on the severity and length of their dizziness symptoms.
Do I need a doctor’s order to see a physical therapist?
While other states may vary, in Maryland, you can visit a physical therapist without checking in with your doctor. However, to understand the causes of the dizziness and its relation to COVID, a doctor’s appointment can be beneficial.
More about: Post-COVID Rehabilitation
Article Resources:
https://www.uofmhealth.org/health-library/hw205519
https://my.clevelandclinic.org/health/treatments/15298-vestibular-rehabilitation