If you think your ears are just for hearing, it might surprise you to know that they aid in balance too. Several structures in the inner ear, together called the vestibular system, send messages to the brain that help you orient to your environment and aid in balance.
“We know that falls impact our seniors,” says Geoff Fraser, partner of Clear Choice Health Care. Falls are a major of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among the ederly, according to the National Council on Aging. Here are some about how the body keeps balance, and what happens when these systems don’t function properly.
Our inner ears contain three fluid-filled tubes called “semicircular canals,” says Paul DiZio, a neuroscientist at Brandeis University who studies balance, motion, and dizziness. Because they each have a different axis of motion, they detect three movements: left, right, up, down and side to side.
“When your head moves, the fluid inside the tubes kind of flows a little bit,” reports DiZio online at Live Science. “And there are sensors — sensors that are like little pieces of seaweed inside the tubes — that float with the fluid and sense what’s going on.”
The movement of your head dictates which canal activates. A nod of yes, a headshake no, or an ear-to-shoulder movement creates a chain reaction that coordinates all the necessary structures to operate normally within the vestibular system.
This coordination relies on and interacts with our eyes, our somatosensory system – our sense of touch, and our proprioception sensors within our joints. When all systems react correctly, we have normal equilibrium. However, conflicting messages can be sent, and their harmony could stop.
For example: If you’ve ever sat at a red light in your car, and looked out the window and suddenly felt like your car was still moving when it wasn’t, blame this on the eyes. Because what you saw was another car moving, this made you feel as though your car was moving in the opposite direction.
The eyes conflicted with your body’s sensory receptors. And your somatosensory system didn’t receive messages of gravity and vibrations to tell us we were moving, but our eyes tricked our vestibular system.
Sometimes loss of balance is caused to mixed messages. For example, a spinning amusement part ride will cause the inner ear to tell you correctly that you are turning. The eyes agree because they see the landscape is moving too. Proprioception sensors in our joints say you’re spinning. All systems agree, until you abruptly stop.
But your inner ear may tell you that you’re still moving. The eyes say that you’re not moving and give conflicting information to the brain. As you try to stand still, you stagger and leave your proprioception testing solid ground.
After a long spin, the inner ear is reflexively driving the eyes in a way that’s going to disrupt vision. It will make your eyes track with the supposed turning; your eyes will rapidly move side-to-side. Confusing your brain, and your proprioception can’t figure it out. So, you grab something for stability or succumb to a fall.
The spinning sensation after a carnival ride and moments in a car are normal reactions. Abnormal happens when the vestibular system is beleaguered by a common vestibular problem known as Benign Paroxysmal Positional Vertigo (BPPV).
Of all falls suffered by the elderly, 50 percent are a result of BPPV. At any time, your balance system can be derailed. One tiny ear crystal that comes loose and rolls, much like a coffee bean in syrup, can trigger intense vertigo when the crystal excites the inner ear canal, telling your brain that you are moving even though you are not.
Loss of balance, for some people, can be caused with a simple sinus infection. Or a cold or flu could impact the inner ear. For others, a fall or car accident could trigger an inner ear disorder. There are many reasons why the inner ear gets blamed for falls.
“The good news is, most balance disorders can be cured or at least improved,” writes Dr. William Wright, a neurotologist and vertigo specialist in his book “Dizziness and Vertigo: A simple guide to figuring it out.” “In general, the worse the dizziness, the better the chance for improvement,” says Dr. Wright.
“The good news is, there’s help for vertigo,” says Geoff Fraser. “A physical therapist with training and certification in vestibular dysfunctions can provide care and solutions.”
There are many ways to treat balance issues and 80%-90% of patients can solve their vertigo with balance retraining exercises.
If you fear that dizzy spells are starting to limit your outings or if you’re experiencing one or more falls per month, Fraser advised to consult with a doctor. “Ask if therapy can help you get on the right track,” says Fraser

Geoff Fraser is a partner at Clear Choice Health Care in Melbourne FL