The Human Balancing System is made up of 3 basic components.
Our Eyes (Oculomotor System)
Our Inner Ears (Vestibular System)
Our Legs/Muscles (Proprioceptive System)
This series will explore the relationship of these 3 systems and the effects it has on neck and back pain, digestive issues, headaches/migraines, balance, dizziness and vertigo, mTBI/concussion, as well as sports performance and injury recovery.
This write up continues to cover the Oculomotor (and vestibular) System and will be a basic explanation of eye movements. Look for future write ups, videos and blog posts to help explain what is happening in the brain of symptomatic people.
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The VOR/COR system is what keeps our eyes fixated on a target during head movement or body movement. Your VOR is your Vestibular-Ocular Reflex and your COR is your Cervical-Ocular-Reflex. It utilizes your inner ear organ called your Semicircular Canal, Otolith and Saccule. These are all separate “apparatus” within the same vestibular organ and measure different directions of turn and tilt of the head, and relay positional information in relation to gravity.
This is one of the most basic systems to make sure works properly or you are in for a world of hurt and instability.
You see (no pun intended), when your eyes do not move equal and opposite to whole body perturbations (think walking or spinning in a chair- when you step you create a “bounce” and your eyes must move equal and opposite this bounce to keep your eyes on target) this creates retinal slip, where the image you’re trying to to keep in focus quickly slides off your retina, which gives you the feeling that something is moving more than what it actually is (have you ever been sitting at a stoplight that’s on a hill and the car next to you starts moving forward and YOU think you’re moving BACKWARD and freak out and push the brakes harder?! I mean) This often results in dizziness or vertigo as the main symptom. Further down the line, this can create conditions like POTS, migraines, vestibular migraines, digestive issues and pain related problems.
Your COR is very similar to your VOR and uses the same system, however your neck muscles are now highly involved and sending much more information in addition to the vestibular system and have to combine their information.
So, if you have chronic neck pain, poor range of motion, “blurry vision” or have sustained any number of concussions in the past, your VOR and COR systems are likely faulty causing chronic issues. The only way to beat those issues are to stabilize your VOR and COR along with the rest of the gaze stabilization system.
We like to preload gaze stability exercises with uni-directional halmagyi/head thrusts in order to promote initially higher activity for one side of the vestibular system. We like to “prime it” so to speak, then this buys us 7 seconds of neurological “charging” of the system where we actually get MORE out of it than simply just doing the look-look, No-No or Yes-Yes head shaking (for those of you who have gone through a bout of physical therapy mediated gaze stabilization or vestibular therapy, you know what I’m talking about here)
If based on this article this system seems to be involved in any of your symptoms or you’ve sustained previous head injuries or concussions, please make sure to reach out and make an appointment to be evaluated. Ask for the complete neurological workup and we will begin exercises for any functional abnormalities we find.
