Condition guide
Balance Disorders Treatment in Sterling, VA
Personalized Physical Therapy to Improve Balance, Walking, Stability, and Confidence
Feeling unsteady on your feet can be much more than an inconvenience. A balance problem can make you hesitate before walking down the stairs, hold onto furniture when moving around your home, avoid uneven surfaces, or become anxious about falling when you are outside.
Care centered on your life
You may notice that you occasionally stumble or sway when walking. Perhaps you feel unsteady when getting up from a chair, turning quickly, walking in a crowded environment, or moving around in low light. Some people experience balance difficulties together with dizziness or vertigo, while others have no dizziness at all and simply feel that their body is not as stable as it used to be.
Balance disorders can affect people of different ages and can have many different causes. Problems involving the inner ear, vision, muscles, joints, nerves, brain, circulation, medications, or a combination of these systems can affect a person's ability to maintain stability. Conditions such as stroke, Parkinson's disease, multiple sclerosis, traumatic brain injury, diabetes, and other neurological or medical conditions can also contribute to balance difficulties.
Balance is not controlled by one single part of the body. Your brain continuously receives information from your eyes, inner ears, muscles, joints, and other sensory systems and combines that information to help you understand where your body is in space. It then coordinates appropriate muscle responses to keep you upright and help you move safely.
When one or more of these systems is not working effectively, you may have difficulty maintaining your balance, particularly during movement.
At 1st Americare Physical Therapy in Sterling, Virginia, physical therapy can focus on improving your strength, mobility, coordination, walking ability, and confidence while addressing the specific factors contributing to your balance difficulties.
Our clinic serves patients in Sterling and surrounding Northern Virginia communities, including Ashburn, Herndon, Reston, Leesburg, Potomac Falls, Cascades, Countryside, and Dulles.
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What Are Balance Disorders?
A balance disorder is a condition in which you have difficulty maintaining a stable body position while sitting, standing, walking, or performing other movements.
Balance does not simply mean being able to stand on one foot. Your balance system is constantly working, even when you are standing still. When you stand, your body makes very small adjustments to prevent you from falling. When you walk, the demands become greater because you are repeatedly shifting your weight from one leg to another.
The challenge becomes even greater when you turn your head, step over an object, climb stairs, walk on an uneven surface, carry something, or perform two activities at the same time.
This is why someone may feel perfectly stable while sitting in a chair but become unsteady when walking through a grocery store.
A person may also have relatively good balance in a well-lit room but struggle when walking outside at night.
Balance problems can therefore affect both static balance, which involves maintaining a stable position while relatively still, and dynamic balance, which involves maintaining stability while moving.
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How Does Your Body Maintain Balance?
Maintaining balance is a remarkably complex process. Your vision helps you understand where you are in relation to your surroundings. Your eyes provide information about the position and movement of objects around you and help your brain understand whether your body is moving.
Your vestibular system, located within the inner ear, detects movements of your head and helps your brain understand orientation and motion.
Your proprioceptive system provides information from your muscles, joints, and other tissues about where different parts of your body are positioned.
Your brain receives and combines this information and uses it to coordinate appropriate muscular responses.
For example, when you step onto an uneven surface, your body needs to recognize the change quickly and adjust your posture and muscle activity to prevent you from losing your balance.
If one system provides inaccurate or incomplete information, the brain may need to rely more heavily on the other systems.
That is one reason some people notice that their balance becomes worse when they close their eyes or walk in darkness.
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What Causes Balance Problems?
Balance problems can have many different causes, and sometimes several factors contribute at the same time.
A person may have reduced leg strength, limited joint mobility, decreased sensation in the feet, vision changes, and an inner-ear problem simultaneously. Each individual factor may be manageable, but together they can significantly affect stability.
Balance difficulties may occur because of problems involving the inner ear, neurological system, muscles and joints, vision, circulation, or other medical conditions. Certain medications can also cause dizziness, lightheadedness, or other symptoms that increase the risk of falling.
For this reason, persistent balance problems should not simply be dismissed as “getting older.” Aging can influence strength, sensory systems, reaction speed, and other components of balance, but significant or worsening balance difficulties deserve appropriate evaluation.
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Inner Ear and Vestibular Problems
The inner ear contains the vestibular system, which plays an important role in detecting head movement and maintaining balance.
Problems affecting the vestibular system can cause symptoms such as dizziness, vertigo, unsteadiness, difficulty walking, or a sensation that your surroundings are moving. Some people describe the sensation as if the room is spinning. Others describe feeling as though they are floating, rocking, swaying, or being pulled to one side.
Vestibular problems can occur for different reasons, including certain inner-ear conditions, infections, trauma, or age-related changes. When balance difficulties are related to the vestibular system, specialized vestibular rehabilitation may be incorporated into physical therapy when appropriate.
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Neurological Conditions and Balance
The nervous system plays a central role in balance because the brain must receive, interpret, and respond to information from different parts of the body.
Neurological conditions can therefore affect balance and walking in different ways. People recovering from a stroke may experience weakness, coordination difficulties, altered sensation, or changes in walking that affect balance.
People with Parkinson's disease may experience changes in movement, posture, gait, turning, and balance. People with multiple sclerosis may experience weakness, sensory changes, fatigue, coordination problems, or other symptoms that influence stability.
A traumatic brain injury can also affect balance, coordination, vision, vestibular function, and the ability to respond appropriately to changes in the environment.
Physical therapy for neurological balance problems is individualized according to the person's diagnosis, symptoms, functional limitations, and goals.
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Muscle Weakness and Balance Problems
Good balance requires more than simply having a functioning inner ear. Your muscles need to be strong enough to make the adjustments necessary to keep your body stable. Weakness in the legs, hips, or trunk can make it more difficult to recover when you lose your balance.
For example, if you trip over a small object, your body needs to quickly move one foot forward or sideways to prevent a fall. If your muscles are too weak or your reaction is too slow, you may not be able to recover effectively. Age-related loss of muscle strength can contribute to reduced balance performance, particularly in older adults. This is one reason strengthening can be an important component of balance rehabilitation.
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Joint Stiffness and Balance
Your joints also need to move adequately for you to maintain and recover your balance.
If your ankles are stiff, for example, you may have difficulty making the small forward and backward adjustments necessary to remain stable.
Hip and knee stiffness can also affect how you shift your weight, step, squat, and respond when your balance is challenged.
A physical therapist can evaluate whether limitations in joint mobility are contributing to your balance difficulties and incorporate appropriate mobility work into your treatment plan.
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Reduced Sensation in the Feet
Your feet provide important information about the surface beneath you.
When you stand or walk, sensory receptors in your feet and lower limbs help your nervous system understand how your body is positioned and where your weight is being distributed.
Conditions that affect sensation, including some forms of peripheral neuropathy, can interfere with this information. For example, a person with reduced sensation in the feet may have greater difficulty knowing exactly where their feet are positioned, particularly when walking on uneven surfaces or in low light.
Diabetes and other medical conditions can contribute to sensory changes that affect balance.
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Vision and Balance
Vision is an important part of maintaining stability. When you walk, your eyes help you identify obstacles, judge distances, recognize changes in the ground, and understand how your body is moving through space. Vision problems can therefore make balance more difficult.
This can become particularly noticeable in environments with poor lighting or visual clutter. If you have balance problems accompanied by changes in vision, double vision, sudden visual loss, or other concerning visual symptoms, appropriate medical evaluation is important.
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Medications and Balance Problems
Certain medications can contribute to dizziness, lightheadedness, drowsiness, confusion, or other effects that may increase the risk of falling.
This can be particularly relevant for older adults who take multiple medications.
If you notice that your balance problems began or became worse after starting or changing a medication, speak with the healthcare professional who prescribed it. Do not stop or change a prescribed medication on your own. Medication changes should be discussed with your physician or pharmacist.
A physical therapist can consider how symptoms affect your movement and safety, but medication-related concerns should be addressed with your medical provider.
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Common Symptoms of Balance Disorders
Balance problems can look very different from one person to another. You may feel dizzy, lightheaded, unsteady, or as though the ground is moving beneath you. You may feel as though you are going to fall even though you have not actually fallen.
Some people notice that they stagger or veer to one side while walking. Others experience repeated tripping, difficulty turning, or a sensation of being unstable when standing up.
You may also notice that your symptoms become worse when you walk in darkness, move your head, turn quickly, climb stairs, walk on uneven ground, or try to perform another task while walking. Balance disorders may also be associated with fatigue, nausea, blurred vision, disorientation, or anxiety related to the fear of falling.
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How Balance Problems Can Affect Everyday Life
A balance disorder can affect much more than your ability to stand. You may begin avoiding activities that previously felt routine.
Perhaps you stop walking around the neighborhood because you are worried about falling. You may avoid shopping alone because crowded stores make you feel unsteady. You may stop using stairs and remain on one floor of your home. Some people become hesitant to shower without holding onto something. Others become nervous about getting out of bed at night.
Over time, this can create a difficult cycle. You become afraid of falling, so you move less. This is because if you move less, your strength and endurance may decline. Reduced strength can make movement more difficult, which can increase your fear of falling. Physical therapy can help interrupt this cycle by gradually improving strength, movement, balance, and confidence in a controlled environment.
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How Can Physical Therapy Help Balance Disorders?
Physical therapy for balance problems is not simply a matter of standing on one leg. Your therapist first needs to understand why you are having difficulty maintaining your balance.
Treatment is therefore individualized. A physical therapist may assess your walking pattern, lower-extremity strength, joint mobility, coordination, ability to change positions, balance while standing, balance while moving, and how you respond to different environmental challenges.
Depending on your needs, treatment may then focus on improving the physical and sensory systems that contribute to safe movement.
Patient-specific balance exercises can be developed by physical therapists according to the individual's balance limitations and underlying condition.
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Balance and Stability Training
Balance exercises are designed to challenge your ability to maintain control of your body.
Your therapist may begin with relatively simple activities and gradually increase the challenge as you become more stable. The goal is not to make you fall. The goal is to create safe, appropriately challenging situations in which your body learns to control movement more effectively.
Exercises may progress from stable, predictable environments toward more complex activities that resemble the situations you encounter in everyday life.
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Gait and Walking Rehabilitation
Walking is one of the most important functional skills addressed in balance rehabilitation. Your therapist may assess whether you walk with unusually short steps, reduced speed, asymmetry, excessive side-to-side movement, difficulty turning, or other changes. Gait training can then focus on improving walking mechanics, coordination, step control, and safety.
Depending on your condition, rehabilitation may also address how you walk while changing direction, navigating obstacles, using stairs, or performing another task at the same time. Physical therapists commonly use gait training, balance exercises, neuromuscular re-education, and functional movement training to address walking problems.
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Strengthening for Better Balance
Strength is an important foundation for balance. Your therapist may work on the muscles of your:
- Legs
- Hips
- Ankles
- Trunk
The objective is not simply to increase muscle size. It is to improve your ability to control your body during real-world activities.
For example, stronger leg muscles may make it easier to rise from a chair, step onto a curb, climb stairs, or recover from a small loss of balance. Your program can be progressed as your strength and confidence improve.
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Improving Coordination
Balance requires your muscles to work together at the right time. You may have adequate strength but still struggle with coordination.
For example, you may find it difficult to take a quick step when you begin to lose your balance or have trouble coordinating your legs when changing direction. Neuromuscular rehabilitation can focus on improving the timing and coordination of movement so that your body can respond more efficiently.
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Functional Balance Training
Good balance in a physical therapy clinic is helpful, but the ultimate goal is to improve your ability to function in everyday life. Your therapist may therefore incorporate activities that resemble your daily routine.
You may practice getting up from a chair, turning, reaching for objects, stepping over obstacles, navigating different surfaces, or moving while carrying an object. The specific activities depend on your goals and safety needs.
For someone whose main concern is falling at home, rehabilitation may emphasize safe transfers and household mobility. For someone who wants to return to community walking, treatment may gradually incorporate more complex walking and environmental challenges.
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Vestibular Rehabilitation for Balance Problems
When balance difficulties are related to the vestibular system, specialized vestibular rehabilitation may be appropriate.
Vestibular rehabilitation uses individualized exercises designed around the person's symptoms and vestibular function.
Depending on the underlying problem, treatment may address gaze stability, habituation to certain movements, balance, walking, and the ability to coordinate head and body movement.
Not every balance problem is vestibular. That distinction is important.
If your primary problem is weakness after a stroke, for example, your rehabilitation may look very different from treatment for a vestibular disorder. A proper assessment helps determine which approach is appropriate.
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Balance Training for Older Adults
Balance difficulties become more common with age, but falling should not be considered an unavoidable part of getting older. Changes in strength, vision, sensation, vestibular function, reaction speed, and other systems can affect balance as people age.
Physical therapy can help older adults maintain or improve their physical abilities and confidence. The focus may be on making everyday activities safer and easier, rather than simply achieving an impressive balance exercise.
Being able to walk safely to the bathroom at night, get up from a chair, step into a shower, climb stairs, or walk through a parking lot can be far more meaningful than being able to stand on one foot for a long period.
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Fall Prevention and Balance Rehabilitation
Falls can have serious consequences, particularly for older adults. They can result in fractures, head injuries, hospitalization, loss of independence, and fear of future activity.
Physical therapy can address modifiable physical factors that contribute to fall risk, such as weakness, impaired balance, walking difficulties, and reduced mobility. Your therapist may also discuss practical safety considerations related to your movement and environment.
However, fall prevention is not only about exercise. Your healthcare team may also need to consider medications, vision, footwear, home hazards, blood pressure changes, and underlying medical conditions.
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Fear of Falling
One of the most overlooked consequences of balance problems is fear. After one fall or even after several near-falls you may begin moving differently. You may walk more slowly, avoid certain activities, hold onto furniture, or stop going outside. This fear is understandable. However, excessive avoidance can reduce your activity level and contribute to further weakness and loss of confidence. Physical therapy can provide a controlled environment in which you can practice movement safely and gradually rebuild confidence.
The goal is not to tell you that there is nothing to worry about. The goal is to help you understand what movements you can safely perform and progressively expand what you are capable of doing.
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When Should You See a Physical Therapist for Balance Problems?
You should consider seeking professional evaluation if you regularly feel unsteady, have difficulty walking, frequently stumble, feel as though you might fall, or have experienced one or more falls. An evaluation is particularly appropriate if balance problems are beginning to interfere with your independence.
You may benefit from assessment if you have started holding onto walls or furniture while walking, avoid stairs because you feel unsafe, have difficulty walking outside, or are becoming less physically active because of concerns about falling.
You do not need to wait until you experience a serious fall. Early evaluation may help identify physical factors contributing to your instability and determine whether physical therapy is appropriate.
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What Happens During a Balance Physical Therapy Evaluation?
Your first appointment should begin by understanding your experience. Your therapist may ask when your balance problems started, whether they appeared suddenly or gradually, whether you experience dizziness or vertigo, whether you have fallen, what situations make you feel unstable, and whether you have difficulty walking in particular environments.
Your medical history is also important. Conditions such as stroke, Parkinson's disease, multiple sclerosis, diabetes, previous brain injury, joint problems, vision changes, and inner-ear disorders may all influence the evaluation. Your therapist may then examine your walking, posture, strength, joint mobility, coordination, balance reactions, and ability to perform functional movements.
If dizziness or vestibular symptoms are present, additional assessment may be appropriate. The purpose is to understand what is affecting your balance and what can safely be addressed through rehabilitation.
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When Should You Seek Immediate Medical Attention?
Balance problems are sometimes caused by conditions that require urgent medical attention rather than routine physical therapy. If your balance problem begins suddenly, particularly if you have never experienced anything similar before, seek prompt medical evaluation. Sudden balance problems accompanied by symptoms such as facial drooping, new weakness or numbness on one side of the body, difficulty speaking, severe confusion, sudden vision changes, or a sudden severe headache can indicate a neurological emergency such as a stroke.
Do not wait for a physical therapy appointment if these symptoms occur. Call 911 for a suspected stroke or another medical emergency.
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Sudden Severe Dizziness or Vertigo
Sudden, severe dizziness or vertigo may have many causes. If it occurs together with new neurological symptoms, fainting, chest pain, severe headache, difficulty speaking, significant weakness, new hearing loss, or difficulty walking that is dramatically different from your normal ability, urgent medical evaluation is appropriate. A physical therapist can treat many balance and vestibular conditions, but the first priority is making sure that a potentially serious medical condition is not being overlooked.
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Repeated Falls
If you have fallen repeatedly, don't simply accept falling as part of aging. Repeated falls warrant medical and functional evaluation because they may indicate problems with strength, balance, sensation, vision, medications, blood pressure, neurological function, or other systems. A physical therapist can assess movement-related contributors while coordinating with your broader healthcare team when appropriate.
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Why Choose 1st Americare Physical Therapy for Balance Disorders?
Balance rehabilitation requires patience, careful observation, and an understanding that every patient's problem may have a different underlying cause.
Someone recovering from a stroke requires a different rehabilitation approach from someone experiencing age-related weakness.
Someone with vestibular dysfunction requires a different approach from someone whose balance problems are primarily related to reduced sensation in the feet.
At 1st Americare Physical Therapy in Sterling, VA, treatment can be individualized around the patient's condition, physical abilities, functional limitations, and goals.
The clinic currently provides neurological and vestibular rehabilitation as part of its broader physical therapy services.
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One-on-One Attention With Your Physical Therapist
Balance rehabilitation is particularly suited to individualized care because the therapist needs to observe how you respond to movement. Your balance may look normal during one activity and become significantly more difficult during another.
For example, you may be able to stand comfortably but become unsteady when you turn your head while walking.
You may walk normally on a flat surface but struggle on stairs. You may be stable during the day but have much greater difficulty walking in low light. Direct observation allows your therapist to identify these differences and modify your rehabilitation accordingly.
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Serving Sterling and Nearby Northern Virginia Communities
1st Americare Physical Therapy is located in Sterling, Virginia, and serves patients from Sterling and nearby Northern Virginia communities. Patients searching for balance disorder physical therapy in Sterling, VA, balance rehabilitation near Ashburn, or fall prevention physical therapy near Sterling may travel to the clinic from surrounding communities such as Ashburn, Herndon, Reston, Leesburg, Potomac Falls, Cascades, Countryside, and Dulles.
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Frequently Asked Questions About Balance Disorders
What is a balance disorder?
A balance disorder is a problem that makes it difficult to maintain a stable body position while sitting, standing, walking, or moving. Balance difficulties can result from problems involving the inner ear, vision, muscles, joints, nervous system, sensation, circulation, medications, or other medical conditions.
What are the symptoms of a balance disorder?
Symptoms can include feeling unsteady, staggering, stumbling, swaying, feeling as though you might fall, dizziness, vertigo, lightheadedness, blurred vision, or difficulty walking. Some people experience symptoms only during movement or in challenging environments such as darkness or uneven ground.
Can physical therapy help balance problems?
Yes. Physical therapy can address factors such as weakness, reduced mobility, impaired coordination, walking difficulties, and balance reactions. When appropriate, vestibular rehabilitation can also be incorporated for people whose balance problems are related to the vestibular system.
Can balance problems be caused by muscle weakness?
Yes. Adequate strength is important for maintaining and recovering balance. Weakness, particularly in the lower extremities, can make it more difficult to respond quickly when your balance is challenged.
Are balance problems a normal part of aging?
Balance can change with age because strength, sensory systems, vision, vestibular function, and reaction speed may change. However, significant or worsening balance problems should not simply be dismissed as normal aging. They may have treatable contributing factors.
Can physical therapy help prevent falls?
Physical therapy can address several physical factors associated with falls, including balance impairment, weakness, walking difficulties, and reduced mobility. Fall prevention may also require attention to vision, medications, footwear, blood pressure, home safety, and underlying medical conditions.
Can balance problems be caused by an inner-ear problem?
Yes. The vestibular system in the inner ear plays an important role in balance. Inner-ear disorders can cause dizziness, vertigo, and difficulty maintaining stability.
What is vestibular rehabilitation?
Vestibular rehabilitation is a specialized form of physical therapy that uses individualized exercises to address problems related to the vestibular system and its interaction with vision, movement, and balance.
Can Parkinson's disease cause balance problems?
Yes. Parkinson's disease can affect movement, posture, walking, turning, and balance. Physical therapy can be incorporated into neurological rehabilitation to address functional movement and balance limitations.
Can a stroke cause balance problems?
Yes. A stroke can affect strength, coordination, sensation, movement control, and walking, all of which can influence balance. Rehabilitation is individualized according to the location and effects of the stroke and the person's current abilities.
Why do I lose my balance when I turn my head?
Turning your head changes the information coming from your vestibular and visual systems while also requiring your body to coordinate movement. Difficulty maintaining balance during head movement can occur with vestibular problems, neurological conditions, reduced balance ability, or other factors and should be evaluated rather than self-diagnosed.
Why do I feel unsteady when walking in the dark?
Vision provides important information that your brain uses to maintain balance. When you remove visual information by walking in darkness, your body has to rely more heavily on vestibular and proprioceptive information. If one of those systems is impaired, your instability may become more noticeable.
Can balance problems cause fear of falling?
Yes. Experiencing falls or repeated near-falls can understandably make people afraid of moving. That fear can lead to reduced activity, which may contribute to further loss of strength and confidence.
Should I see a doctor or physical therapist for balance problems?
It depends on how the symptoms began and what other symptoms you have. Persistent balance problems should be medically evaluated, particularly when they are new, worsening, or associated with falls. Physical therapy may be appropriate when movement, strength, walking, vestibular function, or other rehabilitation needs are contributing to the problem.
When is balance trouble an emergency?
Sudden balance problems accompanied by new weakness or numbness, facial drooping, difficulty speaking, sudden vision changes, severe headache, fainting, chest pain, or other acute neurological or cardiovascular symptoms require immediate medical evaluation. Call 911 when a medical emergency is suspected.
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Schedule Your Balance Rehabilitation Evaluation at 1st Americare Physical Therapy
Whether you are experiencing unsteadiness, difficulty walking, recurring falls, age-related weakness, or balance problems associated with a neurological or vestibular condition, a professional evaluation can help determine an appropriate next step.
1st Americare Physical Therapy Sterling, VA
Serving patients from Sterling and surrounding communities, including Ashburn, Herndon, Reston, Leesburg, Potomac Falls, Cascades, Countryside, and Dulles.
Improve Your Balance. Build Your Confidence. Protect Your Independence.
Contact 1st Americare Physical Therapy to schedule your evaluation. Medical disclaimer: This page provides general educational information and is not intended to diagnose or treat an individual condition or replace advice from a physician or other qualified healthcare professional. Balance problems can have many causes. New or sudden balance difficulties, especially when accompanied by weakness, numbness, facial drooping, difficulty speaking, sudden vision changes, severe headache, fainting, chest pain, or other acute symptoms, require immediate medical evaluation.
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