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Team Spotlight: Meet James, our Balance and Vestibular expert

Dive into our latest blog, an interview with James Saladine, Vestibular Physiotherapist at angli-EAR Hearing, as he sheds light on the vestibular system, its impact on our daily lives, and the comprehensive care offered at angli-EAR to address vertigo, dizziness, and balance issues.

Introduce yourself, job title and what you do:

Hi, my name is James Saladine. I am a vestibular physiotherapist and I work within the Vestibular and Balance Service at angli-EAR Hearing. I am really passionate about vestibular rehabilitation, and I enjoy helping people who are suffering from issues with vertigo, dizziness, and balance problems in regaining control of their life.

What is the vestibular system and why is it important?

 Most people have never heard of the vestibular system before. The vestibular system plays an important role in maintaining your balance, orientation, and coordination of movement. It involves the inner ear and a complex network of structures that work together to inform your brain about where you are and how you are moving in space. Because it is such an amazing and efficient system, when it is functioning as it should, you do not even realise that it is there. However, when there is a problem within the vestibular system, it can cause a significant impact on your life and cause symptoms such as vertigo, dizziness, and balance problems.

 What are some of the symptoms which are caused by problems with the vestibular system?

There are many different symptoms which can occur when a person is suffering from a vestibular problem. The three most common symptoms include: vertigo, dizziness, and imbalance. Vertigo is formally defined as a misperception of movement but is more commonly described as a “spinning sensation” or a “movement of the environment”. Dizziness is a sensation inside the head and is commonly described as feeling giddy, foggy, fuzzy, or woozy. Imbalance is a feeling of unsteadiness on your feet. Depending on the cause of these symptoms, they will present differently and have different associated symptoms. Some of the associated symptoms might include nausea and vomiting, visual problems, issues with your ears, headache and migraine, and for most people it has a significant impact on their mental health and general wellbeing.

 Why should you get your symptoms assessed and treated?

 Although the symptoms of vestibular and balance problems can be frightening, many of these symptoms can be resolved or reduced with a comprehensive assessment and an appropriate tailored treatment plan. Unfortunately, if vestibular or balance problems are left undiagnosed and untreated, it can result in a worsening of symptoms. This may lead to increased unsteadiness, a higher risk of falls, reduced confidence, and often a more significant impact on your quality of life.

 What does angli-EAR Hearing do at an Initial Vestibular and Balance Appointment and what can you expect?

At angli-EAR Hearing we offer all vestibular and balance patients an initial appointment which is 60 minutes long. This allows us time to conduct a comprehensive assessment, where we will discuss your history and presenting symptoms and run through a number of important tests. These tests are simple and non-invasive, and involve eye and head movement, standing balance, and walking, as well as seeing how your vestibular system responds to certain movements and positional changes. Following that, if we have gathered enough information we will provide you with a diagnosis, and you will be given a tailored treatment plan. In those cases where it is complex, we will also discuss whether it may be appropriate for you to have a chat with your GP regarding further investigations and/or specialist review.

 What does vestibular rehabilitation involve? 

Vestibular rehabilitation is a specialised form of physiotherapy, which is designed to enhance your ability to function in everyday activities by addressing the symptoms caused by problems within the vestibular system.

Vestibular rehabilitation should be individualised and tailored to the findings from your assessment, as well as aimed at addressing your specific goals. Vestibular rehabilitation often involves a combination of:

– Education

– A home exercise program

– Certain Repositioning Manoeuvres for those individuals with BPPV.

– Ongoing support and reassessment


– Effective collaboration between you and the members of your healthcare team.

Why is angli-EAR Hearing unique in offering this comprehensive service?

 At angli-EAR Hearing we are privileged to have a highly experienced multidisciplinary team onsite. We are also fortunate to have state of the art facilities and equipment which allows us to carry out thorough diagnostic tests to assist you in identifying the cause of your problem. angli-EAR is Hearing is one of the only audiology clinics outside of London to offer both the assessment and rehabilitation of vestibular and balance problems. Thus, we are able to provide you with a more efficient and cost-effective service, as you are able to have a comprehensive assessment and be provided with a tailored treatment plan within the one location.

 What do you do if you think you might have a vestibular or balance problem?

 If you think you may have a problem with your vestibular system, or you have been suffering from vertigo, dizziness, or imbalance. I would highly recommend contacting the team at angli-EAR Hearing to organise an appointment. By arranging an appointment, you are taking the important first steps to understanding the cause of your symptoms and finding out how to effectively manage or resolve them. If for any reason you are unsure whether our Vestibular and Balance Service is right for you, you can always book a FREE 15 minute Vestibular and Balance Health Check, where you can briefly discuss your symptoms with myself, and we can have a further discussion about what might be the best option for you going forwards.

Ultimately, the team at angli-EAR Hearing want to support you in regaining control of your life and assist you in not having to worry about your vertigo, dizziness, or balance problem.