What Are Cawthorne-Cooksey Exercises?

Medically Reviewed by Christopher Melinosky, MD on March 07, 2024
3 min read

Cawthorne-Cooksey exercises are vestibular training activities used to help those who experience balance disorders such as vertigo. The balance part of each ear works together by sending impulses to the brain necessary for proper balance. When either balance center is damaged, you may experience dizziness. 

Cawthorne-Cooksey exercises help build up tolerance. The more frequently they’re done, the sooner your symptoms will subside.

Vertigo is defined as a feeling of tilting or spinning, even when you’re at rest. This happens when your body’s perception of where it is in space is interrupted. There are two types of vertigo: peripheral, which occurs because of inner ear dysfunction, and central, which is caused by a problem with your brain — an infection, stroke, injury, or tumor. 

‌Some common symptoms of vertigo include:

  • Nausea 
  • Vomiting
  • Dizziness
  • Headaches
  • Ringing in the ears
  • Fullness in the ears
  • Motion sickness

While vertigo can sometimes go away on its own, Cawthorne-Cooksey exercises help you manage your vertigo or balance disorder symptoms. Your doctor can perform audiometric tests to see if you’re experiencing a problem.‌

Many medical conditions can cause vertigo, including Meniere’s disease (fluid buildup in the ear), labyrinthitis (inflamed or infected inner ear), or benign paroxysmal positional vertigo (caused by a change in the head’s position). Some other common causes of vertigo include:

Vestibular rehabilitation is an exercise program with a trained physical therapist to help you reduce problems with dizziness and improve your balance.

Balance disorder exercises help your brain to assist your body in regaining its balance and to minimize any symptoms you’re experiencing. With vestibular training, your body learns to rely on alternative signals coming from your neck, ankles, legs, or eyes to help it regain balance properly. ‌

People with vertigo, dizziness, imbalance, migraines, or Meniere’s disease can benefit from Cawthorne-Cooksey exercises. During an appointment, a physical therapist will evaluate your symptoms and medical history before making a plan for your care. 

Vestibular rehab can last six to eight weeks, one to several times a day, depending on the severity of your symptoms and your response to therapy.‌

Some examples of Cawthorne-Cooksey balance disorder exercises that help manage vertigo symptoms include:


  • Make eye movements up and down and from side to side.
  • ‌Make head movements bending forward and backward and turning side to side.
  • Circle your shoulders.
  • Bend forward to pick up objects from the ground in front of you.
  • ‌Bend side to side to pick up things on the ground next to you.


  • Make the same eye and head movements noted above.
  • ‌Stand from a sitting position with your eyes open, and repeat with your eyes closed.
  • Throw a ball from hand to hand above eye level and under your knees.

In Motion

  • Walk up and down steps.
  • ‌Throw and catch a ball.

The goal is to increase the time you can perform these routines, starting with 1-2 minutes for each. It may take a few days to get used to the activities, and you may experience mild symptoms while performing them. Don’t continue to do exercises if you’re experiencing severe symptoms.

Some benefits of performing the Cawthorne-Cooksey routine and other balance disorder exercises include: ‌

  • Decrease in vertigo symptoms
  • Improved balance
  • Lower risk of falling or injury
  • Better vision
  • Increased strength
  • Return to normal function
  • Increased quality of life

Ultimately, exercises for dizziness and balance can help you feel better and perform daily tasks more easily. With the help of vestibular rehab, your balance disorder or vertigo symptoms can be minimized to improve your lifestyle.