If you have searched for Cawthorne Cooksey exercises, you are in the right place. This structured set of head, eye and body movements is used to treat vertigo and balance problems caused by inner ear damage. The exercises work by training your brain to adjust to the faulty signals coming from your balance system, a process called vestibular rehabilitation. Physio Soton in Eastleigh has set out the full programme below, free to follow at home, along with clear guidance on when to try it yourself and when to book an assessment first.
What are cawthorne cooksey exercises?
The balance parts of your two ears work together, sending equal signals to your brain to help you stay steady. If either balance centre is damaged, that balance is thrown off. The result is vertigo or giddiness, sometimes with nausea and vomiting.
This can feel frightening. It is important to know that on its own it is not life-threatening. This exercise programme is designed to help your brain build a tolerance to the confusing signals causing your symptoms. The more regularly and diligently you do them, the sooner symptoms tend to settle.
Some people search for these as Cooksey Cawthorne exercises, with the two names reversed. It is the same programme either way, set out in full later on this page.
Are these vestibular rehabilitation exercises safe to try at home
For most people with inner ear-related dizziness, yes. The programme was developed for exactly this purpose and has been used safely for decades, and is recommended in NHS patient information on vestibular rehabilitation. You should expect some temporary dizziness during the exercises themselves. That is normal and part of how the treatment works.
You should stop and seek medical advice if you develop sudden severe headache, weakness down one side, slurred speech, or vision loss alongside your dizziness. These are not signs of typical inner ear vertigo and need urgent assessment.
When this approach is not right for you
This programme helps conditions caused by a stable, settled inner ear problem. It is not effective for spontaneous, recurring attacks of spinning vertigo such as active vestibular migraine or active Meniere’s disease, because the brain cannot adapt to symptoms that come and go unpredictably. If your vertigo comes in sudden, unpredictable episodes rather than being triggered by specific head movements, a proper assessment matters more than starting this programme alone.
Signs you have BPPV or a balance problem these exercises help
BPPV, short for benign paroxysmal positional vertigo, is one of the most common causes of this type of dizziness. Typical signs include:
- Brief spinning sensations triggered by turning over in bed, looking up, or bending down
- Dizziness that settles within a minute or so once you stop moving
- Balance problems following an ear infection, labyrinthitis, or vestibular neuritis
- Ongoing unsteadiness after a bout of dizziness has technically passed
- Dizziness that has followed you for weeks and is not improving on its own
If this sounds like your experience, the exercise programme below is a reasonable place to start.
How to use cawthorne cooksey exercises properly
- Do the exercises for about ten minutes, twice a day.
- Repeat them daily for the best results.
- Do not push through severe symptoms. If they become too intense, take a break.
- Start at exercise set one and work through the sets within your ten minutes.
- If one exercise makes you feel unsteady or dizzy, stay on that exercise for the rest of the ten minutes rather than moving on.
- Only move to the next exercise once you can do the current one comfortably.
- Keep going until you can complete every set and stay active long term.
- Where you can, work the same movement principles into your everyday life.
- If symptoms return later, simply start the programme again.
Cawthorne Cooksey exercises, the full programme
Exercise set 1, in bed or sitting
Eye movements. Start slowly, then move quicker.
Look up and down. Look side to side. Focus on a finger as you move it from 60cm to 30cm away from your face.
Head movements. Start slowly, then move quicker. Try with your eyes closed once you are confident.
Bend your head forward and back. Turn your head side to side.
Exercise set 2, sitting
Repeat the eye and head movements above.
Shrug and circle your shoulders.
Bend forward and pick an object up from the floor.
Exercise set 3, standing
Repeat the eye, head and shoulder movements above.
Move from sitting to standing, first with your eyes open, then with your eyes shut.
Throw a small ball from hand to hand above eye level.
Throw a small ball from hand to hand under your knee.
Move from sitting to standing, turning around in between.
Do you need to see a physiotherapist first?
Not always. Many people start this programme on their own and see real improvement. It is worth booking an assessment if your dizziness has lasted more than a few weeks. The same applies if you are unsure whether your symptoms fit the BPPV pattern described above, or if you simply want a proper diagnosis before you begin.
At Physio Soton, an assessment can include a check of your balance system and, where relevant, an on-site diagnostic ultrasound scan if we need to rule out a neck-related or other physical cause for your symptoms. No GP referral is needed, and appointments are usually available the same week.
What happens if you leave dizziness untreated
Untreated balance problems tend to reduce confidence in everyday movement, which often leads people to move less. Moving less makes deconditioning worse and can raise the risk of falls, particularly in older adults. Most people who follow a structured routine like Cawthorne Cooksey exercises see their symptoms settle faster than those who avoid movement altogether out of fear of triggering dizziness.
Who is behind this advice?
This programme is provided by Physio Soton, an Eastleigh physiotherapy clinic that has guided patients through Cawthorne Cooksey exercises across Southampton and Hampshire since 2017. Our lead clinician, Marek Czeladzki, is HCPC and CSP registered, an Independent Prescriber, and a qualified musculoskeletal sonographer with a postgraduate certificate in clinical ultrasound. He is a member of the British Medical Ultrasound Society and the American Institute of Ultrasound in Medicine.
Why patients choose Physio Soton for balance problems
Most clinics hand you a generic exercise sheet and little else. Here, if your dizziness needs more investigation, the same clinician who assesses you can also scan you, rather than sending you elsewhere and starting the wait again. Appointments are usually available the same week, with no GP referral required, so you are not left managing uncertain symptoms for months while you wait for a routine referral to come through.
Simple ways to protect your balance day to day
Stay physically active rather than avoiding movement out of fear of dizziness. Take your time when standing up, particularly first thing in the morning. Keep your home well lit and clear of trip hazards while your balance is settling. Build the exercise principles above into ordinary activities like gardening or housework, not just a dedicated ten-minute session.
If falls or general unsteadiness are a bigger concern than vertigo itself, our physiotherapy for the elderly service covers balance and strength work in more depth.
Common questions about cawthorne cooksey exercises
Is it safe to do these exercises without seeing a doctor first?
For most people with typical inner ear-related dizziness, yes. If your symptoms are severe, sudden, or accompanied by other neurological signs, seek medical advice before starting.
How long until I notice an improvement?
This varies by person and by cause. Many people notice a gradual reduction in symptoms over several weeks of consistent daily practice with Cawthorne Cooksey exercises, though some improve sooner.
Can these exercises help Meniere’s disease?
Not reliably during active episodes. This programme works best for stable, settled inner ear problems, not the unpredictable flare-ups typical of active Meniere’s disease.
What is the difference between these exercises and the Epley manoeuvre?
The Epley manoeuvre is a specific repositioning technique aimed at moving displaced crystals in the inner ear, most often used for BPPV. This routine is a broader habituation programme that retrains your brain’s response to balance signals generally. The two are often used together.
Will I feel worse before I feel better?
Some temporary dizziness during the exercises is expected and is part of how the treatment works. This is different from your symptoms getting worse overall.
Can elderly patients do these exercises safely?
Generally yes, though balance in older adults deserves closer attention to fall risk. If you are unsteady on your feet, doing the standing exercises near a wall or with someone nearby is sensible.
What if the exercises are not working after several weeks?
That is a good reason to book an assessment rather than continuing indefinitely without progress. There may be a different cause worth investigating.
Do I need any equipment?
No, aside from a small ball for one of the standing exercises, which a rolled-up sock works just as well for.
Book a balance assessment in Eastleigh
Has your dizziness lasted more than a few weeks? Does it not quite fit the pattern described above? Either way, do not just keep searching Cawthorne Cooksey exercises hoping for a different answer. Book an assessment with our Eastleigh team, or simply come in for a proper diagnosis before you start. No GP referral is needed, and appointments are usually available the same week.
Call 023 8218 2416 or book online today. Serving Eastleigh, Southampton, Chandler’s Ford, Winchester and the surrounding Hampshire area. Not ready to book yet? Read more about physiotherapy at our Eastleigh clinic first.