Grounded | The Vestibular Podcast

147. Scaling & Pacing Physical Activity with a Vestibular Disorder

Grounded | The Vestibular Podcast

Show Notes

If you’ve ever tried to do too much, crashed hard, and then felt like you were back at square one—this episode is for you. I’m talking about two of the most important concepts we teach in Vestibular Group Fit: scaling and pacing.

It cannot be stressed enough how important this is and how much we talk about it in VGF.

Scaling and pacing aren’t about doing less forever. They’re about building capacity strategically so you can eventually do MORE without paying for it for days afterward.

I’m walking you through real-life examples of how to scale movement, exercise routines, walking, driving, and other daily activities — plus what to do on higher symptom days and post-attack so you can recover faster and get back to living your life.

In this episode, we’ll dig into:

What scaling and pacing actually mean and how they’re different

Why you should never increase more than 10% at a time

How to scale things like strength training, walking, and driving

The difference between “immediate” responders and “hangover” responders

Real-life pacing strategies you can add into your day-to-day life

How to scale down on post-attack or high symptom days

The 30-day to 30-minute return to walk program results from VGF

Summer consistency challenge details for Vestibular Group Fit members

Whether it’s exercise, grocery shopping, driving, or attending your nephew’s graduation—the same principles apply. Scaling and pacing are skills. As with any skill, it takes time, practice, and a whole lot of grace and patience with yourself.

Links Mentioned:

Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit

Inside VGF, we have two helpful lessons: Visualization exercises for return to driving, and a 30-day to 30-minute return to walk program

Free Resources:

⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n

⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd

⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership

⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit

⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots

Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor

Work with Dr. Madison:

For 1:1 Vestibular Rehabilitation Therapy, email [email protected]

Otherwise, I’ll see ya in Vestibular Group Fit!

Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/

Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit

Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you!

This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

physical activity intensity, scaling and pacing, activity pacing, scaling physical activity, vestibular disorder management, chronic dizziness, living with vestibular disorder, migraine attacks, nervous system regulation, exercises to improve balance, return to walking, driving with vestibular disorder, vestibular exercises

More from Grounded | The Vestibular Podcast

Oct 20, 2026

If you hadn’t heard yet, Daylight Saving Time is coming up on November 1st. If you have a vestibular disorder, that one-hour shift can do a number on your routine, sleep, and symptoms.

Oct 13, 2026

One of the most common things I hear from people with vestibular disorders is how hard it feels to do things with family (especially kids).

Oct 6, 2026

In this episode, we’re going to cover some common questions about advocating for treatments at the doctor’s office, which can occur for a few different reasons.

Sep 29, 2026

Histamine and MCAS are everywhere on the internet right now, but there’s a huge piece missing from the conversation. Genetics.

Sep 22, 2026

If you have a vestibular disorder, there’s a good chance your thyroid is part of the story.

See all episodes →