The prime job of the balance organs, or vestibular system, is to tell us which way is up and which way we are going.
There are two distinct parts of the vestibular system: the semi-circular canals and the otolith organs. The first detects head movements as they are occurring and the second, where the head is in space when there is no head movement – this is how we know where our head is in relationship to everything else when we wake up in the morning. The otolith organs also detect linear movement: up and down, side to side, and forwards and backwards, along with acceleration and braking.
The eardrum. or tympanic membrane, which detects sound, is part of the inner ear and all signals from the eardrum and the vestibular system join together in the same cranial nerve, cranial nerve 8, and travel to the brain for further processing.
In the womb, the vestibular system is the first to develop and all other systems grow out of it and are inextricably interlinked.
For example, vision and the vestibular system absolutely work together. Part of the function of the vestibular system is to stabilise the eyes and keep vision clear. This is what I mean: look at a letter on a wall or bookcase and quickly shake your head in a variety of directions and body positions. The letter should stay absolutely still and clear, no matter what is going on with your head and body. This is another job of the semi-circular canals: to keep the gaze stable as we enjoy nodding our head to a particularly good tune whilst driving.
Keep staring at that same letter and tip your head on one side and leave it there. The letter should remain clear, no matter how long your head is on one side. It is quite possible that the letter gets either clearer or fuzzier as time goes on – either indicates a problem. Maintaining this clarity of vision is another job of the utricles. Also if you jump up and down or leap from side to side, that letter is still completely clear, showing your utricles are up to their job. A good reason to dislike running is having less than perfect otoliths. Essentially running is a series of jumps and if the vision does not remain utterly clear in both eyes on every single stride, your brain will stop you from running. The opposite is also true: if you love running, your brain is possibly craving otolith stimulation.
When the eyes and the inner ears are not tuned up properly, problems arise like motion sickness or dislike of skiing. This is why sea sickness is more of a problem below deck – the inner ears detect movement, but the eyes see none = sensory mismatch. And why sitting in a cinema seat enduring a roller coaster ride makes you feel much more queasy than when strapped into one of those machines that throw you about as you journey along the roller coaster.
Other vestibular problems include needing to hold the bannisters when going up or down stairs (like Donald Trump), finding heights challenging, dizziness when standing up quickly and, of course, bad balance, which is considerably worse when the eyes are shut. And vertigo.
Vertigo has many causes. A bad attack of vertigo – the room spinning madly no matter what you do, and even when stone cold sober – may be caused by the utricles. The utricles detect movement and head position with little stones lying in a bed of jelly. These stones slide to give their information. Sometimes one of these little tiny stones breaks loose from its bed and all hell ensues. This is cured by the Epley manoeuvre – lying on your side with your head tilted in such a position that that wretched stone sinks back into its place. They tell they are in the right position, incidentally, by the amount of eye shaking or nystagmus, and this is why the manoeuvre feels so utterly terrible, until the stone settles. However, they will tell you the Epley manoeuvre doesn’t always work and that is because of the other causes of nasty vertigo.
A common cure for balance issues is to play music or speech into one ear, which works best when active. One part of the brain affects the other, and so it is with the cochlea (ear drum) and the vestibular system. Spinning, bouncing, rocking can also help. Eye position – where you are looking, has a huge effect on the vestibular system. So there are many answers to improving balance! Just practising it helps, but does not cure it.
As a final note: both ears need to hear. Hearing loss is associated with going on to develop dementia – all types. This was first discovered in 1989. And a quick search of Google Scholar of Demential and hearing loss will uncover many pieces of research. Therefore, if in doubt, it is, without a shadow of a doubt, worth getting the hearing tested and, if need be, get a hearing aid. I realise that is fraught! But anything we can do to prevent dementia is worth it. Hearing and balance matter.