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Dizzying Hikes - How to Manage Height Vertigo on the Trail

Some hikers experience dizziness when climbing. Here are the causes of height vertigo, how it can impact your safety hiking, and what to do about it.

My son began to feel dizzy as we walked along the ridge-line at around 11,000 feet, and we had nearly 1,000 feet left to the summit. He was well acclimated and didn't show any other signs of altitude sickness. What he experienced is called height vertigo.

Height vertigo happens when the sensors of your vestibular systems don't match up. We keep our balance due to the feedback from nerves in our skin, muscles, and joints (proprioception), eyes, and ears. When you're standing on a ridge-line or mountain top (or even the Empire State Building) with the ground far below you, it's difficult for your eyes to make sense of the situation. The sensors in your feet tell your brain you're standing on something below you. The neurons in your ears tell your brain that your body is upright. However, your eyes can't see the ground and don't have a reference point in front of them to confirm that you are standing up. Therefore, it sends your brain one of those spinning circles of doom, like when a computer takes forever to load. Your eyes are trying to make sense of the situation, and it makes you feel dizzy or like you're going to fall. It can also trigger nausea or vomiting, symptoms similar to altitude sickness. Since altitude sickness can be an emergency, be sure to eliminate that as a cause first.

Many people who are "afraid of heights" experience height vertigo, which triggers a feeling of fear. Knowing what is happening can help you implement some strategies to help. If this fear has been ingrained so deeply that it becomes a phobia, cognitive-behavioral therapy can help replace feelings of anxiety with more calming thoughts. Other techniques include keeping your eyes fixed on where you are going ahead of you and avoiding looking down. It helps to have a hiker ahead of you to focus on as a point of reference. If you find yourself alone along a mountain wall, focus on the interior of the trail or the wall side, not the exterior. Deep calming breaths and reassuring thoughts such as, "I'm safe," can help get you back down to an area where you feel more comfortable. If the trail is wide enough, get down on hands and knees to return to safe spot.

If you experience heights vertigo, it's best to conquer this in safe situations before attempting to reach high summits. Vertigo at elevation can put a hiker in danger of falling. Guided and supervised repeated exposure therapy can help where the challenges start small and get bigger. Contact a physical therapist who specializes in balance training to help you train your body to handle the experiences of vertigo. If vertigo persists beyond the elevation situation, contact your physician immediately.

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