VIMS - Is It the Camera, the Level, or the Tripod?

Visually Induced Motion Sickness or Sensation (VIMS)

Last week, I had the privilege of attending the VIMS conference in Toronto, an exceptionally well-run and insightful event dedicated to exploring visually induced motion sickness (or sensation). The presentations highlighted the intricate interplay between the visual and vestibular systems in maintaining balance—a critical area of research as we navigate an increasingly screen-focused world and dive deeper in VR and AR.

However, as I took in the information shared, I noticed a surprising gap: while the somatosensory system was briefly mentioned, the role of the neck—specifically cervical proprioception—was conspicuously absent from the discussions. This oversight is significant, as the neck serves as the crucial "tripod" that stabilizes and integrates visual and vestibular inputs.

In an increasingly screen-based world, many people experience visually induced motion sickness (VIMS) without fully understanding what’s happening or why. If you’ve ever felt queasy during a movie, disoriented after scrolling on your phone, or even suffered lingering dizziness after a VR session, you may have encountered VIMS. Likewise, for those experiencing mal de débarquement syndrome— a fancy French name for sea-legs, where it feels like you’re still on a boat long after stepping on solid ground—the disruption is real and often debilitating. But what underlies these sensations? And why does motion leave some feeling sick while others feel stable?

In this newsletter, let’s take a closer look at the body’s stabilizing systems—using the analogy of a camera, a level, and a tripod—to understand why these sensations occur and how we might address them.

The Camera (Visual System)

Imagine your visual system as a camera lens, constantly capturing and interpreting the world around you. A clear, focused lens gives us a sharp picture of our environment, but when the visual input is inconsistent or rapid, the camera starts sending mixed signals to the brain. Just like a shaky or poorly adjusted lens would distort an image, your visual system can create discord when overloaded, leading to the uncomfortable symptoms of VIMS.

When exposed to rapid visual changes—like fast-moving scenery in a film or scrolling on a screen—the visual and oculomotor system's ability to keep a stable 'focus' becomes strained. In these cases, our ‘camera’ starts signaling a mismatch, which in turn can leave us feeling unsettled or dizzy.

The Level (Vestibular System)

The vestibular system, located in the inner ear, functions like a level, helping maintain balance by monitoring movement and orientation. This “level” tells us if our head is upright, tilted, moving, or still. But when there’s a mismatch between the movement our vestibular system detects and what our visual system sees, confusion arises. For example, during air or sea travel, our vestibular system senses motion, while the visual system, if fixed on a stable object, reports stillness. This conflict between systems is a classic trigger for motion sickness.

Similarly, in cases of mal de débarquement syndrome, the vestibular system struggles to recalibrate after prolonged motion, as if the level hasn’t quite settled back to zero, leaving a lasting feeling of imbalance and sway.

The Tripod (The Neck)

Finally, there’s the neck—our body’s internal “tripod.” Our neck muscles and joints feed crucial spatial orientation information to the brain, which relies on these cues to support balance and stability and fine-tune movements of the eyes. And as I discussed in previous newsletters, the neck has a LOT of movement to control and the neck muscles are much more complicated than we realize! Just like a tripod holds a camera steady, the intricate muscles, ligaments and joints of the neck provide a stable platform to keep our eyes steady against perturbations (both real and virtual) through complex reflex systems that respond to changes in muscle length and tension. If the muscles of the neck are not well balanced, or if the muscles or joints have been strained or sprained, would this not have an impact on the complex system that keeps our eyes level? We know how detrimental an ankle sprain can be to ankle proprioception, and we know that the neck has the most proprioceptive fibres in the entire body, so why do we not think a neck sprain, strain or dysfunction could be the source of the ‘balance’ disruption associated with VIMS?

If there’s any instability or misalignment in this “tripod,” it compromises the entire setup. This also helps explain why people with neck tension or dysfunction experience dizziness or feel more susceptible to motion sickness. When our cervical spine is dynamically and functionally stable, it provides a solid base for our visual and vestibular inputs to align. But without this reliable “tripod,” the other systems struggle to maintain equilibrium.

Putting It All Together

For those experiencing VIMS, understanding the interactions among these systems is critical. The camera, level, and tripod analogy illustrate that when one system falters—or if the focus remains too heavily on just one or two systems—overall stability and comfort can suffer. While visual and vestibular rehabilitation are essential first steps, persistent symptoms may indicate the need to address the often-overlooked proprioceptive system of the neck. Techniques like multi-planar neck training—such as those achieved with the TopSpin360—target cervical proprioception, enhancing dynamic stability and reinforcing the “tripod” that supports the visual and vestibular systems. By broadening the scope of treatment to include this vital component, we may unlock new pathways to relief for those still struggling with VIMS.

By recognizing the interconnectedness of our internal “camera, level, and tripod,” we can better understand and potentially alleviate visually induced motion sickness and related symptoms.

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