Click here to get the ‘Semicircular Canal Influence – The VOR Connection’ handout
In Parts 1 and 2, we built the foundation: conjugate gaze and how individual muscle actions combine into synergistic patterns.
Now the payoff: why the vestibular system cares about all of this.
The VOR isn’t random. It exploits the exact same muscle pairings we use in cardinal gaze testing—but at speeds voluntary control can’t touch.
Your conscious eye movements max out tracking slow objects. The VOR operates automatically at up to 500°/second.
That’s the difference between “follow my finger” and “keep your vision stable while your head is moving through space.”
The mechanism is elegantly simple: push-pull.
Each semicircular canal has a partner on the opposite side. When you turn your head right, endolymph flow excites the right horizontal canal and inhibits the left. That differential signal drives compensatory eye movement in the opposite direction.
Head goes right. Eyes go left. Target stays stable on the fovea.
RALP. LARP. These aren’t just mnemonics—they’re the functional planes that drive vertical and torsional VOR responses.
This is why the Head Impulse Test works. We’re testing whether push-pull is intact at speeds that reveal what slow tracking never could.
Part 3 of 5 in my Visual-Vestibular Foundations series.
Next up: Why nystagmus is named for the wrong phase—and why that confuses everyone.
New course alert: VestibularSOAP Pro Bootcamp is HERE!
The VestibularSOAP Pro Bootcamp isn’t just a template; it’s clinical, on-demand education built on real experience. Together, we’ll explore why each component matters, what findings signify, and how to interpret results with the confidence that comes from understanding expert clinical judgment—regardless of your practice setting.
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Hard-Won Clinical Insights That Textbooks Don’t Teach
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By Bridgett Wallace, PT, DPT ~ 360 Neuro Health Co-Founder & Director of Clinical Education
