Quick answer: The half somersault maneuver, also called the Foster maneuver, is a repositioning exercise for confirmed posterior-canal BPPV. It is not a general treatment for every type of dizziness. The affected ear must be identified first because the head turns toward that side during the maneuver.
Before trying the half somersault maneuver
Brief spinning when rolling in bed, looking up or bending down can fit BPPV, but similar symptoms can have other causes. A clinician can use the Dix–Hallpike test to confirm a posterior-canal pattern and identify the likely affected ear. Horizontal-canal BPPV needs a different test and a different maneuver.
Do not attempt this maneuver alone if you cannot kneel and rise safely, have marked neck, back, hip or knee limitation, recent relevant surgery or injury, severe balance impairment, or a high risk of falling. Pregnancy, cardiovascular disease or another condition that limits positioning should be discussed with the treating clinician first.
Half somersault maneuver steps
The sequence below follows the University of Colorado patient instructions. Have a stable padded surface and another adult nearby the first time. Stop if the movement causes severe pain, faintness, new weakness, trouble speaking, double vision, a severe new headache or an inability to stand safely.
- Start kneeling: kneel on the floor or in the middle of a large firm bed. Look straight upward toward the ceiling. Brief vertigo may occur.
- Move into the somersault position: place the top/back area of the head on the supporting surface, tuck the chin and wait without changing position until any spinning settles.
- Turn toward the affected side: slowly turn the face toward the elbow on the affected side and keep the head turned. Wait again until any vertigo settles.
- Raise the head to back level: keeping the face toward the same elbow, raise the head promptly to approximately back/shoulder level. The head remains angled toward the affected side. Wait for spinning to settle or for about 15 seconds.
- Return upright: keeping the head partly turned toward the affected shoulder, raise it promptly to an upright position. Once any spinning settles, sit upright and rest.
Right-ear BPPV
For a confirmed right posterior-canal BPPV pattern, face the right elbow in step 3 and keep the head turned toward the right through steps 4 and 5.
Left-ear BPPV
For a confirmed left posterior-canal BPPV pattern, face the left elbow in step 3 and keep the head turned toward the left through steps 4 and 5.
How often should it be repeated?
The University of Colorado instructions advise resting for at least 15 minutes between attempts and not repeating the maneuver when the provoking head movement no longer causes dizziness. Do not keep repeating it many times because symptoms persist or because no vertigo occurred during a step. Persistent symptoms may mean the side, canal or diagnosis is different and should be reassessed.
Does temporary dizziness mean it worked?
A brief burst of positional vertigo can occur during the maneuver, but it does not by itself prove that the diagnosis, affected side or movement was correct. Mild residual imbalance can also occur after successful treatment. New continuous vertigo, repeated vomiting, hearing loss, neurological symptoms or worsening inability to walk needs clinical review rather than more home maneuvers.
Half somersault versus Epley maneuver
Both techniques aim to move particles out of the posterior semicircular canal. The Epley maneuver is usually performed or taught with controlled head positioning, while the half somersault is designed for self-administration in people who can kneel and move safely. Comparative evidence suggests that both can reduce symptoms, although Epley may resolve BPPV more often after a single maneuver. The best choice depends on the diagnosis, mobility, neck/back safety and access to trained care.
When the half somersault is the wrong maneuver
- Horizontal-canal or anterior-canal BPPV.
- Dizziness without a confirmed positional BPPV pattern.
- New hearing loss, ear discharge or severe ear pain.
- Severe neck, back, knee or hip limitation.
- Fainting, chest pain, new weakness, facial droop, slurred speech, double vision, severe new headache or inability to walk.
What if the maneuver does not help?
Do not assume that persistent dizziness means the particles are “stuck.” The problem may be a different canal, the opposite ear, residual imbalance, vestibular migraine or another cause. Review the broader BPPV diagnosis and treatment guide, or arrange a clinician-performed positional examination.
Frequently asked questions
Can I do the half somersault without knowing the affected ear?
No. The direction of the head turn depends on the affected side. Guessing may fail and can delay the correct diagnosis.
Is it suitable for horizontal-canal BPPV?
No. The Foster half somersault is intended for posterior-canal BPPV. Horizontal-canal BPPV requires clinician interpretation of the roll-test pattern and a canal-specific treatment.
Is it safer than Epley?
Not for everyone. It avoids lying back with the neck extended, but it requires kneeling, bending forward and rising safely. Mobility and fall risk matter.
For diagnosis-based BPPV care, book an appointment or call/WhatsApp 7393062200.
References
- Foster CA. Patient Instructions for Half Somersault for Right- and Left-Sided BPPV. University of Colorado Hospital.
- Foster CA, Ponnapan A, Zaccaro K, Strong D. A comparison of two home exercises for benign positional vertigo: half somersault versus Epley maneuver. Audiology and Neurotology Extra. 2012.
- Fouladvand T, et al. The efficacy of the half somersault maneuver in comparison to the Epley maneuver in patients with benign paroxysmal positional vertigo. 2021.
- Bhattacharyya N, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). 2017.
Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice, diagnosis or prescribing guidance. Consult Dr. Prateek Porwal at Prime ENT Center, Hardoi for personalised treatment.