Oct 11, 2026 · 21 min · 11 segments
In this episode, we're taking a closer look at the otolith system, including the utricle and saccule, and how understanding their role can lead to more specific assessment and treatment. You'll learn…
Natasha WilchHost
So-- And I don't know why I love the otol- Like, it's just, like, I dork out on it so much.
Uh, and it-- We're gonna go here because for some reason, and I don't know why, most concussion education completely ignores the otolith.
They ignore it, right? We talk a lot about the vestibular system, obviously, like over a third of individuals that have concussion fall into our vestibular phenotype.
But, [laughs] but we, when we think vestibular and when it's taught vestibular, we talk about BPPV, and then we talk about angular VO- Like, we talk about VOR in that angular sense and the semi-circular canals, and we ignore the other half of the vestibular system, the part that honestly, in my persistent clients, is the part that I see missed over and over and over again.
It's the part that links into our relationship with actually knowing where we are with gravity, yet we don't ever talk about it.
So we're gonna talk about it today because that's the otolith, the utricle, and the saccule, right? And I will say, for some reason, too, the vestibular system is the system that, holy hell, like, there's something about it.
Like, I have-- I had to go back and study this system more than any other system throughout my time because there's just so much to it.
So it has two distinct sensor types with different functions, right? Different vulnerabilities and different clinical implications.
Uh, and like we said, most concussion education focuses on one of them, uh, and pretty much ignores the other one.
We have our anterior, posterior, and horizontal canals, okay? Their job is basically to detect angular acceleration, turning our head, okay? Head turning, tilting, nodding, all these things.
So-- And I don't know why I love the otol- Like, it's just, like, I dork out on it so much.
Uh, and it-- We're gonna go here because for some reason, and I don't know why, most concussion education completely ignores the otolith.
They ignore it, right? We talk a lot about the vestibular system, obviously, like over a third of individuals that have concussion fall into our vestibular phenotype.
But, [laughs] but we, when we think vestibular and when it's taught vestibular, we talk about BPPV, and then we talk about angular VO- Like, we talk about VOR in that angular sense and the semi-circular canals, and we ignore the other half of the vestibular system, the part that honestly, in my persistent clients, is the part that I see missed over and over and over again.
It's the part that links into our relationship with actually knowing where we are with gravity, yet we don't ever talk about it.
So we're gonna talk about it today because that's the otolith, the utricle, and the saccule, right? And I will say, for some reason, too, the vestibular system is the system that, holy hell, like, there's something about it.
Like, I have-- I had to go back and study this system more than any other system throughout my time because there's just so much to it.
So it has two distinct sensor types with different functions, right? Different vulnerabilities and different clinical implications.
Uh, and like we said, most concussion education focuses on one of them, uh, and pretty much ignores the other one.
We have our anterior, posterior, and horizontal canals, okay? Their job is basically to detect angular acceleration, turning our head, okay? Head turning, tilting, nodding, all these things.
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