The delivery of small drug particles from a dry powder inhaler (DPI) into the patient’s peripheral airways requires the dispersion of the powder. In DPIs that contain a rotating pierced capsule, the capsule’s motion is paramount to powder dispersion. Previous studies have simplified the capsule motion in an Aerolizer® inhaler as a constant rotation around a fixed center. The present work examines deviations from this simplified motion and describes the capsule collisions with the surrounding inhaler walls. High-speed photography was employed to analyze the motion of a size 3 capsule in an Aerolizer® inhaler at various flow rates ranging from 30 to 100 L/min. Frequent collisions of the capsule with the surrounding inhaler walls were observed. Computational fluid dynamics (CFD) simulations indicated that the air flow through the capsule governs the behavior of small drug particles, while inertial forces are the dominant influence on large carrier particles in the capsule. Discrete element method (DEM) simulations were employed to study the effect of the capsule-inhaler collisions on the powder discharge from a rotating capsule. The collisions vastly improved the discharge of a polydisperse model carrier powder from the capsule over a wide range of cohesiveness.