Vertigo, Dizzy, BPPV? Time to See your Physical Therapist

By: admin Published: September 7, 2020

 

by Deborah Bodin, PT

Wake Up Spinning?

Did you wake up one morning and feel like the room was spinning when you tried to get out of bed? Did this make you feel like you might throw up? Unfortunately, you’re not alone. This sensation is called vertigo and it is very common–it is experienced by 40% of US adults in their lifetime.

dizzy person

It is likely that you have Benign Paroxysmal Positional Vertigo (a.k.a. BPPV) as it is the most common cause of vertigo.  Almost 1 in every 10 older adults (75 or older) has BPPV.  This is important because BPPV increases your chance of experiencing a dangerous fall up to 12 times.

Now for some good news! BPPV is very treatable with physical therapy. Many times your current symptoms can be resolved in one or two physical therapy sessions.

What is BPPV?

 

anatomy of inner ear

There are 3 semicircular canals and 2 balance organs in each ear.

  • Benign: not life-threatening
  • Paroxysmal: recurrent, sudden, intense symptoms
  • Positional: related to a change in the position of the ear
  • Vertigo: sensation of rotation or spinning

BPPV is a problem where “crystals” (actually small pieces of calcium carbonate) break loose from where they normally belong in your inner ear. They get stuck in a part of your inner ear where they are not supposed to be. This can be related to a blow to the head, recent illness, or, more commonly, no reason at all.

When the crystals are in the wrong place, a short, often intense, sensation of dizziness called vertigo can occur with a change in your body’s position. The most common activities that cause vertigo are: rolling over in bed, getting out of bed, bending forward, or looking up.

What are the symptoms of BPPV?

 

Symptoms of BPPV include:

  • Dizziness
  • Vertigo – the sense that you or the room is spinning
  • Loss of balance or unsteadiness
  • Nausea
  • Vomiting

What can physical therapists do?

The physical therapists at CoreBalance Therapy have specialized training in the assessment and treatment of dizziness.  They will take a detailed history of your symptoms that may include:

  • when they started
  • what you were doing when they began
  • how long your dizziness lasts
  • what makes it worse/better
  • other recent illnesses or injuries that may be contributing to your symptoms

To evaluate for BPPV your therapist will be looking at how your eyes move when you are both sitting still and when your head is moving or you are changing position.  Special video goggles may be used to record how your eyes move.  The testing involving putting you in a variety of positions is designed to recreate your symptoms to help your therapist decide what maneuver is appropriate for treatment of your BPPV.

Physical therapy evaluation is also checking for other possible causes of your symptoms. Dizziness can be caused by many other issues and if your therapist does not think that BPPV is your problem, they may offer you different physical therapy treatment exercises or refer you to another medical specialist.

How long does it take to feel better?

BPPV is treated by a series of maneuvers designed to put the crystals back where they belong.  This is usually effective in a few treatment sessions. As the crystals move back to where they belong, you may experience your familiar symptoms. Your therapist expects this and will help you get through them.

What happens if I don’t do anything?

If you do nothing, the symptoms of BPPV can sometimes decrease or resolve without any treatment; this can take only a few days or up to several months. In general, it is not recommended to leave this condition untreated. Falls, imbalance and depression are more common in individuals with untreated BPPV.  There are some medications that may decrease your acute dizziness symptoms, but they don’t fix the problem and may lead to worsening of your symptoms if taken long term.

How effective is treatment?

Physical Therapy maneuvers are very effective at eliminating your current episode of BPPV and, many times, it only takes a few treatment visits.  Your therapist can also teach you how to self-manage any future episodes if your BPPV returns. We understand how frustrating it is when vertigo occurs and we want to get you back to your life as quickly as possible!

Call CoreBalance Therapy to Schedule Your Visit with your PT to Treat Your BPPV Today!

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Staying Active While Injured

By: admin Published: November 24, 2013

by Katie Pierce, PT, DPT

Has being laid up with an injury gotten you down?dog play and knee scooter 073 (956x1280)

Dealing with a physical injury, chronic pain, or other health condition can be a real game-changer. Activities which used to be easy (like walking across a room, let alone taking your dog out for a run), now seem almost impossible.  Even if the condition is short-lived (such as I faced this fall when I injured my ankle while running, and had to wear a cast and use crutches for several weeks), plummeting physical activity levels can be a real downer. But with a little determination and some creativity, an injury or health condition doesn’t have to be a sentence for house-arrest. Here are some tips to help you find ways to safely engage in physical activity while dealing with an injury or other health condition:

Alter your workout: Change mode, intensity, frequency, or duration:

The mode (how you are exercising) may be the first thing that needs to change while you’re recovering from injury. No matter how much I would love to deny the fact, I was NOT going to be able to run while my leg was in a fiberglass cast and I was non-weight-bearing on crutches. Arghh… But I could don my water-proof cast cover and get in the pool.  Or ride a “New Step” seated stepper machine at my local community center  by peddling with both arms and my left leg only.

Your favorite activities may be out-of-reach for awhile, but there are other creative ways to keep your activity level up. And “New Stepping” with the folks at the local senior center, I learned, no matter how much it’s NOT running, is much better than staying home and skipping the day’s exercise altogether. Why? Because I crave those exercise-induced endorphins! Any exercise which gets the heart rate up and keeps it there for a period of time, can effectively boost feel-good neurotransmitter levels in the brain, such as serotonin and epinephrine  (DG Amen, 2010).

Other, more subtle changes to your exercise routine may do the trick. Reducing intensity, for example , may be all it takes to allow a less serious injury to heal. Or reduce frequency of the offending activity (e.g. biking 5 times a week was nagging at your knee, so you reduce to twice a week), while choosing a different mode of exercise on the days off. Or duration: simply do the activity for less time. Your Physical therapist can help you decide which changes need to be made to your typical exercise program to help you heal, while still meeting your needs for physical activity.

winter crutch outings

Disclaimer: Special equipment is being used to keep me safe in this photo (Yak Trax on the boots, metal spikes on the crutches… Don’t try this without proper gear! See next section, below)

Nature has been called “Vitamin N,” because outdoor time is so essential to our well being as homo sapiens (Louv, 2012). Getting outside can be key to boosting mood, especially if your primary mode(s) of physical activity before your injury involved the out-of-doors.

Meeting your cardiovascular exercise needs outdoors may not  be possible, depending on your injury or health condition. But just “being” outside can still provide a needed lift to your spirits.  Earlier this fall, while non weight-bearing on crutches, and nursing a sore shoulder, I could literally only propel myself a few hundred feet at a time.  But I still made plans to drive up with a friend to the edge of the National Forest almost daily. We’d park, and I’d crutch out several yards and sit on rock, listening to the sounds of Nature and feeling the warmth of the sun on my skin. I couldn’t exercise outdoors, but I could still enjoy the gifts of beauty of it.  And then I’d go to the pool for my aerobic exercise. It took some planning and extra time, yet I could feel the mental boost it gave me to spend time outdoors every day.

Be creative:  Special tools and equipment can help you do what you love

Sometimes the limitations of an injury make certain forms of exercise unsafe (think rubber crutch tips on snow and ice) or impractical (a fiberglass cast in the swimming pool?).  My clients with dizziness and imbalance, for example, just can’t safely ride their bikes when dealing with a flare in their symptoms.

But a little creativity – and some special products – can help solve problems like these. “Crutch tips for snow and ice,” (my actual Google search terms) for example, were my best friends last winter, and turned seemingly treacherous situations into an easy crutch-walk. Can’t get a cast wet? No problem: Waterproof vacuum-sealed cast covers are at your service. Just search online, you’ll be surprised at what’s for sale.

jog belt

Ask to borrow a blue “aqua jogging belt” at a local aquatic facility – You can use it in deep water, or if you can bear some weight, in chest-high water with your feet touching bottom…

But what about more complicated conditions, like spine pain or dizziness? Spine pain can be a tricky injury for those wanting cardiovascular exercise, because many motions can trigger pain – twisting, flexing, bouncing, etc.  But what about deep water jogging?  Aqua Jogging belts are designed to allow you to move in deep water without sinking, and allow you to maintain good postural alignment while moving your limbs and raising your heart rate. Here in Flagstaff, you can borrow an “Aqua Jogger” at no extra charge with your day pass to both the Aquaplex or NAU’s Wall Aquatic Center.

Dizziness and imbalance can be tricky, too. A few of my clients have returned to their love of biking while still healing from vestibular disorders, by setting up a stationary bike trainer and getting those wheels turning, safely.

Rental products for mobility can help with leg injuries: my “knee scooter” and I, below, had a great time participating in a “Splash 2 Dash” race at NAU.  So what if I didn’t finish the 5K run (OK, so I scooted about 400 meters then called it a day)? I still had a blast, and I rocked the swim portion, waterproof cast protector and all.

 So the moral of the story?  Exercise is good for the body, and for your spirits, too. Your Physical Therapist can help you design an exercise program to keep you as fit [and happy] as possible while you let your body heal.

Contact the expert physical therapists at CoreBalance Therapy, for evaluation for an injury or mobility condition, and learn how to stay active while you recover.

You just might see this active P.T. crutching around the clinic, for a few more weeks…

Yours,

Katie

Posted in Athletes, Back pain, Balance, Community, Tips | Tagged | No Comments

Fall Recovery

By: admin Published: January 6, 2012

Fall recovery training

by Amy Flory, PT, MPT

Often, people don’t realize how much their strength has declined until they’ve fallen and are unable to get up off the floor—even if they weren’t injured in the fall. If this unfortunate person finds themselves, fortunately, referred to physical therapy for balance training, the physical therapist should evaluate why you are not able to get up off the floor.

A couple of simple tests I do with patients are:

  1. While standing, can you “hike” your hip? Hiking your hip involves tightening one side of your waist so your hip bone gets closer to your ribs.  The foot on that side should be lifted off the floor, but the leg remains straight.
  2. Can you move from hands-and-knees to side-sitting and back to hands-and-knees?

In my clinical experience (disclaimer: this isn’t seen—yet—in the research literature!), if you cannot do one or both of the above activities, you probably are not able to get up off the floor easily, and, more importantly, you probably will not do well with certain balance activities.  Therefore, you are more likely to fall in the first place.

I didn’t even know I couldn’t do this anymore!

Perhaps you lost the ability to do these things because you hurt your shoulder years ago and have avoided bearing weight on your hand, or pulling with your arm certain ways.  Perhaps you’ve been sitting watching TV a couple of hours a day and now your back is stiff enough to keep you from being able to hike your hip, or makes you lose your balance while looking over your shoulder.

Your physical therapist at CoreBalance Therapy will look at the obvious factors causing you to lose your balance, but they will also search for the hidden reasons you’ve been falling as well.  It might seem like opening a can of worms, but identifying these problems and addressing them will help your balance therapy be much more successful in the long run!

To begin improving your strength, call to schedule your appointment today: (928)556-9935.

 

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