Dizziness is common in people over 20, and it can be a big problem in daily life. Feeling unsteady, lightheaded, or like the room is spinning is alarming and makes daily tasks difficult.

The good news is that dizziness often has treatable causes, and your physical therapist can be
the perfect person to help.

Understanding Dizziness

Dizziness isn’t a specific problem—it’s a symptom that can be caused by many different issues.
Feeling dizzy most commonly occurs due to issues with the inner ear, but it can also occur due
to vision, joint or muscle issues in the neck, migraines, changes in blood pressure, head
injuries, or other neurological problems.

How Physical Therapists Help

To understand dizziness and how a PT can help, you must know a little about how balance
works. Your brain uses information from your inner ears, your vision, and input from your joints
about their position and movement to keep you balanced and stable. Typically, all of this
information paints the same picture for your brain. If your brain gets conflicting information –
say, your inner ear sends different information than vision and your joints – that often results in a
feeling of dizziness, unsteadiness, or vertigo.

Your physical therapist will ask questions about your history and then test all of the systems that
help you stay balanced to determine the cause of your dizziness.

Your treatment plan will vary depending on what your PT finds. Some typical examples include:

● Exercises: Your PT may prescribe specific exercises to improve your balance, strengthen or
stretch specific muscles, or help retrain your brain to interpret sensory information. These can
include gaze stabilization exercises, which help your eyes and inner ears work better
together; habituation exercises, which help your brain get used to different types of input; and
balance training on various surfaces.

● Canalith repositioning maneuvers (CRM): If your dizziness is caused by benign
paroxysmal positional vertigo (BPPV), a specific type of inner ear problem, your therapist
may perform maneuvers to reposition tiny crystals within your ear canal, alleviating your
vertigo. They can also teach you how to do these at home.

● Education: Your therapist will educate you about your condition, how to manage dizziness,
and exercises you can perform at home. They may also help you modify activities that cause
dizziness or train you on ways to work through it.

Dizziness doesn’t have to interfere with life. Physical therapists can help reduce dizziness,
improve balance, lower the risk of falls, and increase confidence in daily activities.

References:
1. Cervicogenic Dizziness: A Review of Diagnosis and Treatment
a. https://www.jospt.org/doi/10.2519/jospt.2000.30.12.755
2. Physical therapy interventions for older people with vertigo, dizziness and balance disorders
addressing mobility and participation: a systematic review. BMC Geriatr 20, 494 (2020).
a. https://doi.org/10.1186/s12877-020-01899-9
3. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical
Practice Guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY
SECTION. J Neurol Phys Ther. 2016 Apr;40(2):124-55. doi: 10.1097/NPT.0000000000000120.
PMID: 26913496; PMCID: PMC4795094
a. 10.1097/NPT.0000000000000120
4. Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular
Physical Therapy After Concussion. Clin J Sport Med. 2016 Jan;26(1):46-52.
a. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856020/
5. Physical Therapy lowers falls by 68% after Dizziness
a. https://www.apta.org/article/2023/09/19/study-physical-therapy-after-dizzinessdiagnosis-lowers-fall-risk-by-86
6. Physical Therapy Guide to Dizziness
a. https://www.choosept.com/guide/physical-therapy-guide-vertigo
7. Vestibular Rehabilitation Therapy
a. https://my.clevelandclinic.org/health/treatments/15298-vestibular-rehabilitation

Physical Therapy for Chronic Pain

Chronic pain can be a debilitating condition, limiting your mobility and impacting your daily life.
The CDC estimates that around 50 million Americans experience chronic pain, and 17 million
have substantial reductions in activity because of pain. Beyond limiting activity or your ability to
work, chronic pain has been linked to depression, Alzheimer’s disease, and substance abuse.

Chronic pain is complex. There’s no single intervention to treat it, but physical therapy should be
part of the mix. Here’s why:

How PT Approaches Pain:

Physical therapy often provides relief that’s just as effective as medication but without the
potential side effects. Here’s a breakdown of how PT tackles pain and its effectiveness:
Identify the Root Cause: PT goes a step further than medication that masks pain. Therapists
assess your posture, muscle strength, flexibility, and joint mechanics to pinpoint the source of
your discomfort.

Address the Underlying Issues: Based on the evaluation, PT focuses on strengthening weak
muscles that support your joints, improving flexibility for a better range of motion, and correcting
any imbalances or postural problems that might contribute to pain.

Use A Multi-Faceted Approach: A PT treatment plan will be customized based on the
evaluation. In addition to therapeutic exercise, a PT might use various techniques. Examples
include:

• Manual Therapy: PTs use massage, joint mobilization, and trigger point therapy to
address muscle tension, improve circulation, and alleviate pain.
• Modalities: Techniques like ultrasound, heat therapy, or electrical stimulation can
reduce inflammation, promote healing, and manage pain.
• Aquatic Therapy: A warm, therapeutic pool supports your body and joints while offering
gentle resistance. This can often make it easier to start moving again after being in pain
for an extended time.

Educate and Empower Patients: PTs equip you with the knowledge and tools to manage your
pain independently. This might include learning a new exercise routine, how to modify activities,
or how to modify your daily schedule when you’re feeling better (or worse) than normal.

It’s also becoming increasingly likely that you’ll learn how pain works. Research shows that
combining pain education with physical therapy is an effective treatment.

If you’re struggling with chronic pain, call your physical therapist. They might have the key that
will unlock a pain-free life.

Physical therapy and nutrition are often seen as separate, but the truth is, they are deeply
intertwined. To get the most out of PT, especially after an injury or surgery, integrating both is
crucial. Here’s why:

Food Fuels The Body

During recovery from an injury or surgery, your body is working to heal itself. The activities and
exercises you’re doing in PT are designed to help it along. To take advantage of all the work
you and your body are putting in, proper nutrition is critical.

Protein provides the building blocks for tissue repair and muscle growth. Carbohydrates provide
energy and help support your immune system. Your body also needs healthy fats to regulate
inflammation and to build certain cells. Being short on any of these critical components will slow
your recovery down.

You also need enough micronutrients, like vitamins and minerals. For example, vitamin C is
needed to make collagen, which goes into bones, skin, and connective tissue. Vitamin D helps
your body absorb calcium, which is important for healing fractures, or surgeries involving bones.

Iron helps your blood cells carry oxygen throughout your body, which is needed for healing in
general. Again, being low on any of these micronutrients will affect your healing.

Your Weight Affects Your Health

Being overweight directly affects your health. It puts you at higher risk for cardiovascular
disease, stroke, osteoarthritis, back pain, diabetes, sleep apnea, and more. All of these are
conditions that you might see a PT directly for, or that will impact your healing. Eating a healthy
diet is the most effective way to reduce body weight. Combining a healthy diet with exercise is
even better for your health.

As an example, an 18-month study of 450 people with knee osteoarthritis showed that the group
that lost weight through a diet and exercise had less pain, better walking speed, and lower joint
forces in their knees than groups who either only lost weight, or only exercised.

How can a physical therapist help with nutrition?

While PTs are not authorized to provide individual diet plans or medical nutritional advice, they
can still help with your nutrition.

• PTs can screen for potential nutritional deficiencies or imbalances that may impact your
progress in PT or your overall health. This might involve screening for malnutrition,
sarcopenia (muscle loss), or assessing dietary habits affecting energy levels, healing, or
muscle building.

• Your PT can educate you on the importance of nutrition for various aspects of
rehabilitation and recovery. This includes explaining how specific nutrients like protein,
vitamins, and minerals contribute to tissue repair, muscle building, energy production,
and pain management.

• They can offer general guidance on healthy eating patterns, portion control, and
choosing nutrient-rich foods to support reaching your specific physical therapy goals.

• PTs recognize that overall health and well-being involve various factors, including proper
nutrition. They can encourage you to adopt healthy lifestyle habits that include a
balanced diet alongside regular exercise and proper sleep hygiene.

Finally, your PT can recognize when your nutrition needs exceed what they are able to provide.
In that case, they can refer you to and collaborate with a registered dietician or other qualified
healthcare professional for help in dealing with complex nutritional needs or recommending
specific dietary changes.

By combining the power of physical therapy and nutrition, you can achieve your
recovery goals faster and feel your best!

References:
1. Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and
Clinical Outcomes Among Overweight and Obese Adults With Knee
Osteoarthritis: The IDEA Randomized Clinical Trial Effects of Intensive Diet and
Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among
Overweight and Obese Adults With Knee Osteoarthritis: The IDEA Randomized
Clinical Trial | Obesity | JAMA | JAMA Network
2. Ottawa Panel Evidence-Based Clinical Practice Guidelines for the Management
of Osteoarthritis in Adults Who Are Obese or Overweight Ottawa Panel
Evidence-Based Clinical Practice Guidelines for the Management of
Osteoarthritis in Adults Who Are Obese or Overweight | Physical Therapy |
Oxford Academic (oup.com)
3. Strategies for optimizing nutrition and weight reduction in physical therapy
practice: The evidence Strategies for optimizing nutrition and weight reduction in
physical therapy practice: The evidence: Physiotherapy Theory and Practice: Vol
25, No 5-6 (tandfonline.com)
4. Body mass index and risk of knee osteoarthritis: systematic review and metaanalysis of prospective studies Body mass index and risk of knee osteoarthritis:
systematic review and meta-analysis of prospective studies – PMC (nih.gov)
5. Nutrition: A Portion of PT’s Menu of Services Nutrition: A Portion of PTs’ Menu of
Services | APTA
6. Considerations for PT’s Role in Nutrition Considerations Related to the PT’s Role
in Nutrition and Diet | APTA
7. Nutrition and PT a Powerful Combination – Nutrition and Physical Therapy: A
Powerful Combination | APTA

Aquatic physical therapy involves performing exercises and activities in water, usually a heated
pool. Aquatic physical therapy can have lots of benefits for people with conditions like arthritis,
back pain, fibromyalgia, osteoporosis, neurological disorders, sports injuries, and more. Let’s
DIVE IN and explore some of the advantages of aquatic physical therapy.

Reduced Weight Bearing

One of the main benefits of aquatic physical therapy is that it reduces the impact and stress on
the joints and muscles, thanks to the buoyancy of water. When submerged, you feel lighter and
more supported, which allows you to move more easily and comfortably. Your therapist can use
different depths of water to change how much force you experience. For example, when the
water is up to your neck, you only bear about 10% of your body weight. This can be especially
helpful for people who have difficulty walking, standing, or exercising on land due to pain,
stiffness, or weakness.

Built-In Resistance

Another benefit of aquatic physical therapy is that water provides natural resistance. You’ve felt
this if you’ve ever tried to move your arm or leg quickly underwater, or run in a pool. Water
resistance can be adjusted by changing the speed, direction, or surface area of the movement.
There is also equipment like hand webs, water weights, and kickboards that can make
movements more challenging. Resistance training can help increase muscle strength and
endurance, as well as improve blood circulation and heart health.

Compression

A third benefit of aquatic therapy is the hydrostatic pressure. This is the force that water exerts
on an object, which increases with depth. If you’ve ever dove to the bottom of a deep pool and
felt pressure on your body or in your ears, this is what caused it. The pressure of the water can
be used to help reduce swelling in joints or tissues. The pressure of the water also gives your
brain more input about the position your body and limbs are in. This can help improve
proprioception, or the sense of where your body parts are in space. Improving proprioception
can help enhance balance, coordination, and stability.

Heat

Our last benefit of aquatic physical therapy is that it takes advantage of the warmth of the water,
which can help relax the muscles and relieve pain. Warm water stimulates nerve endings in
your skin, which can help block pain signals. It also dilates the blood vessels, which can
increase blood flow and oxygen delivery to the injured or affected areas. Lastly, warm water can
also have a calming effect on the mind and body, which can help you feel better.
Aquatic PT can reduce the impact and stress on the joints and muscles, provide resistance and
hydrostatic pressure, and use the warmth of the water to reduce pain while improving strength,
endurance, proprioception and function. Aquatic physical therapy can also be fun and
enjoyable. If you are interested in aquatic physical therapy, talk to your doctor or physical
therapist to see if it is suitable for you.

References:

• Research (peer-reviewed)
o Efficacy of aquatics for LBP – https://pubmed.ncbi.nlm.nih.gov/34994794/
o Aquatics for people with MS – https://pubmed.ncbi.nlm.nih.gov/32114368/
o Aquatics for people with stroke – https://pubmed.ncbi.nlm.nih.gov/32340581/
o Aquatics for Knee OA – https://pubmed.ncbi.nlm.nih.gov/35346294/
• Articles and Content
o Benefits of Aquatic Therapy – https://medical.texasneurorehab.com/therapyservices/aquatic-therapy/
o Who is a good candidate for aquatic PT –
https://www.upmc.com/services/rehab/crs/services/aquatic-therapy
o Aquatic exercises – Mayo Clinic

Physical therapy for dogs, also known as canine or veterinary rehabilitation, is a growing field of
treatment that can help dogs with various conditions. Whether your dog has suffered an injury,
undergone surgery, or has a chronic condition like arthritis, physical therapy can help!

What is physical therapy for dogs?

Physical therapy for dogs is similar to physical therapy for humans, just with more treats! It uses
techniques like exercise, massage, heat and cold therapy, hydrotherapy, laser, ultrasound, and
even treadmill therapy to improve your dog’s range of motion, strength, flexibility, and
endurance. Just like in humans, the goal is to decrease pain, speed up recovery, and improve
your dog’s quality of life.

Physical therapy for dogs is usually performed by a certified canine rehabilitation therapist.
These are veterinarians and physical therapists who have undergone extensive training and
certification. They will assess your dog’s condition, medical history, and goals, and design a
customized treatment plan for your dog.

What do dogs need physical therapy for?

Physical therapy for dogs can treat lots of conditions, including:

• Arthritis: Physical therapy can help reduce inflammation, stiffness, and pain in your
dog’s joints. It can also improve your dog’s mobility and prevent further deterioration of
the cartilage.
• Hip dysplasia: Physical therapy can help strengthen the muscles around your dog’s hip
joint and improve its stability. It can also reduce the risk of developing osteoarthritis in
the future.
• Torn cruciate ligament: Physical therapy can help your dog recover from surgery or
avoid surgery altogether. It can help restore your dog’s normal function and prevent
muscle atrophy and joint instability.
• Neurological conditions: Physical therapy can help your dog with conditions that affect
the nervous system, such as intervertebral disc disease (IVDD), degenerative
myelopathy (DM), or stroke. It can help stimulate nerve function, improve balance and
coordination, and prevent muscle wasting.
• Obesity: Physical therapy can help your dog lose weight and improve its overall health.
It can help your dog burn calories, increase metabolism, and reduce the strain on the
joints and organs.
• Sports injuries: Physical therapy can help your dog heal from injuries sustained during
activities like agility or flyball. It can help prevent scar tissue formation, enhance
performance, and increase body awareness.

Physical therapy for dogs is a great way to help your best friend heal from injuries, improve their
mobility and fitness, and enhance their quality of life. If you think your dog could benefit from
physical therapy, consult with your veterinarian first. They can refer you to a certified canine
rehabilitation therapist who can evaluate your dog and create a suitable treatment plan. With
physical therapy, you can help your dog live a happier and healthier life.

References:

(1) The Power of Canine Rehabilitation Therapy – American Kennel Club.
https://www.akc.org/expert-advice/health/the-power-of-canine-rehabilitation-therapy/.
(2) Physical Therapy For Dogs: How Can Canine Rehabilitation Benefit Your ….
https://www.caninejournal.com/physical-therapy-for-dogs/.
(3) Dog Rehabilitation – A Detailed Physiotherapy Guide. https://topdogtips.com/dogrehabilitation-a-detailed-physiotherapy-guide/.
(4) Dog Physical Therapy: Exercises, Modalities, Techniques – TopDog Health.
https://topdoghealth.com/what-are-dog-physical-therapy-exercises/.
(5) A Complete Guide to Physical Therapy for Dogs – RocketDog.
https://rocketanimalhealth.com/blogs/news/a-complete-guide-to-physical-therapy-for-dogs.
(6) Canine Pelvic Osteotomies Outcomes – https://pubmed.ncbi.nlm.nih.gov/34643966/
(7) Canine hip dysplasia study – https://pubmed.ncbi.nlm.nih.gov/20740258/
(8) Canine Rehabilitation Institute – https://www.caninerehabinstitute.com/
(9) Dog physical therapy exercises – https://www.lakecross.com/site/blog-huntersvillevet/2020/08/12/dogs-physical-therapy-exercises
(10) What can be included in rehab – https://www.aaha.org/your-pet/pet-owner-education/askaaha/what-is-veterinary-physical-rehabilitation/
(11) Evidence for canine PT – https://pubmed.ncbi.nlm.nih.gov/25432679/
(12) Select Technique for PT for dogs – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9312226/
(13) Dogs Physical Therapy Exercises | LakeCross Veterinary Hospital.
https://www.lakecross.com/site/blog-huntersville-vet/2020/08/12/dogs-physical-therapyexercises.
(14) Overview of the role of rehabilitation for arthritis. https://caninearthritis.org/article/role-ofrehabilitation-arthritis/.
(15) Pet Rehab. https://www.petrehab.net/.
(16) Advanced Canine Rehab Center – Home. https://www.dogpt.com/.

What Is Autism?

Autism, or autism spectrum disorder (ASD) describes a range of developmental conditions that
affect how a person communicates, interacts, and behaves. ASD is called a spectrum disorder
because the symptoms and severity can vary widely from one person to another.

Typical signs and symptoms of autism include:

• Having difficulty with communication and social interaction
• Restricted or repetitive patterns of behavior such as repeating words or phrases, lining
up objects, or having intense and narrow interests
• Sensory issues, such as being over- or under-sensitive to sounds, lights, or textures

How Can PT Help?

Children with autism also often have difficulties with motor skills, which affect their daily
functioning and quality of life. For example, they may have trouble with balance, coordination,
motor planning, and body control. They may also have low muscle tone, which can make them
appear floppy or weak. These challenges make it hard for them to participate in physical
activities like playing games or on playgrounds with peers, which are important for both their
physical and mental health.

Physical therapy can help children with autism overcome these difficulties and improve their
motor skills. Using individualized and structured interventions, pediatric physical therapists help
children with autism learn new skills and practice them in a fun and motivating way. Physical
therapy can also help children with autism develop a positive attitude toward physical activity
and enjoy the benefits of exercise, such as improved mood, energy, and sleep.

Improved gross motor skills and increased physical activity can also support the development of
other areas that are affected by autism, like social and emotional skills. Physical activities can
provide opportunities for children with autism to interact with their peers and family, express
their feelings, and follow rules and directions. Physical therapy can also help children with
autism cope with sensory issues, such as hypersensitivity or hyposensitivity to touch, sound, or
movement, by exposing them to different stimuli and helping them regulate their responses.

How Do I Find A Qualified PT For My child?

If you think your child with autism may benefit from physical therapy, you should consult with
your child’s pediatrician, who can refer you to a physical therapist who specializes in working
with children with autism. You can also search for a physical therapist near you using the
American Physical Therapy Association website.

References:
• Research (peer-reviewed)
o Physical Activities for Children with Autism –
https://pubmed.ncbi.nlm.nih.gov/32192008/
o Exercise for children with autism – https://pubmed.ncbi.nlm.nih.gov/31615098/
o Physical activity effects on sleep and executive function –
https://pubmed.ncbi.nlm.nih.gov/30663324/
• Articles and Content
o Recognizing Autism in Healthcare – https://pubmed.ncbi.nlm.nih.gov/34983217/
o Autism – diagnosis and management – https://www.nice.org.uk/guidance/cg142
Supporting people with autism 19 or under – https://pubmed.ncbi.nlm.nih.gov/34283415/

What is dry needling?

Dry needling is a procedure where a physical therapist inserts a fine needle into what is known as a trigger point. A trigger point is a tender palpable nodule in muscle that can cause pain locally or referred to other parts of the body. The term dry is used to describe the insertion of a needle without any medication.

What causes trigger points?
There are many potential causes but commonly trigger points are caused by overload of a weak muscle or prolonged muscle contraction such as with maintaining posture. These causes can turn into a self-sustaining cycle if not addressed.

How does dry needling help?

• Creation of a Local Twitch Response which is a spinal cord reflex in response to the insertion of the dry needle
• Decrease in inflammatory and pain causing chemicals
• Improvement in circulation
• Activation of pain relieving processes in the central nervous system

What areas of the body can dry needling be performed?

Dry needling can be performed throughout most of the body with our most commonly treated areas including the shoulder, neck, low back, and hip/glutes. Our therapists have extensive training in dry needling and are able to competently and safely perform dry needling on your area of pain or dysfunction.

How often is dry needling performed?

The typical trajectory is to dry needle more often early on with visits becoming spaced out over time as self-care techniques and exercise are implemented to create lasting changes. 

Call us today to find out more information or to schedule an initial evaluation!

The American College of sports medicine (ACSM) recommends that,

“All healthy adults aged 18–65 years should participate in moderate intensity aerobic physical activity for a minimum of 30 minutes on five days per week, or vigorous intensity aerobic activity for a minimum of 20 minutes on three days per week.”

Examples of moderate intensity activities include:

• Riding a bicycle 
• Walking a dog/Brisk walking
• Mopping
• Vacuuming
• Weeding
• Bowling
• Golf

Examples of vigorous activities include:

• Shoveling snow
• Mountain biking
• Stationary bike at moderate to vigorous effort
• Running
• Racquetball
• Tennis 
• Soccer

There are more heart healthy activities than just walking and running for distance. Many activities that people already do during their day can add up to meeting activity requirements. Physical therapy exercises, most chores, and hobbies such as tennis or golf are great paths to meeting the minimum activity requirements to see increased health benefits.

Why is reaching 75 to 150 minutes of physical activity a week so important?

• Exercise reduces blood pressure in adults with high blood pressure. More exercise leads to larger reductions in blood pressure reducing the progression of cardiovascular disease.
• Men and women that are less active are more likely to die or become injured from heart attacks, strokes, and chronic medical conditions such as diabetes. Increased physical activity decreases the risk from these medical conditions with more activity showing even higher benefits.
• Regular physical activity reduces the risk of fall-related injuries by over 30%.

If you have pain or difficulty leading an active lifestyle, give us a call to see how we can help.

Two very common scenarios are seen every day at Gold Medal Physical Therapy and other clinics across America:

You bend over one day to tie your shoes before work and feel a jolt shoot from your back all the way down your right leg.
You recently retired and want to take control of your back or neck pain that you have been dealing with for decades so that you can enjoy time with your grandchildren or traveling the world.

When this happens, it is common for people to seek out an MRI to try to determine what is truly going on.

After an MRI, you receive a report detailing the findings. The report will include many words such as degenerative, desiccation, osteophyte, bone spur, spondylosis, herniation, or bulge.

So would mine, and I am completely pain-free!

A 2014 study by Brinjiikji et al. reviewed MRIs of over 3,000 people grouped by decade from people in their 20s to people in their 80s. Everyone in the study had no history of back pain and had full pain-free function.

Thirty percent of participants in their 20s had lumbar (low back) disc bulges and seventy-three percent of participants in their 70s had lumbar disc bulges – without even knowing!

A similar 2015 study by Nakashima et al. showed that eighty-seven percent of the over 1,100 study participants had a disc bulge in the cervical spine (neck) without any pain, history of pain, or other symptoms.

Just because there are findings on an MRI report does not mean that your pain will be forever, unchangeable, or that you will require surgery to fix it. Every day in our clinics we help people regain function, decrease pain, and avoid surgery.

Often, findings on an MRI report can be viewed as simply a natural process of life, just as one’s hair turning gray. We observe what is on the report, but then treat the deficits we can change as physical therapists: muscular weakness, flexibility, mobility, etc.

There are times when an MRI report or a patient’s current symptoms and presentation will mean they need further medical intervention such as consultation with an orthopedic surgeon or neurosurgeon. We as physical therapists are well versed in noticing the signs and symptoms of a patient that needs to seek out further consultation, and we will refer out for anything that we believe will not respond to conservative care or is an emergency.

What is Vertigo?

There are several types of vertigo that can be treated in physical therapy. The most common type of vertigo is known as benign paroxysmal positional vertigo commonly referred to as BPPV. BPPV is twice as common in women than men and also more common in individuals greater than 60 years old. This type of vertigo is due to crystals known as otoconia in the inner ear that become dislodged and are now free floating in the semicircular canals in the inner ear. These crystals are gravity sensitive and there is a feedback loop that works with the vestibular nerve to send signals for posture, balance, eye and head position. When there is dysfunction present patients often report dizziness and nausea, and present with nystagmus which is involuntary eye movements.

How can Physical Therapy help?

Physical therapy uses head movement techniques known as the modified Epley maneuver and the barbeque roll maneuver to help the crystals move back to their original resting position. This decreases the dizziness and nausea that are often the main symptoms of BPPV. Symptoms can resolve quickly within the first few treatment sessions. Exercises are then implemented to improve the vestibular system to prevent reoccurrence. These exercises include balance, eye and head movements, and also strengthening of the head, neck, and shoulder for improved proprioception and optimal positioning of the head and neck.

What can I do for prevention? 

There has been some recent research to figure out some of the causes of BPPV. Some research suggests a link with BPPV diagnosis and low vitamin D and calcium levels. Vitamin D helps with the absorption of calcium and phosphorus from the food you eat. The otoconia are calcium crystals and with low calcium the crystals become less dense and easier to become dislodged. There is also a link between BPPV and osteoporosis for the same reasons for low vitamins D and calcium. It is theorized that BPPV is more common in the older population due to nerve atrophy and the loss of the nerve cells and the nerves pass the messages along more slowly. No matter the cause, BPPV is treatable and responds very well to physical therapy and often patients find that they are able to return to their previous level of function.

Call us today to see if you could benefit from physical therapy.