Vertigo, Imbalance, Dizziness

What is Vertigo?

Vertigo is caused by a inner ear disorder, in which a person experiences a false sensation of himself or the world around him spinning.  Common symptoms include spinning sensation, floating, imbalance, nausea, and light-headedness with quick head movements or- turning in bed. One of the most common types of vertigo is BPPV- Benign Paroxysmal Positional Vertigo. BPPV is a mechanical problem in the inner ear where tiny calcium carbonate crystals, otoconia, become dislodged from their natural placement within the gel in the utricle (balance organ than senses head tilt and linear motion). When otoconia accumulate in the semicircular canals(balance organ that sense angular motion), they stimulate the nerve endings in the inner ear as well as our eye muscles causing false sense of movement leading to imbalance and nausea.  

Is treatment available?

Yes. One of the treatment methods used to target the symptoms of vertigo is the Canalith Re-positioning Maneuver- Epley , Liberatory or the Apiani, depending upon which semi-circular canal is affected. A PT trained in treating these conditions can perform some specific and quick tests to match the right procedure to your condition. In this method, a trained therapist will treat a patient using a specific series of head and neck movements. The motion in this maneuver aims to displace the tiny crystals of calcium carbonate, to their original location within the inner ear. Proper placement will prevent these crystals from sending false signals of movement to the brain, thus restoring balance and alleviating motion sensitivity. 

What other Vestibular conditions PT’s treat…

Physical therapists can treat a variety of vestibular and balance disorders including concussion, labyrinthine dysfunction, vestibular neuritis, post-surgical conditions dizziness. Vestibular rehabilitation therapy (VRT) can alleviate your symptoms and help you to return to your normal level of activity. VRT is a method that uses habituation exercises, eye muscle exercises, and balance and proprioception training exercises to improve balance during functional activities. A physical therapist will assess you to identify the root of your balance deficits  and address these through educations, individualized home exercises and home exercise program to help you resume your prior activity level.

Winter is Around the Corner!

Tips to help you have a Safe Holiday Season

Given the changing weather conditions during this time of year, it is important to be cautious of winter conditions such as snow, ice, and the cold temperature. 

Most common winter Injuries & how we can avoid them: 

1.       Falling on snow & ice

  • Making sure your winter shoes have good traction is important. When purchasing winter shoes, pay close attention to the material and tread pattern on the soles of the shoes. Plastic or leather shoes are not optimal slip-resistant materials, a good tread design on the sole of a shoe is one that is spread out and has depth. 
  • While proper footwear is helpful, it is equally as important to be conscious as you walk outdoors in the winter, because black ice can be present. Instead of only looking down as you walk, try to glance in front of you to detect uneven surfaces that are in your direction.
  • Keep your arms and hands close to your body and take small steps like a penguin when walking- ankle is positioned under the hip. If you take big steps, placing the heel of your foot too far ahead of you, and the rest of your weight is shifted backwards, you are more prone to fall.

2.      Experiencing muscle strain from shoveling snow/ scraping ice

  • Muscle contraction is directly affected by temperature. Oxygen is carried into your body through hemoglobin. In colder temperatures, oxygen is bound to hemoglobin more tightly which impedes the rate at which oxygen reaches the muscles. For this reason, you should always warm up before engaging in physical activity including activities like shoveling the snow. By warming up, more oxygen will be available to the muscles to allow for a stronger force of contraction.  
  • Muscle strain can occur in an instant, or over time. Acute muscle strain can be a result of a slip/ fall, or heavy lifting; chronic muscle strain may arise from long-term harmful repetitive movement.  Acute strain can be minimized by being cautious of your movement, and avoiding strenuous activities. If you do not feel physically fit, shoveling heavy snow yourself may not be the best option. Look into finding an alternative by asking a neighbor/ friend, or hiring a snow cleaning service. Chronic muscle strain can be avoided by being aware of your form when you’re engaging in physical activity.
  • Some tips to keep in mind when shoveling snow is to find your balance before beginning to shovel the snow. Keep your feet wide and shift weight to the front foot when digging into the snow. When pulling the snow-filled shovel upwards, shift weight to the back foot and be sure to use the strength in your arms not your back when lifting. When throwing the snow, turn your body in the direction of the shovel instead of twisting at the waist.

3. Accidents while playing winter sports and activities

  • As we should do during all times of the year, wearing proper protective gear is key to having a safe athletic experience!
  • Be adventurous, but dive into it slowly. Trying a sport for the first time can go two ways, it may be a very enjoyable or a very frightening experience. While it may be very tempting to try new tricks, or experiment free-style, having the proper initial training is critical. With guidance from a professional, you can learn critical skills such as how to stop, slow down, and change directions. This basic training will help you have a safe experience.
  • Be mindful of barriers! Especially in popular winter sports, such as skiing and snowboarding, facilities will mark safe areas to be in. The cones, flags, and other barriers that are blocking off certain ground is placed for your safety. Do not venture off past marked trails. 

A Parent’s Guide to Concussion in Sports

According to the NFHS, National Federation of State High School Associations, it is estimated that over 140,000 high school athletes across the United States suffer a concussion each year. As a parent of active children, being aware of symptoms of a concussion is important. While many believe that concussions only occur when an athlete loses consciousness, in actuality, a concussion can occur even when symptoms are not as apparent.

Recognizing Symptoms:

A critical step you can take to ensure your child is having a healthy athletic experience is to be aware of warning signs of a concussion. You may notice changes in your child’s behavior or thinking, or your child himself may complain about cautionary symptoms.

Symptoms:

Thinking

  • Feels confused
  • Appears dazed or stunned
  • Not thinking clearly
  • Slow process of thinking
  •  Concentration/ Memory problems

Physical

  • Nausea/ Vomiting
  • Headache
  • Dizziness/ Imbalance
  • Blurred vision
  • Sensitivity to light/ noise
  • Diminished energy

Emotional

  • More emotional
  • Anxious/ nervous
  • Easily upset/ angered

Sleep

  • Changes in normal sleep pattern
 When one or more of these symptoms are evident, it is important to
1.       Stop sport/ activity                           2. Seek medical evaluation

When Can An Athlete Return to Play?
No athlete should return to play on the same day.
All athletes who sustain a concussion must undergo an evaluation by a healthcare provider and must be clear of all symptoms during physical testing. Even if it appears that your child is symptom free, healing my not be complete. For this reason, ample rest is required for complete recovery.

  • Following medical clearance, a return to play schedule should be followed to allow the brain to re-adjust to exertion. This schedule should be enforced over time allowing your child to be asymptomatic for each step for a period of time prior to progressing. 

Step 1: Light exercise, including walking or riding an exercise bike. No weight-lifting.
Step 2: Running in the gym or on the field. No helmet or other equipment.
Step 3: Non-contact training drills in full equipment. Weight training can begin.
Step 4: Full contact practice or training.
Step 5: Game play.

When Can An Athlete Return to Learn/ School?

  • Just as a child should gradually increase physical activity post-concussion, all cognitive activities should slowly be reintroduced after a period of rest. By consulting your doctor, you can create the optimal return to learn schedule for your child similar to the one presented below. 

Step 1: Post concussion take a rest from cognitive activities. 
Step 2: Slowly reintroduce light cognitive activities for short periods of time (coloring, drawing,                        listening to audio books, and watching television).
Step 3: School-specific activity can be increased gradually (up to 30 minutes). 
Step 4: Allow your child to return to school under a modified schedule. This means fewer classes, or                providing extra time to complete activities when needed. 

* Note: If symptoms worsen at any time, allow your child to rest until symptoms improve. When they improve, the child may return to class. 

By having a deeper understanding about concussion identification & care, you will be able to help your child live a healthier lifestyle. 

Physical Therapy: A Beginner's Guide

Physical Therapy

A Beginner's Guide.

Who are Physical Therapists?
Physical Therapists (PT's) are movement specialists who treat individuals of all ages who have health related conditions that limit their ability to move and perform functional activities in their daily lives. They can work with patients to offer preventative care or even to develop fitness programs to promote healthier living.

What qualifications do PT's have?
PT's are required to receive a graduate degree from an accredited PT program. As of 2015, all accredited PT programs are Doctor of Physical Therapy (DPT) programs in which a student will receive a doctorate after successful completion. In order to practice, students must pass a national licensure examination. A PT must also acquire state license in each state he or she wishes to practice in. There are several areas of practice that PTs can specialize in, such as Neurology, Orthopedics, Pediatrics, Geriatrics etc. Seeing a specialized clinician can ensure effective and efficient care.

Where do PT's Practice?
You may encounter PT's in a variety of settings. From inpatient facilities, tofree standing outpatient clinics, to schools, or even at workplaces. PT's can be found working with a large population base to help promote wellness.

What can a PT assist me with?
PT's are qualified to help treat patients with a range of conditions. From working with a patient prior to surgery for preventative care, to helping a patient after the surgery to assist with healing, a therapist helps promotes well-being, and maintenance of functionality. Commonly, PT's work with patients who experience joint or muscle pain, loss of balance, feelings of dizziness, difficulty with gait, spasticity, concussions, and lymphedema.

How can I find the right PT for me?
Most importantly you should know that in all 50 states in the US, you can use some form of direct access to visit a PT without a physician's referral. You have the freedom to choose your PT! Here are a few tips to help you find the right PT for you:

·         Make sure you find a Licensed PT. Always make sure you are receiving care from a qualified professional.

·         Do some research to find a PT who specializes in the area you need care in.

·         Find out if you will be receiving care from a PT or a PTA. PTA's are licensed therapy assistants who provide care under the direct supervision of a licensed Physical Therapist.

·         Check with your insurance plan if your PT facility in network with them, as they will offer you services at lower services than out of network providers.