VeDA's Balance Awareness Week is here!
This week means a lot to me. Each year I would hold balance contests in the clinic, put up posters, gather donations and raise awareness around vestibular disorders and VeDA's impact. But for the first time I feel as though I can do a little more.
Our Interactive BPPV App was created to help those who can't get in to see a vestibular therapist, don't have access to one, or can't afford the therapy. Because the reality is, only 8% of people with BPPV actually get effective treatment.
Our goal at Healing Vertigo is to improve that, so for the entirety of #BalanceAwarenessWeek you will be able to get the App at 50% off!
You can find the App on both Google Play and the Apple App Store
Do you take supplements to help with your vestibular disorder?
Both Magnesium and Riboflavin have been shown to help migraines and can even reduce the number of migraine attacks experienced! 🧠 A daily dose of 400-800mg of magnesium and 400mg B2 Riboflavin has been recommended in the research.
Vitamin D is a favourite around here as it has been shown to help prevent BPPV attacks, and may also reduce Meniere’s symptoms 🌀. Vitamin D is easy to test for, and it is recommended dosage is based on your current blood levels.
Ginger, as many of us know, is a great remedy for nausea, but studies have also shown it to also be helpful with reducing migraine pain (although unclear if it helps with dizziness experienced in vestibular migraines). It is recommended you take a quarter teaspoon of ginger powder at the first sign of a migraine attack.
Make sure to speak to a doctor before starting any supplement program. Also also remember that many of these vitamins and minerals can be found naturally in food, so eat up those healthy proteins and leafy greens!
Who's in the "no comment" zone!? Just when we think aging is hard enough, BAM, now you're getting dizzy too!?!
BPPV has been shown to occur more often the older we get. The reason for this comes down to tiny otoconia, or "crystals" inside our inner ear. These crystals are an important part of our inner ear as they give us our sense of gravity.
It is normal for these crystals to break off and get absorbed throughout our lifetime, but what we have noticed is that as we get older we seem to be breaking more off.
As we age, the crystals themselves also show wear and tear; tending to fragment, get smaller, and break away from the microfilaments that normally hold them together. With more crystals loose in our inner ear, there is just a higher chance some fall into one of our canals, causing BPPV.
👉 Now, although this is a natural part of aging, BPPV doesn't have to be! It's easily treated with simple maneuvers which move the crystals out of the canals and back to the area where they can be absorbed.
If you are feeling dizzy, connect with a vestibular therapist in your area! And if you don't have access to someone, check out the Healing Vertigo App as an alternative resource for you 😊
So I'm seeing you for my dizziness and your solution is to make me dizzy??? Head scratcher, I know, but...yes! In vestibular therapy we need to challenge your system in small ways to promote change. I like to use the analogy of learning how to run. If you currently don't run and try to run 10km you're going to feel pretty crappy. So instead we train! We start at 2km, and it's still going to hurt but it's manageable. Soon 2km will feel easy, and so we go a little further until we can do 10km!
Vestibular therapy is the same as training. Trying to live your everyday life is like trying to run 10km. It makes you dizzy and it sucks so instead you stay on the couch. In therapy we show you how to "run 2km" for your vestibular system! You may feel dizzy at each new challenge, the same way running will feel hard every time you go a little further. But with small steps you will make gains and get back to feeling like yourself again. And that's going to feel good!
Studies show that our bodies are less able to cope with dizziness when we are under stress.
One reason for this is that the system that triggers nausea and dizziness also controls the “fight or flight” stress reflex.
When you are under stress, your body ramps up this stress reflex, making you breathe faster, increases your heart rate and increases your blood pressure. This also can make us nauseous and dizzy, even without a vestibular disorder. But when we do have a vestibular disorder, this will be even worse. And with worse symptoms severity, our stress levels increase more, and the cycle can become vicious.
Above you will find some stress management tips from www.menieres.org “Controlling Your Symptoms” booklet. Be sure to check it out as it goes into MUCH more depth than this post.
And don’t forget having a solid vestibular physiotherapist as part of your healthcare team can make all the difference. Healing Vertigo treats virtually to all Ontario Residents.
This is how we celebrate after teaching a 3h webinar on @embodia today!
Ribs boiled in Guinness Beer and then oven roasted
French fries with all the dipping sauces
Ice cream cone (eaten prior to dinner, don’t judge me)
A super cold cider
Thanks to everyone who spent their precious Saturday learning with me!
As I prepare for my course discussing vestibular neuritis and labyrinthitis, I can't help but also look into the recent evidence surround COVID-19 and vestibular symptoms.
In a large systematic review done this year, they reported that up to 14% patients who have sustained COVID-19 may now be reporting ongoing symptoms of hearing loss, tinnitus and vertigo.
The reasons behind it are still unclear and more research is needed, but what we do think is that COVID-19 can have isolating effects on a cranial nerve, with the 8th cranial nerve (also referred to as the vestibulocochlear nerve) being involved in these cases.
We are going to get into this, along with other causes of vestibular hypofunction in my new webinar and course on @embodia.
If you are interested in the LIVE webinar, join us June 5th at 11am EST! (To register, click link in Bio)If you can't make that time, the webinar will be recorded and available as a course on @embodia shortly after :)
Health and fitness come in a variety of flavours, and making your health practice personal is important.
My health and fitness looks like swimming, hikes with friends and podcasts that make me happy. For my mom, it looks like walks, crafting and strong female connections. And for my grandma, it’s gardening, volunteering, and talking to her family daily.
Health and fitness goes beyond just the body and movements, it includes the mind, nature, and even our relationships with others. And as we age, our health and fitness routines will change, and that’s a beautiful thing!
So from my family to yours, Happy Senior Health & Fitness Day!
I had so much fun and interest in my first webinar about BPPV, I’m back to do another!
In this webinar I get into the aspects of vestibular rehabilitation, discussing the conditions that require vestibular rehab (e.g. vestibular hypofunction), how to complete an assessment, and how to develop and progress a treatment program.
It’s a perfect introductory course for anyone who is new and just getting into vestibular therapy. I will give you the tools that will allow you start seeing patients right away, while also developing a solid foundation for future continuing education.
I even kept specialized equipment out of this course to make it fully accessible and perfect for building a teleheath practice
Join me Saturday, June 5 at 11am EST on @embodia, it’s going to be a good one!
Benign Paroxysmal Positional Vertigo, also known as BPPV, is a widespread and common condition, affecting 2.4% of the general population. Despite how common this condition is, only 8% of affected people receive effective treatment for it1. Many patients get bounced around our healthcare system, seeing multiple physicians and incurring high medical fees before receiving just a diagnosis, let alone treatment. This is a significant problem; however, it is a problem we can change.
BPPV is a condition of the inner ear and the most common cause of vertigo. Although its name is complex, it outlines really well what is going on:
· Benign: meaning it is not life-threatening
· Paroxysmal: sudden brief spells
· Positional: symptoms are brought on by certain head movements or positions
· Vertigo: a sensation of spinning
The cause of this condition stems from tiny calcium particles called otoconia breaking free from their normal location in the otolith organs and migrating into the semicircular canals. Their presence generates incorrect signals, triggering symptoms of dizziness, vertigo, imbalance, and nystagmus. The role of the therapist is to maneuver the patients head in specific orientations to move these otoconia out of the semicircular canal, where the body can then absorb the particles, resolving the patients’ symptoms.
The prevalence of BPPV, as mentioned above, is quite
high, especially in our older population. In fact, it is estimated that 1 in 10
people over the age of 65 have BPPV, with many going undiagnosed2. The
major consequence to this condition in our elderly population is the increase
risk for falls. Although BPPV isn’t in itself deadly, balance-related falls
account for more than 50% of accidental deaths in the elderly, which BPPV plays
a contributing factor in3.
The issue surrounding BPPV at the moment is the time
and cost to diagnosis. In general, vestibular disorders are difficult to
diagnosis. It is common for a patient to consult 4 or more physicians over a
period of several years before receiving an accurate diagnosis, and BPPV is no
exception to this, being the most prevalent of the vestibular conditions
(VEDA). And the cost? It has been estimated that is costs nearly $2000 to
arrive at a diagnosis of BPPV and that 86% of patients suffer some interruption
in their daily activities and lost days at work because of BPPV.
Improving these statistics lies in our hands as
healthcare providers. BPPV is a condition that is part of the vestibular
system, a system that wasn’t taught for many years in the Physiotherapy
Program. It has recently been included into the curriculum, but there are
thousands of therapists out there who missed this opportunity to learn and
understand this condition.
Cheryl Wylie, a
vestibular physiotherapist, along with Embodia are looking to change this. In
her course, BPPV Focus: Assessing and Treating Dizziness, Cheryl focuses in on JUST
BPPV, educating practitioners on how to recognize it in our patients, test for
the variations of BPPV, and how to treat each type with maneuvers. In
conjunction, Embodia’s BPPV Resource Package sets practitioners up with
patient-focused videos on how to do each maneuver which can be assigned to your
patients through Embodia’s HEP, along with a patient education handout and a
Practitioner BPPV Flow Chart. The goal of this course and package is to set
practitioners up for success in adding BPPV to their repertoire. It allows you
to learn about the most common vestibular disorder, from simple to complex
variations, in as little as 2 hours without having to dive into other aspects
of vestibular therapy. Thinking back to that statistic we mentioned earlier that
the average patient moves through 4 practitioners before receiving a diagnosis,
improving practitioner awareness and confidence in treating BPPV is the first
step in improving our patients access to BPPV treatment.
This course and resource package, however, are just the start of Cheryl’s mission to increase access to BPPV Treatment. In the past year she has also developed an App called Healing Vertigo, which applies the logic flow of BPPV treatment along with the patient-focused videos into a simple resource tool that can be used by anyone, including patients themselves. We have learned quickly after the pandemic hit, that access to healthcare is not a guarantee. Merging into the technology world is an important step for physiotherapy, and BPPV treatment is no exception. In fact, it may be one of the easiest conditions to take the leap, and the App is a perfect example of that.
To give you an example of BPPV Training, tet’s take a look at the most common BPPV variation, which would be floating otoconia in the posterior semicircular canal. This is referred to as posterior canalithiasis and is treated with the Epley Maneuver. Many therapists have heard of this maneuver, and likely you have even given it a try with your patients when you suspected BPPV as a cause of their vertigo. The Epley maneuver is designed to move otoconia from the back of the posterior canal into the otolith organs through four simple steps. Below is a video from Embodia’s BPPV Resource Package HEP of the Right Epley Maneuver:
Cheryl has completed this maneuver numerous times with her patients, and here is what she has learned to make it the most successful:
1. Take your Time. Traditional Epley Maneuver instructions recommend you hold each position waiting for your patient’s dizziness to stop, plus 30 seconds. Personally, I wait an additional 2 minutes after my patient’s dizziness has stopped. I do this because it often takes time for the otoconia to move within the canal, especially in our older population. By slowing down, I find I have increased success with fewer repetitions of the maneuver.
2. Focus on the Third Position. There’s a reason why this position often causes the most dizziness in our patients, and that’s because it is the movement that really mobilizes the otoconia toward the exit of the canal. Make sure you roll your patients all the way onto their side and have them tuck their chin and point their nose down towards the bed.
3. Tuck the Chin! This is one of the most important tips to prevent complications such as converting the otoconia to a different canal. As just discussed, have your patient tuck their chin when you roll them onto their side, and then keep their chin tucked in the final movement when you sit them up. This ensures the otoconia move exactly where they are supposed to, and you get a quick resolution.
Hopefully these tips help you the next time you do the Epley Maneuver with your patients. Overall, BPPV is no longer a condition that has to be intimidating or reserved for management by vestibular physiotherapists. The more therapists that are aware of BPPV and know how to manage it, the more patients we will see get resolution in a timely manner, with a lower cost to the system and the patients themselves. Take Embodia’s BPPV Focused Course and/or download the Healing Vertigo App to initiate your BPPV learning!
1. von Brevern M., Radtke A., Lezius F., et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. Journal of Neurology, Neurosurgery and Psychiatry. 2006;78(7):710–715. doi: 10.1136/jnnp.2006.100420.
2. Oghalai JS, Manolidis S, Barth JL, Stewart MG, Jenkins HA. Unrecognized benign paroxysmal positional vertigo in elderly patients. Otolaryngol Head Neck Surg. 2000 May;122(5):630-4. doi: 10.1067/mhn.2000.105415. PMID: 10793337.
3. Agrawal Y, Ward BK, Minor LB. Vestibular dysfunction: prevalence, impact and need for targeted treatment. J Vestib Res 2013;23:113–7. 10.3233/VES-130498
Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD, Steiner RW, Do BT, Voelker CC, Waguespack RW, Corrigan MD. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngol Head Neck Surg. 2017 Mar;156(3_suppl):S1-S47. doi: 10.1177/0194599816689667. PMID: 28248609.
Join Cheryl Wylie, vestibular physiotherapist, in this 2.5 hour course titled Beyond BPPV – Understanding Vestibular Rehabilitation.
This live online course will take your vestibular knowledge a step beyond the classic BPPV condition, where you will learn about the most common conditions that cause vestibular dysfunction and gain an understanding of vestibular rehabilitation.
When we look at a typical caseload of vestibular physiotherapists, we see two diagnoses most often over any others: Benign Paroxysmal Positional Vertigo (BPPV) and Unilateral Vestibular Hypofunction (UVH).
This course is here to focus on the latter, along with its counterpart, Bilateral Vestibular Hypofunction (BVH). UVH and BVH result in reduced function of the vestibular nerve in either one or both ears.
Patients typically report dizziness, vertigo, and imbalance along with reduced quality of life. The good news is that many of these patients are candidates for vestibular rehabilitation, so gaining an understanding of how to assess and implement a vestibular rehabilitation program will allow you to greatly impact their recovery.
Review the anatomy and physiology of the vestibular system in relation to UVH and BVH
Discuss the primary causes of UVH and BVH including vestibular neuritis, vestibular labyrinthitis, and ototoxicity
Go over the signs and symptoms of UVH and BVH, comparing their presentation to BPPV
Learn about the Vestibular Ocular Reflex (VOR) and how it is affected with vestibular hypofunction
Complete a vestibular assessment without any specialty equipment (e.g. vestibular goggles, VNG equipment, or balance assessment platforms) including VOR testing, balance and gait assessments and motion sensitivity testing
Be able to generate a diagnosis based on your assessment findings
Learn the concepts of vestibular rehabilitation, including specific vestibular exercises that can be found on Embodia and how to implement them.
This online course is intended for physiotherapists, occupational therapists, chiropractors, kinesiologists, athletic therapists, PTA/OTAs and anyone else in the healthcare industry who has an interest in vestibular rehabilitation. Vestibular and concussion therapists who are looking to understand Embodia’s vestibular exercise platform, education material, and resources will also find this of value.
Note that no pre-requisite course or knowledge is required. If you are interested in learning about BPPV however, check out Embodia’s BPPV Feature Course also with Cheryl Wylie as well as the Benign Paroxysmal Positional Vertigo (BPPV) Resource Package which contains 15 BPPV exercises, patient education, and an assessment and treatment flow chart.
You wake up one morning and suddenly your head is spinning and it feels like you are going to fall over. Sound familiar? What’s going on? Could this be BPPV?
Dizziness and vertigo can be caused by a variety of things, anywhere from medication usage to blood pressure issues or even jaw problems! So how do you know if your dizziness is due to BPPV?
I recommend you ask yourself these 4 simple questions:
1. Does looking up increase your dizziness?
2. Do quick movements of your head increase your dizziness?
3. Does turning in bed increase your dizziness?
4. Does bending over increase your dizziness?
What were your answers? If you answered YES to all of these questions, there’s a pretty good chance your dizziness is being caused by BPPV.
So now what? Stay tuned as I dive into what BPPV and what you can do about it!
Do you think you have BPPV, but are not getting relief from the Epley Maneuver? It could be because your BPPV is in a different canal!
BPPV occurs in the posterior canal 9/10 times, and the Epley Maneuver is the go-to treatment for this. But for 10% of cases, BPPV can occur in the horizontal canal.
So how do you know if this could be your case?
I recommend testing for this using the Head Roll Test. This test isolates the horizontal canal and will pick up on BPPV if it is present. When you do this test, you may feel dizzy on both sides, so pay attention to which side makes you feel the most dizzy, as that is likely the side you will need to treat!
Swipe to see sections of the Head Roll Test to try at home. For a full video of the Head Roll Test, along with treatment recommendations, check out the Healing Vertigo App or the Healing Vertigo YouTube Channel.
An implant to treat chronic dizziness is in the testing phase and its really exciting!
The John Hopkins University School of Medicine has begun research into a multichannel vestibular implant. The implant bypasses the malfunction area of the inner ear and stimulates the vestibular nerve in response to signals.
It consists of two parts:1. An implanted device that stays just under the skin and connects to the vestibular nerve2. An external tiny gyroscope that can track head rotations in three dimensions
The external device sends movement data to the implanted device and stimulates the vestibular nerve.
By stimulating the nerve in the right way, people now get vestibular function data to the brain, which can improve balance and reducing dizziness!
So keep an eye out for the progression of this research in the next few years! This could be game changing for people with Bilateral Vestibular Loss!
In celebration of
we will be giving away the Healing Vertigo App to 5 lucky winners!
The Healing Vertigo App is a tool to help you assess and treat Benign Paroxysmal Positional Vertigo (BPPV) all from your mobile device. It can be used by both patients and practitioners, so we welcome everyone to participate!
How to enter:
Follow us @healing_vertigo
Like this post on facebook or instagram!
Tag a friend in the comments who you think would like the App - unlimited entries! *One tag per comment
Bonus 5 entries: share this post to your story and tag us! (P.S. If your account is private, please screenshot and send to us for proof)
Giveaway ends May 15 at 8pm EST! Winners will be chosen at random and will be notified within 24hrs of the giveaway closing.
This promotion is in no way sponsored, endorsed, administered by or associated with Instagram
Research has shown that people with lower levels of Vitamin D not only have a higher tendency of getting BPPV, but they also have higher recurrence rates as well.
The good news is that emerging evidence is showing that we can now do something about that!
In a study published in Neurology in 2020, researchers were able to show that taking Vitamin D and Calcium supplements reduced the recurrence of BPPV by an average of 24% over a one year period.
And the lower your Vitamin D levels were, the more beneficial the supplement seemed to be. At the lowest level of 10ng/mL, Vitamin D supplements reduced peoples recurrence of BPPV by an outstanding 45%!
So if you are dealing with recurrent BPPV, I recommend you have your doctor check your Vitamin D and Calcium levels and ask them about supplementation. It may make a world of difference!
There are many causes of vertigo which this article outlines really nicely.
The most common cause, which also happens to be one that you can treat yourself at home, is BPPV, and that is what the Healing Vertigo App focuses on! In this case your vertigo comes in short episodes and is often related to movements such as looking up or rolling over in bed.
If you have vertigo review this short article and reach out to us with any questions you may have!
I feel so grateful! Today was InterACTION 2021 held by the Ontario Physiotherapy Association @ontariophysio. Normally being “stuck” abroad the thought of attending something like this and connecting with my colleagues would be out of the question. One silver lining of COVID was the movement of this summit to an online platform. I loved spending the day listening to brilliant colleagues discuss various topics, visiting the sponsor booths, and catching up with old friends while meeting new therapists in the OPA Networking Room. Congrats @ontariophysio on a successful and deeply rewarding experience! I can’t wait for next year!
There are many predisposing factors for BPPV such as older age, female, and even genetics.
But one connection that surprised myself and I think many therapists was the link between BPPV and Anxiety.
In fact, people diagnosed with an anxiety disorder are TWICE as likely to be diagnosed with BPPV than those without.
We don’t completely understand this linkage yet, but theories connecting the inflammatory process and the neuroendocrine process of the two conditions appear similar.
So how does this affect how we treat BPPV?
Personally, my take home message from this research is that we need to listen to our patients and understand the connection. Anxiety disorders produce a variety of symptoms which can vary from person to person, and dizziness can be one of them.
It is important to not sum up all symptoms to someone’s anxiety disorder and instead inquire and ask more questions, especially if dizziness is new to the patient, or their dizziness has changed recently.
If you or your patient are feeling dizzy, it takes only 2 minutes to run through the BPPV tests which can be done at home. If you aren’t sure how to do that, head to the Healing Vertigo App or our free YouTube Channel to learn how!
This month, Almufarrji & Munro published a study in the International Journal of Audiology linking Covid-19 with ongoing audio-vestibular symptoms.
They looked specifically at hearing loss, tinnitus and vertigo, and found a prevalence rate of 7-15% in adults. This research is still new and more rigorous studies are needed, but these findings are important as we look forward into our future. We may be seeing an emergent health condition that is going to require understanding and patience as we learn to manage and treat these secondary effects of Covid-19.
A year long study is being initiated to look more into the long term effects of Covid-19 on the audio-vestibular system, specifically amongst people who have been previously hospitalized with the virus.
Resource: Ibrahim Almufarrji & Kevin J. Munro (2021). One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms, International Journal of Audiology, DOI: 10.1080/14992027.2021.1896793
Some interesting new research is emerging regarding the effects to the audio-vestibular system and COVID-19. More research is needed, with more rigorous measures, but preliminary studies show anywhere from a 7-14% prevalence of hearing loss, tinnitus and vertigo after suffering from COVID-19.
Some healthcare providers that can help with these symptoms include your family doctor, audiologists, vestibular physiotherapists and ENTs just to name a few!
I am reading the chat script from the @embodia BPPV Webinar I hosted with @maggiebpt and I am absolutely blown away! Attendees were from all across Canada, even reaching international folks, and the feedback from the webinar was beyond my expectations. I am still new at this teaching game, with only a few years of experience. So reading all of your encouraging words and feedback was amazing!
The webinar was such a success that Embodia has recorded it and turned it into a course! This course is designed for healthcare providers, however its ease and simplicity makes it also accessible to patients as well who are looking to learn more about their condition. Access to the course can be found in our bio, or on @embodia
And if the course seems like too much work to you, well there’s an app for that! The Healing Vertigo App takes all the knowledge and logic flow clinicians use to treat BPPV and puts it into an app, making treatment accessible to all. For more information, click on the Link in our Bio!
I had a wonderful time speaking with Maggie from Embodia and all the attendees who joined us on a Saturday morning to learn about BPPV! Despite the webinar going longer than expected, the turnout was amazing. And a special thank you to those 100 people who stuck around right until the end for the full question and answer period! You guys are rockstars!
If you weren't able to catch the webinar live, not to worry. We recorded it all and it is being turned into a course on Embodia
Cheryl will be doing a live webinar on BPPV Saturday. While the event is full it will simulcast on facebook live.
I'm very excited this webinar has now sold out! Not to worry though there is a wait list as well as a live Facebook stream for those who weren't part of the first 500 to get a seat.
#Repost @embodia• • • • • •Cheryl Wylie (@healing_vertigo), vestibular physiotherapist, is teaching a free 90-minute webinar with us about Benign Paroxysmal Positional Vertigo (BPPV).
BPPV is a condition of the inner ear which causes episodes of dizziness, vertigo and imbalance.
The webinar room is full but we've started a waitlist! We will let everyone on the waitlist know when seats become available!
“It is common for a patient to consult 4 or more physicians over a period several years before receiving an accurate vestibular diagnosis” – @vestibularveda, Top 10 Facts About Vestibular Disorders.
Does this statement surprise you?
One of the goals of creating Healing Vertigo was to increase exposure of vestibular impairments, such as BPPV, and help people learn how to address and treat it. Having to see 4 different practitioners before understanding your dizziness is due to BPPV, or any other vestibular disorder, is unacceptable. So let’s change that! Let’s discuss our vestibular disorders, share resources, and educate those around us.
What has been your vestibular experience?
Now not only is Healing Vertigo available on Google Play, but you can also find it in the App Store. Don’t believe me? Go check it out!
But before you do that, here’s a reminder of who I am, and what Healing Vertigo is. I am a physiotherapist and passionate about vestibular rehabilitation. Vertigo caused by Benign Paroxysmal Positional Vertigo (BPPV) is very common and can be treated independently if you have some guidance. And with everyone being told to stay home, we thought it was important to give people a tool they can use at home to help treat their vertigo.
This in an interactive app which walks you through the testing, clinical impression and treatment of BPPV. Included are videos of the maneuvers along with helpful tips and recommendations. All videos are also published on YouTube as a free resource.
So if this interests you, a fellow colleague, a patient, or someone you know, please share this with them.
Okay, NOW you may go a check out Healing Vertigo on the App Store! And don’t forget to rate us and let us know what you think!
P.S. I didn’t have an apple for this photo so I’m holding a grapefruit instead
For the first time in 6 months I finally feel recovered! Warning: this post has nothing to do with vertigo! This summer I fell and broke 3 ribs, which left me fairly immobile for nearly 6 weeks. On the day of my final appointment with the doctor I fell off the bus and broke my ankle!
Turns out being a physiotherapist does not make you immune to clumsiness! So began another 6 week recovery period
My ribs overall improved well but my ankle continued to give me trouble (doesn’t help this was the 6th time this ankle has broken!) I am currently living in the Caribbean on a boat, and my balance was horrible. I had trouble walking on sand, I couldn’t put my fins on to swim, and hiking was totally out of the question.
With lots of focused rehab I began to slowly overcome each obstacle:
Walk on sand
Snorkel with fins (just achieved this one last week! This one was tough!)
Yesterday was the final accomplishment, completing a hike up to the top of a mountain with no pain or mobility issues! So big oldfor me!
Where ever you are in your recovery process, stay positive and keep going! Not every day will be a step forward, but don’t let that discourage you. Trust me, I thought break number 6 just may be the last straw for this ankle and felt sad and frustrated many days. So I hope sharing this helps to keep you motivated, to keep up your exercises, and to keep attending those healthcare appointments. You got this!
To remind you, the Epley Maneuver is a BPPV treatment technique used to move crystals out of the posterior canal. After completing this maneuver hundreds of times with hundreds of patients, here is what I’ve learned to make it successful:
1. TAKE YOUR TIME. Many instructional videos recommend you wait in each position for your dizziness to stop plus 30 seconds. Me? I wait a full 2 minutes after your dizziness has stopped. This is because it often takes a while for the crystals to move within the canal, especially if you are older.
2. FOCUS ON THE ROLL STEP. There’s a reason why this position often causes the most dizziness, and that’s because it’s a key position that really moves the crystals. Make sure you roll all the way onto your side, tuck your chin, and point your nose down towards the bed.
3. TUCK YOUR CHIN! This is one of the most important tips to prevent complications such as converting the crystals to a different canal. As just discussed, tuck your chin when you roll onto your side, and then keep your chin tucked in the following movement when you sit up. This ensures the crystals move exactly where they are supposed to, and you get a quick resolution.
If you are looking for instructional videos which includes tips like these, head over to our YouTube Channel. You can find the Epley Maneuver, along with many other BPPV tests and treatment maneuvers!
Is it okay to take anti-nausea medication when treating BPPV?
My opinion? Absolutely!
The treatment of BPPV can cause many people to be nauseous or sick. In fact, some can’t even get through the treatment maneuvers due to nausea, limiting them from resolving their BPPV and ultimately feeling better.
The good news is that managing your nausea has no effect on the success of your BPPV treatment. So go ahead and consider nausea management. And management doesn’t just mean medication. Below is my favourite ginger tea recipe I make for myself when feeling nauseous.
1 cup water
2-3 slices of fresh ginger
½ tsp honey
½ tsp lemon juice
Boil water and add ginger, honey and lemon juice. Let steep for 5-7 minutes. Remove ginger, drink and enjoy!
For more tips from a vestibular therapist, follow along!
If you have used the Healing Vertigo app, or have searched how to test for BPPV, you may have come across the Side-Lying Test. This test assesses the same thing as the Dix-Hallpike Test. So why use it?
The Side-Lying test is a great alternative if you are not able to lie on your back. Do you have low back pain? Maybe gastrointestinal issues or heart burn? Lying flat on your back, even for just a minute, can be very uncomfortable and avoided with the Side-Lying Test.
What about limited neck mobility? The Side-Lying test also doesn’t require as much neck extension as the Dix-Hallpike test, making it a great option if you cannot look up to the ceiling easily.
Next time you or someone you know experiences vertigo, keep this test in mind. It is just as effective as the Dix-Hallpike in detecting BPPV, and may just save you a lot of aches and pains!
If you are looking for instructional videos which includes advice and tips like this, head over and subscribe to our YouTube Channel. You can find the Side-Lying Test, along with many other BPPV tests and treatment maneuvers, all for free!
There are three canals in our inner ear which could be affected by BPPV, but did you know that over 80% of most cases stem from the posterior canal?
When you look at how the inner ear is orientated it makes sense. Crystals normally sit in the centre part of the inner ear, but sometimes the crystals break free which allows them to fall into other areas (and cause BPPV). And due to the orientation of the posterior canal, this poor guy seems to get most of the visitors!So when checking for BPPV, I keep this in mind and assess the posterior canal first with the Dix-Hallpike test.
Below is a example of the test. If you want to see more instructional videos head over to YouTube!
If you have you will know it can stop you in your tracks! So what is going on that is making you so dizzy?
It is all coming from a little system deep in our inner ear called our vestibular system. This system consists of three circular canals, which are important for our balance and orientation.
Small crystals that live in the centre part of our vestibular system can fall out and they can end up in one or more of these canals. This changes how our system works and the result is a whole lot of spinning, dizziness and vertigo, especially when you move your head.
The assessment and treatment of BPPV is all about finding which canal these small crystals are in, and then moving your head in a specific way to move the crystals out of that canal and back where they belong.
So next time you set out to treat your BPPV, try to imagine all that is happening inside this teeny tiny system!