Vertigo, Inner Ear & Dizziness

Vestibular Rehabilitation (Dizziness and Vertigo)

Vertigo, Inner Ear & Dizziness

Vestibular Rehabilitation’ is an area of focus in my physiotherapy practise – I am often asked what exactly that means. The vestibular system (involving your inner ear) is responsible for sense of movement, body orientation and balance. The vestibular system (along with our eyes, muscles, and joints) send constant feedback to our brain about our body’s movement and orientation.

Dysfunctions, disorders, trauma or viruses that affect the inner ear can be a potential cause of vertigo, dizziness, decreased balance, tinnitus (ringing in the ears) or a change in hearing. As a vestibular therapist I can assess the potential causes of the mentioned symptoms and provide treatment to help decrease dizziness, vertigo and improve balance.

Dizziness is the umbrella term that refers to a sensation of abnormal, unwanted, movement – a feeling of unsteadiness, lightheaded or feeling ‘off’. Vertigo is a more specific term and implies that there is a rotational component to your dizziness – either the room is spinning around you or you are spinning in the room. Both vertigo and dizziness are symptoms, not a diagnosis, so part of my job is to figure out the possible cause and provide treatment.

One of the most common conditions within the inner ear that I treat is a condition called BPPV – benign paroxysmal positional vertigo. BPPV is caused by a crystal that is free floating within the inner ear. The signs and symptoms are pretty easy to recognize (vertigo brought on when lying flat, rolling in bed, looking up to the ceiling or bending forward). Treatment for BPPV is also quite effective.

It is also important to recognize that not all causes of vertigo or dizziness are associated with problems in the inner ear. Cardiovascular (heart) disorders, thyroid conditions, anxiety, migraines, neck disorders/injuries and neurological conditions are all potential causes.

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Sun City Physiotherapy Locations

Robina Palmer, B.Sc.PT, CAFCI, Vestibular Therapist

Robina Palmer is a registered Physiotherapist and co-owner of Sun City Physiotherapy.

Robina is a graduate of University of British Columbia’s School of Rehabilitation Medicine. She has practiced in sports and orthopaedic rehabilitation in various clinical settings throughout the United States and Canada.

suncityphysiotherapy.com/our-team/the-downtown-kelowna-team/robina-palmer/

BODY ROLLING: A new way to enhance flexibility and well being.

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Physiotherapy » Posts Tagged "physiotherapist winfield" (Page 2)

BODY ROLLING: A new way to enhance flexibility and well being.

How often do you get a tight area in your back that you’d love to get rid of? Or a tense band in your buttock or hamstring that has plagued you for weeks?
Have you noticed that your shoulders round forward, and you’re tight across the back of your shoulders?
The nagging tight spots we feel can be the result of restricted mobility or adhesions in fascia, the elastic web of connective tissue that surrounds and connects muscles.

There is a technique to improve flexibility that is easy, inexpensive and works extremely well in conjunction with stretching to improve myofascial mobility. It’s called Body Rolling, and it’s a powerful self-treatment tool using a firm 5” diameter ball. It is similar to using foam rollers, which are popular in gyms. Because of its size and compressibility, it is useful in areas other tools can’t reach.

Body Rolling techniques combine the relaxing effects of massage with the toning effects of exercise. Working with your own body weight, the exercises ease movement by loosening the muscles and their surrounding fascia, with the benefits of a deep self-massage. It can take as little as 10 minutes to work a specific area, and you can do it at your convenience. Working an entire region or chain of muscles gives the best results, since fascia is connected in long tracts that can span more than one joint.

The techniques of Body Rolling can: free adhesions in the connective tissue sheath that wraps around muscles and lies between muscle fibres; help muscles lengthen; improve muscle flexibility and tone thereby improving range of motion and shock absorption in the joints; improve circulation; and assist in correction of faulty posture

People with an active lifestyle often come in to see a physiotherapist with unexplained pain in a muscle, tendon or joint. Physiotherapists look at posture, movement and perform selective tissue tension testing to determine the problem. As a physiotherapist, I use many tools, such as manual therapy, exercise and soft tissue releases to improve freedom of movement.

With exercise that is highly repetitive in nature such as running, cycling, rowing, racquet sports, fascia surrounding the working muscles tends to be loaded in one direction and can subsequently shorten. Movement patterns and normal posture can be altered, which can lead to injury and pain. Learning to use Body Rolling, and stretching along planes of movement, rather than spot-treating tight areas can free things up most effectively.

People working at a desk job every day tend to develop shortening in certain muscle groups– typically the pectoral muscles, the hip flexors, and the hamstring muscles. Over time, this can result in adaptive shortening. The price tag of a desk job can be poor posture, aches and pains at the end of the workday. Activity breaks and Body Rolling can help.

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Iliotibial Band Syndrome and Running

Sports

Running is a popular activity that can help maintain or improve your cardiovascular fitness and in some cases help you lose weight. There are many different reasons to run but often there is a goal set that may include 5Km, 10Km, half marathon, or full marathon.
When training for longer runs including 10km, half and full marathons it is important to remember that the training schedule should take place over long periods of time to allow your muscles and joints to accommodate for the increased strain that will be placed on them during the long run. As a physiotherapist, I treat many runners with all sorts of injuries. Some of the most common injuries include plantar fasciitis, achilles tendonitis, muscle strains, and Iliotibial band friction syndrome (IT band syndrome).
IT band syndrome is a repetitive stress injury that occurs when the iliotibial band glides over the lateral femoral condyle on the outside part of the knee. The iliotibial band is the thick band that runs from the outside of the hip down to the outside of the knee. It is a common injury for long distance runners (20-40 miles/week) but is not limited to only long distance runners. Running on various terrains can increase the risk of developing this condition. Up and down hills, graded slopes, and cambered roads have all been shown to increase the risk. This syndrome may also be found in other athletes or weekend warriors such as cyclists, weight lifters, and participants in jumping sports.
With IT band syndrome there is rarely a history of trauma. Patients will often complain of knee pain that may be difficult to localize and usually increases with repetitive motions like running. The symptoms usually get worse with changes in training surfaces, increasing mileage, or training on crowned roads.
Studies have found that long distance runners with IT band syndrome have weaker hip abductor and glut muscles on the involved leg compared to the uninvolved leg. The hip abductor muscles are located on the outside part of the hip and help prevent the leg from moving towards the centre of the body. It is also noted that fatigued runners are more prone to having their hip adduct (move towards the centre) and internally rotate (leg turns inwards) which causes more friction on the iliotibial band and therefore the symptoms get worse.
The management of IT band syndrome usually includes: 1) activity modification (usually decreasing mileage). 2) New running shoes. Shoes should be replaced about every 500km. 3) Heat or ice. 4) Stretching the IT band. 5) Strengthening the hip abductors and glut muscles.
If you are interested in pursuing long distance running you should: 1) follow a certified training schedule. 2) Make sure the shoes you are wearing are the right shoes for you. 3) Increase your mileage slowly to allow your body to accommodate for the increased strain. 4) Hit the gym – muscle weakness can cause problems down the road. 5) Go in for an assessment with a health care professional if you start to experience aches and pains that aren’t going away.

Tennis Elbow

Elbow, Wrist and Hand

Tennis Elbow – you don’t need to play tennis to get it!

Tennis elbow is so called as one of the reasons you can get it is from faulty technique in a tennis shot. This is only one of the ways that you can get tennis elbow though, it can come on from many other activities that involve a lot of wrist and forearm use.

The medical name for this condition, lateral epicondylitis, gives us more information about where the problem occurs. The lateral epicondyle is a small bony prominence on the outside of the elbow and is the point of attachment for the tendons of the wrist extensor muscles. These muscles run up the top of the forearm and play a role in movements such as bending the wrist back, making a fist, and twisting the forearm.

Lateral epicondylitis occurs if these muscles are used more than they are used to, resulting in pain and damage to the tendon where it attaches onto the bone at the lateral epicondyle. If you have tennis elbow, you will likely report an increase in pain when gripping tightly or shaking hands, using a screwdriver or twisting a jar, or any activity that requires wrist and hand use. The outside of the elbow can be very sensitive to touch, and you may find it will get very stiff, especially first thing in the morning.

In order to treat tennis elbow, it is important to identify the reason why it became injured in the first place and correct that. Apart from stopping the aggravating activity, there are often other contributing factors that need to be changed in each individual case. These can be related to our own anatomy in the elbow and arm, movement patterns which are overloading and therefore damaging the tendon, or factors relating to the equipment being used.

A physiotherapist can identify the changes that need to be made in each individual case and implement these. As well as this there is specific treatment that can be done to the tendon to ensure optimal healing such as friction massage and laser, and a stretching and strengthening program should be implemented too to ensure the muscles and tendons are in good shape to be able to cope comfortably with being used in the future.

So even if you don’t play tennis, you can still be affected by tennis elbow. Taking the right action will take your pain away.

Don’t take a holiday from good low back posture.

Back

Don’t take a holiday from good low back posture.

Trains, planes and car rides to visit friends and family; sitting down for a big turkey meal; sledding or hitting up the ski hill on snowy days; lounging around on Christmas morning admiring the tree and wrapped presents – this all sounds like a perfect holiday. While it is a wonderful combination for good times and many smiles, it unfortunately for some can also be a perfect recipe for a sore back. Something that all of those activities listed above have in common is a forward bent – or ‘flexed’ – position of the low back.

With normal standing posture, the low back has a slight curve, which is known as ‘lordosis’. When we bend forward or sit, we lose the lordosis and our lumbar spine – the low back – goes into flexion. Spending too much time flexed, or performing heavy tasks in this position, can put a strain onto the lumbar discs. The ‘intervertebral disc’ is a structure that sits between adjacent vertebrae in the spine. It is composed of a tough, fibrous periphery with a gel-like nucleus in the centre. Repetitive or sustained flexion, as well as heavy lifts or bends, can injure the disc by causing tears in the fibrous rings. When this occurs, the gelatinous nucleus can bulge into the tear. In more severe cases, the gel can even push outside of the disc. It is most common for injury to occur in the back of the disc rather than the front.

To visualize what happens, imagine a jelly donut, where the dough is the fibrous outside of the disc, and the filling is the nucleus. Line up the hole that was used to fill the donut as being at the back/side of the imaginary spine. If you push on the front of the donut, the jelly will squeeze out toward the back, and can even push out of the donut (which would be the case in severe injury, or ‘prolapse’). Forward bending is similar to this – there is an increased pressure on the front, and a suction force at the back, causing the gelatinous nucleus to move posteriorly if the fibrous rings are not holding it in place. Even with just an outward bulging of the disc (so, the jelly in the donut has moved but hasn’t escaped through the hole) can cause inflammation, and irritation of surrounding tissues, including nerves.

There are several strategies that can be used to help in the prevention of lumbar disc injuries. A few are:

Use a firmly rolled towel, or a ‘lumbar roll’, in the curve of your low back if sitting. It is helpful to keep one in your vehicle
Avoid the slumped position when sitting. A lumbar roll helps with this, as does your leg posture. Having your hips and knees in a deep bend, such as in a low chair, increases the forward bend in your back
Take standing and walking breaks when traveling, or during long meals
Stay flexible – tight hamstrings (backs of the thighs) in particular can have an effect on low back posture
Keep a strong core to help support your back during activities. This doesn’t necessarily mean doing crunches or sit-ups, but exercises that target the deep core muscles
During the post-holiday clean-up, avoid stooping to bend down to pick things up. Instead, bend your knees and hips to get into a good squat position. It’s a good way to exercise your legs, too!

Even with taking precautions, injuries can occur either with a single incident or over time. When this is the case and you notice you are having back pain, it is important to seek care from a health provider. Lumbar disc injuries, along with other causes of low back pain, can often be treated conservatively (meaning, non-operatively). It is important to note that not all back pain is due to disc injury. A physiotherapist can help to determine what structure may be causing your pain, and give you appropriate exercises, stretches, hands-on treatment, and strategies for management, specific to your injury.