People often use the word “dizziness” when talking about a variety of symptoms. It is important for you to be able to differentiate between these symptoms, because the cause, diagnosis and treatment cn be quite different. Dizziness is a sensation of lightheadedness, faintness, or unsteadiness. Unlike dizziness, vertigo has a rotational, spinning component, and is the perception of movement, either of the self or surrounding objects.
Vertigo is often caused by an inner ear problem. One common cause is called benign paroxysmal positional vertigo (BPPV). This occurs when tiny particles of calcium form in canals of the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity. With this move of crystals from one area to another, the inner ear tells the brain you’re moving when you are really not.
Physical therapists can perform specific testes to determine if you have BPPV and will guide the treatment. One such test includes examination of the eyes for nystagmus, an involuntary rapid eye movement. If BPPV is found, the patient is guided through a repositioning treatment involving the head and neck called the Eppley maneuver. The PT will guide you through a series of position changes designed to relocate the crystals to their appropriate area in the inner ear. With treatment, symptoms should significantly decrease or completely resolve.
Physical therapy can play a strong role in recovery of symptoms. Treatment would involve an exercise-based program to improve balance and reduce symptoms related to dizziness. Specifically, treatment would include:
● visual stabilization training
● postural education
● balance training
● cervical mobility and stretching
Expected outcomes from treatment include decreased risk of falls, improvement in balance, improved ability to stabilize vision, an increase in cervical mobility, and a return to prior level of function.
Active Marin Physical Therapy is excited to offer Myofascial Decompression to help patients dramatically improve mobility and reduce muscle tissue tension. This technique, rooted in Eastern Medicine, uses negative pressure cups coupled with functional movement patterns and Neuromuscular Reeducation. Myofascial decompression is currently being used by Olympic athletes such as gold medalist Michael Phelps and US men’s gymnast Alex Naddour for pre and post-workout recovery and detoxification.
What Is Myofascial Decompression?
It is used to decompress adhesions and scar tissue, relax muscles in spasm, decrease trigger point pain, and to reduce inflammation following trauma. Over time, the treatment can be used to increase muscle endurance, circulation, and lymphatic drainage and to enhance the overall ability to recover from strenuous activity.
What are the benefits?
1. Decompresses adhesions and scar tissue
2. Helps relax muscles in spasm
3. Stimulates oxygenation and detoxification of blood while promoting a feeling of lightness and relief of pressure
4. Helps separate the various layers of fascia and muscle under skin
5. Increases range of motion and promotes healing in scar tissue and chronic injury sites
6. Increases lymphatic drainage & promotes circulation
7. Enhances the overall ability to recover from strenous activity
What can it treat?
Myofascial Decompression has been shown to be effective for tight and stiff muscles as well as those suffering from back pain, sciatica, piriformis syndrome, IT band pain, rotator cuff injuries, and plantar fascitis.
Sometimes when we are injured we forget to remember that the simple act of getting adequate sleep can be a huge contributor in helping us heal. The National Sleep Foundation’s sleep guidelines recommend 7-9 hours for the average adult with additional sleep and recovery time needed after injury and surgery.
Sleep is an active physiological process, one in which your body is busy carrying out vital activities while you are unconscious. While asleep your body alternates between 2 forms of sleep, REM (rapid eye movement) and non-REM. While REM sleep provides the energy needed to restore the mind, non-REM sleep is essential for restoring the body.
During the restorative phase of non-REM deep sleep, the blood supply available to your muscles increases, delivering extra amounts of oxygen and nutrients to facilitate healing and growth. Additionally, deep sleep allows for scar tissue to form which the body needs to create and repair injuries and allows our pituitary gland to release growth hormone that is essential for increased muscle mass, bone strength and energy.Physical Therapists can teach you how to position your body in the most effective way while sleeping to promote productive healing. For instance, if you have a low back injury it is helpful to keep your spine in a neutral position by putting a pillow under your knees while you sleep on your back or between your knees if you sleep on your side. Proper positioning techniques for shoulder or neck pain can also be instrumental in sleep comfort.
How Can Physical Therapists Help With Sleep?
Physical Therapists provide education about the importance of aerobic exercise to aide with sleep as well as teach relaxation techniques. Diaphragmatic breathing is one such technique which helps relieve physical muscle tension, allows the mental function to slow and relax, improves blood flow to muscle tissues and activates parasympathetic nervous system.
Sleep Hygiene Tips:
- Go to bed and get up at more or less the same time every day
- Sleep when sleepy
- If you haven’t been able to get to sleep after about 20 minutes or more, get up and do something calming or boring until you feel sleepy, then return to bed and try again
- Avoid caffeine, alcohol and nicotine for at least 4-6 hours before going to bed
- Develop a sleep ritual 15 minutes before bed each night to remind your body that it is time for sleep
- Eat a healthy, balanced diet
- Having a hot bath 1-2 hours before bedtime can be useful to , as it will raise your body temperature, causing you to feel sleepy as your body temperature drops again
- Avoid taking naps
- Regular exercise is a good idea to help with good sleep, but try not to do strenuous exercise in the 4 hours before bedtime
- Avoid clock-watching which can reinforce negative thoughts such as “Oh no, look how late it is”
Recommended Sleep Positioning
It is recommended that you either sleep on your back with a pillow under your knees to protect your back or on your sides with a pillow between your legs and arms. A body pillow can be a very nice purchase for proper alignment. Sleeping on your stomach can be very aggravating for your low back and neck as the extreme rotation and hyperextension can cause tissue imbalances.
This month I would like to discuss the benefits of dynamic over more traditional, static stretching when it comes to warming up before training or competition.
Most of us are familiar with “static stretching” which consists of various techniques to gradually lengthen a muscle for up to 2 minutes while the body is at rest. Although this type of stretching has been routinely used as a way to loosen up muscles before exercise, research is now showing that static stretching can actually hinder one’s power output, joint stability, reaction time and coordination. When you think about it, why would one stretch while the body is “at rest” when within minutes you might need to explode from a starting block or hustle up and down a basketball court? Current research suggests that static stretching should be reserved for after work outs or sporting events and may have little benefit before your activity.
The use of “dynamic stretching” which involves stretching specific muscle groups while continually moving throughout a warm up is now considered to be a much more effective, efficient and fun way to warm up before intense exercise.
Benefits of Dynamic Stretching
1. Prepares your body for exercise by actually activating sport-specific muscles and joints you will be using during your workout.
2. Increases your muscles’ core temperature for improved power output
3: Helps you mentally transition from rest to competition by challenging your body awareness, balance and coordination.
4: Improves range of motion and flexibility around your joints which helps reduce chance of injury and improve performance
The Rotator Cuff and Shoulder Girdle
By Megan Morgan, DPT
A recent study that was conducted in Finland determined that Physical Therapy alone for non-traumatic rotator cuff tears (supraspinatus) results in equal functional outcomes at one year compared to surgically repaired tears. All of the groups in the study received the same Physical Therapy (PT) instruction and prescription of a home exercise program as well as 10 PT sessions. The study found that patient’s who did receive surgery did not report any superior results than those who only received PT.
Role of the Rotator Cuff and Scapular Stabilizers
The rotator cuff is a group of four muscles that connect the humerus (upper arm) to the scapular (shoulder blade). These muscles not only create movement of the arm but they play an integral role in providing stability to the shoulder joint. The tendons of these muscles form together to create the cuff; which work together to create a force couple relationship that results in the humerus to remain centered on its base of the scapula (also known as glenoid). When a muscle of the rotator cuff is torn dysfunction of this force couple relationship results and the shoulder has difficulty maintaining its stability.
Another critical component of a healthy functioning shoulder is scapular strength and proper muscle activation. The scapula is the base that connects our humerus to our body via the placement of the humeral head on the glenoid of the scapula. There are multiple muscles that connect our scapula to our spine and these are referred to as our scapula stabilizers. A common analogy for the role of these stabilizers is a seal trying to balance a ball on its’ nose; they have the role of creating a stable base so the ball (humeral head) can stay balanced for the humerus to move on. These muscles are just as important to providing stability to the shoulder joint, as the rotator cuff. Therefore it is important to strengthen these stabilizers and create the proper awareness of one’s scapula position. Physical Therapists are here to help develop your awareness and the appropriate individualized strengthening program.
The study was limited in that it only incorporated individuals whose tears were <75%. Therefore, we cannot apply these findings for all rotator cuff tears, as the severity of tears varies between individual cases. But an important take away message from this study is that for partial rotator cuff tears PT and a home exercise program can independently get you back to your prior activities of choice.
The overall injury rate related to ski injuries has declined due to the improvement of ski equipment in recent years; such as decreased extremity fractures and other severe injuries. However, the incidence of knee sprains has increased; and according to a recent survey study by the Orthopaedic Journal of Sports Medicine knee injuries account for 1/3 of skiing injuries. The top causes of injury include mechanical forces that occur during a fall, collisions and equipment induced injury.
The two most common injuries are medial collateral ligament (MCL) sprains (15-20% of ski injuries) and anterior cruciate ligament (ACL) tears (~100,000 reported annually from skiing). The MCL is a ligament that stabilizes the inner portion of your knee from valgus forces (lateral to medial). The ACL is an internal ligament in the center of your knee, which stabilizes your knee to maintain proper alignment. With injury to your ACL, your knee becomes unstable.
Regardless of the severity of a ligament sprain, physical therapy is an integral part of your rehabilitation. In certain cases surgery is the treatment of choice due to the severity of the tear and patient’s desired return to physical activity. Physical therapy is important for surgical cases, pre-operatively and post-operatively. Less involved tears can be treated successfully with conservative care (non-operatively) with the help from physical therapy to normalize an individual’s knee range of motion, strength, proprioception and walking pattern. All of these factors are important variables for an individual to return to their prior level of physical activity; such as the ski slopes.
General Reminders to Avoiding Ski Injuries:
- Preparation: Lower extremity strengthening and proprioceptive exercises should be a part of your work-out routine in the couple months leading up to ski season. Follow the link below for strengthening exercises, use exercise code: KJ8UHAT Preventative Exercises
- Appropriate equipment and equipment settings: bindings should be adjusted to your level of skiing experience
- Stay on slopes appropriate to your skill level
- Consider taking lessons: it never hurts to get tips from the professionals on the mountain to work on your form
- Fatigue: last run of the day, only you know your body and if you feel fatigued, do not push yourself to squeeze in one last run, as this is the most common time injuries occur
To see the original article click here (http://ojs.sagepub.com/content/2/1/2325967113519741.full.pdf+html) and to read more on tips for knee friendly skiing click here (http://www.vermontskisafety.com/kneefriendly.php)