Vertigo, Inner Ear & Dizziness

Vertigo, Inner Ear & Dizziness

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.

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
downtown@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
glenmore@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
winfield@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
lowermission@suncityphysiotherapy.com
more info
BODY ROLLING: A new way to enhance flexibility and well being.

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

Physiotherapy » Posts Tagged "Kelowna physiotherapy" (Page 5)

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.

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
downtown@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
glenmore@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
winfield@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
lowermission@suncityphysiotherapy.com
more info

TMJ Dysfunction Part 2

Argh! You woke up with another headache, and your teeth hurt from clenching yesterday at work, as you just met another stressful deadline. As you massage your temples and face, which actually feels relieving, your significant other tells you about your loud teeth grinding last night. As you look in the mirror while brushing your teeth, you are always intrigued by how your jaw “wiggles” side to side when you open your mouth. It’s done that for years but hasn’t created any other problems to your jaw function. Sound familiar? You are presenting with Myofascial Pain Dysfunction (MPD) of the Temporomandibular Joint, the TMJ.

The TMJ is the ball and socket joint that connects the Mandible (jaw bone) and the Temporal bone (one of the bones of your skull). It’s the small joint located in front of your ear. There is a cartilage cushion in between the ball and socket, referred to as the Disc. The disc is supported by special Ligaments, which keep the disc in place. Movement problems of the disc can be responsible for creating many symptoms in the TMJ, such as clicking, crepitations, locking, muscle spasm, and pain. There are several muscles which support and control movements of the TMJ. Symptoms can often be related to these muscles. These include temporal pain, headaches, muscle spams, tinnitus and ear pain, and even teeth pain.

TMJ Disorder/Dysfunction, or TMJD/TMD, is seen more commonly in women than men. There is a 3:1 incidence in females to males, and can include one or both jaw joints. In most instances, the dysfunction is a result of an imbalance or change in the normal function of the bones, ligaments, muscles, disc, or nerve components of the TMJ complex.

MPD can be due to various causes of increased muscle tension and spasm. In some instances, MPD can be a physical manifestation of psychological stress. Often, there is no disorder of the joint itself. There is often a history of facial pain and temporal headaches, secondary to Nocturnal (night time) jaw clenching and Bruxism (teeth grinding). Dental issues may have influenced symptoms over time. This might have lead to the use of a nighttime splint. There may also be ear pain, fullness, or tinnitus. Erratic movement patterns of the jaw during opening and closing are related to lack of neuromuscular control, which requires re-education through physical therapy.

The TMJ specific muscles involved in MPD are the Temporalis and Masseter. The temporalis is a fan-shaped muscle that fills the temporal space, and inserts onto the mandible. Its function is to raise the mandible to close your jaw. The masseter is a thick and strong muscle attached at your cheekbone and runs to the angle of the mandible. Its function is to also raise the mandible to close your jaw. Try this: clench your teeth several times and press your fingers firmly on your temples; now on your cheeks. Did you feel tenderness? Aching? Maybe even a sensation like a toothache? WHAT IS THE SIGNIFICANCE? These muscles become subjected to fatigue and overuse with prolonged and persistent clenching and bruxism, which leads to MPD symptoms. It’s like these muscles are running a marathon without rest, everyday!

Proper assessment, diagnosis, and successful treatment rely on a skilled physical therapy practitioner, with expertise in TMJ management. Treatment of MPD is focused on desensitizing muscles through hands-on mobilization, restoration of normal functional movement pattern through exercise, and providing education regarding prognosis and self applied maintenance. Treatment may also include other muscle re-education techniques such as Intramuscular Stimulation (IMS). We look at other mechanical influences such as neck disorder and posture, to assist in maximizing treatment management. At times, we often work with your oral practitioner (dentist, orthodontist, oral surgeon), and other practitioners who deal with behavioural modification, to optimize results.

Vince Cunanan is a TMJ Specialist and registered physiotherapist and associate at Sun City Physiotherapy Downtown Kelowna. He can be contacted at downtown@suncityphysiotherapy.com.

Treatment Options for Hip Osteoarthritis

Hip osteoarthritis is a common condition that involves the degeneration of the articular cartilage of the hip joint. If you have this condition and are noticing an increase in pain and a decrease in physical function you may be wondering what treatment options are available to you.

With osteoarthritis of the hip you may feel a constant ache localized to the groin and side of your hip and sometimes extending into the front of your thigh and knee. The hip often feels stiff, especially first thing in the morning when you get out of bed and it can make activities of daily living much more painful including standing, walking and stairs. It can also make it difficult to put your socks on, get into and out of your car and even get on and off of the toilet.

Stiffness, pain and having difficulty with many previously easy daily activities may lead you to want to do less physical activity. The trouble is, not moving will often lead to weakness, further stiffness and general deconditioning.

A physiotherapist can help design a treatment program with a focus on decreasing pain, increasing range of motion and flexibility, improving core stability, gaining muscle strength and endurance and improving general conditioning. Other functional goals often include improving walking pattern, speed and distance, ability to go up and down stairs without pain and better control going from sit to stand.

This is often accomplished through a combination of education, manual therapy and exercise. An exercise program is often extremely beneficial to help improve physical function and decrease pain. A physiotherapist is an excellent resource to put together a safe and effective home exercise program for you to perform daily at home or at your local gym. Also, if you enjoy swimming, bring this up with your physiotherapist as aquatic exercise is a great form of treatment for hip osteoarthritis.

Other possible physiotherapy treatments that may be effective for some individuals with arthritis of the hip include: acupuncture, massage, heat on the muscles around the hip, ice, TENS, supportive footwear and/or a gait aid such as a cane or walking poles. It is important to talk with your doctor about your arthritis to discuss other treatments that may be beneficial to help manage your symptoms. Certain medications may be helpful, but it is important to bring this up with your doctor to be sure they are appropriate for you. Also, if you are overweight, a weight management program can be extremely beneficial to decrease the stress on your joints. Since nutrition plays a crucial role in weight management, it is important to have this discussion with your doctor.

A small portion of individuals with hip osteoarthritis will eventually opt to have a total hip replacement. This is often the case when symptoms are progressively getting worse and significantly limiting activities of daily living. If you have had a total hip replacement a physiotherapist guided post-operative hip strengthening program is ideal in order to decrease pain, improve your hip function and return to your active lifestyle.

Iliotibial Band Syndrome and Running

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.