Falls

Vestibular Rehabilitation (Dizziness and Vertigo)

The winter Olympics in Sochi was filled with scary crashes in nearly every sport. Hearts sank when seeing chances at a medal slip, the pain on the athletes’ faces, and some of the injuries that resulted. We probably all know someone who has, or have ourselves, taken a big spill at the local hill.

But that’s not the only place where falls can occur, especially during this time of year with the fluctuating melt and freeze of roads and walkways. Slips and trips can happen in the community, even in our own homes, for a variety of reasons. Sometimes we can walk away from them with little injury, other than to our pride, but unfortunately sometimes injuries occur.  In order to avoid beginning the spring season hurt, it’s good to know what the risk factors to falls are and to address any concerns that may exist.

Some readers may recall a previous article I wrote about vertigo– a condition that makes you feel like you or the world is spinning. This or other conditions of the vestibular system can contribute to feeling dizzy or losing your balance. The vestibular system is partially located in the inner ear, and gives our brain information about where our head is relative to gravity. When it is affected, a conflict of information between the vestibular system and other sensory systems happens. Some related conditions include: Benign Paroxysmal Positional Vertigo (“BPPV”), labryinthitis or neuritis (types of infections), or Ménière’s disease. This in turn may cause vertigo, dizziness, or unsteadiness. Some of the causes of vertigo or dizziness can be treated to help you feel more stable on your feet.

Weaknesses in the legs or trunk, sensory conditions of the feet, or decreased ‘proprioception’ (the information about where a body part is relative to the rest of the body) are other risk factors for falling. Proprioception, balance, and strength can be trained through regular exercise. Tai Chi and Yoga are examples of programs that assist in reducing fall risk. However some people require exercises tailored to their individual abilities and needs. It is important to evaluate whether a particular exercise is safe and appropriate for you. Having an understanding of the exercise and of your own abilities is helpful, but when in doubt, it is helpful to consult a health care provider, or discuss with the instructor.

Risk factors for falling don’t only exist within our bodies, but also in our environment. It’s important to note that while the temperatures have been going above freezing, those cold nights and days can result in a layer of ice. Slowing your pace over these areas, wearing proper footwear, and always being aware of the conditions will help. Within your home, having adequate lighting, keeping the floors and hallways clear of obstacles, and keeping rugs or carpets secured down will also reduce your chances of tripping.

With the example of the Olympic sports of skiing, snowboarding and skating, big falls occur frequently. It’s not often a case of needing to address strength or balance, and rarely is the environment controllable. For these activities, it’s important to protect yourself as much as possible. Wrist guards are light, can fit under gloves, aimed at reducing the risk of a facture when impacting the ground. A common injury with falling is the FOOSH – a ‘Fall Onto an Outstretched Hand’. A brace will keep your wrist in an ideal position and can absorb some of the force to reduce, but not eliminate, the likelihood of a wrist fracture. If you ski, braces also exist to protect the thumb, which can be injured by the ski pole.

If you feel you are at risk of falls, or have an injury after taking one, it is important to see a health care professional to either assist in the prevention of, or in the rehabilitation after, a slip. Reducing the risk can be easy in some situations: adjusting your footwear, modifying your gait aid if you use one (for example, attaching an ice grip onto a cane), making changes to your home environment, or partaking in a strength and balance program designed for your needs. In some cases, dizziness or lightheadedness occurs as a side-effect from medication, so speaking to your doctor may help. From a physiotherapy context, your strength, balance, vestibular function, or any combination of those factors can be assessed and treated as is appropriate for you.

May is National Physiotherapy Month

Physio Articles

Across Canada, during the month of May there will be promotion of the profession of physiotherapy. Meanwhile, across Canada during the month of May, many people will be asking the question of “What is physiotherapy, anyway?” With National Physiotherapy Month nearing, I felt this would be a great time to answer that very question, and others that I have been asked from friends, family, and clients.

Questions such as:

  • What is physiotherapy?
  • What do you do?
  • Who gets physiotherapy?
  • Where can you work?
  • How long did you have to go to school?

My dad, while I was undergoing my studies, once asked, “So, you’ll be cracking backs then?”

 

In short, physiotherapy is the assessment, diagnosis, and treatment of pain, injuries, and a broad range of chronic conditions. It is delivered in a number of ways including soft-tissue techniques (i.e. massage), hands-on manual therapy, modalities, and the most fun (for us) – exercises. Physiotherapy is often a complement with other health professions to help decrease pain, and optimize strength, function and overall well-being.

 

To become a physiotherapist in Canada now, an undergraduate degree must be completed, followed by a two-year Master of Science degree. The latter involves extensive hands-on practice both in class and in placement settings. The schooling doesn’t end there! Physiotherapists are committed to life-long learning, taking further education to improve current, or gain new, skills. (So to answer my dad’s question: yes, after courses and a specified number of hours of training, physiotherapists can ‘crack’ backs. Although we prefer to use the term ‘manipulate’.)

 

Physiotherapy isn’t limited to people with acute injuries – the service is also provided for people with heart disease, stroke, amputations, chronic pain, and lung disease, to name a few conditions. All ages and abilities can be treated: from pediatrics to geriatrics and everything in between. Physiotherapy can also be proactive, by promoting healthy living and avoidance of injuries and illness.

 

There are many settings in which physiotherapists work. The most commonly thought-of environments are the clinic or hospital. Physiotherapy is also provided in retirement residences, long term care facilities, hospices, community health centres, in home, in the work place, on the sports field, and in schools.

 

When looking at how many systems of the body can be treated with physiotherapy, and all the different environments in which it can be delivered, it is understandable for there to be some mystery around the subject.  I hope this was helpful in understanding what the profession is. For further information, you can visit the website for the Canadian Physiotherapy Association (www.physiotherapy.ca), and the BC division (www.bcphysio.org). To learn more about National Physiotherapy Month check out www.npmcanada.ca, where you can find information, take a survey, or thank a physiotherapist.  Although, seeing people feeling and functioning better is the best ‘thanks’ of all!