Our Blog - Advanced Physical Therapy and Fitness

Dizzy? What May Be Causing Your Symptoms?

Published on Wednesday, 22 May 2013 12:46
Written by Kateri Kane

Dizziness is a symptom that can severely inhibit a person’s day to day life. It can cause a person to feel cognitively unclear, nauseous, unsteady, and can even lead to a fall. But what is it that causes dizziness? The answer to this question is not simple, because there may be several causes.

Dizziness is a common side effect for many different medications. One medication alone may contribute to dizziness, but when multiple medications are taken with several listing dizziness as a side effect, the likelihood of experiencing this symptom is increased. A medication may not simply cause dizziness, but may rather cause changes in blood pressure.

Orthostatic hypotension is one particular change in blood pressure that may occur when taking various medications. Orthostatic hypotension occurs when your blood pressure decreases quickly after changing positions from lying down to sitting up or from sitting to standing. This blood pressure change may in turn cause a light headed or dizzy feeling. Other than medications, causes for this form of hypotension include dehydration, heart problems, diabetes, and nervous system disorders.

Orthostatic hypotension is not the only cause of dizziness with position changes. Your vestibular system may develop one of many disorders, ultimately resulting in symptoms of vertigo. The vestibular system is particularly related to the perception of the body’s position and movement. According to Merriam-Webster Dictionary, vertigo is defined as “a sensation of motion in which the individual or the individual's surroundings seem to whirl dizzily.” There are several different types and sources of vertigo, but we will focus on one particular form called benign paroxysmal positional vertigo (BPPV).

In the population under 50 years old, BPPV is most commonly the result of a head injury; whereas over 50 years old, the cause is idiopathic (no known cause), but often associated with degeneration in the inner ear due to aging. It can also result from a virus of the ear, Ménière’s disease, or prolonged positioning in the “face up” position (i.e. during surgery or a dentist appointment) but these causes are much less common. The affected area in BPPV is the inner ear. This inner ear consists of three semicircular canals that detect rotational movement and a utricle which holds tiny crystals called otoconia. If these crystals get dislodged and end up in any of the semicircular canals, the body’s rotational sense is distorted and any head movement results in a dizzy or spinning sensation.

So how do we fix these dizzy symptoms? The dizziness that results from medication should be discussed with your doctor in order to determine which medication is problematic and if the benefits of the medication out way the symptoms of dizziness. Your doctor may be able to switch your medication to something that produces fewer side effects. If you are experiencing orthostatic hypotension, then you should not be rushing though any movements from lying down to standing up. As you gradually arise from lying down to sitting up, if you get dizzy symptoms, move your ankles up and down until the dizziness subsided. Pumping your ankles assists with pumping blood back toward your heart and increasing your blood pressure. If your orthostatic hypotension is caused by dehydration, then try drinking more water throughout the day. Other causes of orthostatic hypotension (i.e. heart problems, diabetes, nervous system disorders) may need to be discussed with your doctor. Lastly, if your dizziness is caused by BPPV, see a physical therapist. BPPV can be addressed with specific treatments to help position the loose crystals of your inner ear back where they belong.

We hope that this helped to give you an idea of what may be causing your dizziness and how you can best address the problem. If you have any questions on this topic or any others in which you are interested, feel free to leave any questions, comments, or suggestions. Thank you for reading and stay active.

Resources:

Are You Getting Pain After Sitting At A Desk All Day?

Published on Wednesday, 08 May 2013 09:57
Written by Kateri Kane

By Kateri Kane, PT, DPT

Let’s say you’ve had a busy week. You had a major project that was due by the end of the week and you didn’t have time to worry about taking breaks and getting up to grab lunch. How sore are you? How is your back feeling? How about your neck? Your arms? I’m going to venture to guess that you’re having some aches and pains, maybe even some numbness and tingling in your arms. What does all of this mean? What caused you to be in this pain?

Many people end up in this situation, but not necessarily because they’ve had a busy work week. This kind of problem can occur simply because you have to do the same tasks day in and day out at your computer or desk. But this is your job! You have to do it! So how can you prevent the pain that so often occurs after working at your desk?

The first thing that we need to look at is your POSTURE. Do you tend to slouch with your head forward while you are working? This is a position that commonly causes pain in the back and neck. If you maintain this inappropriate position for a prolonged period of time while also using your arms for typing, you may end up with symptoms into your shoulders and arms as well. Activating your back muscles in order to hold your chest upright is the best way to correct poor posture. Maintaining the head, neck, and shoulders in a neutral position instead of forward, helps to decrease strain along your joints and ligaments. If the pain you are getting is lower, then your problem may be related to the lumbar spine. Sitting upright is also important for this low back region, but other practices including abdominal muscle strengthening and hamstring stretching may also be beneficial. Tightening the abdominal muscles helps to strengthen those muscles that surround and support your spine, thus stabilizing you and decreasing pain. Hamstring tightness can easily occur when you sit for most of your day, so stretching is important after long periods of sitting.

The second thing that we want to look at is your WORKSTATION and ERGONOMICS. If your desk is not set up appropriately, then you may be experiencing more strain on your body than necessary. This link gives an excellent depiction for the proper set up of a workstation. Consider 4 steps when setting up your computer work station. Step 1 is your chair. Push your hips as far back as possible in your chair, adjust the seat so your feet are flat on the floor with the knees even with the hips, adjust the back of the chair to a 100-110° angle, and adjust the armrests so that your shoulders are relaxed. Step 2 is your keyboard. Pull up close to your keyboard, position the board directly in front of your body, adjust the board height so that your elbows are at 100-110° and your wrists and hands are straight, and place the mouse as close to the keyboard as possible. Step 3 is your monitor, documents, and telephone. Center the monitor directly in front of you, position the top of the monitor approximately 2-3 inches above seated eye level, sit at least an arm’s length away from the screen, reduce glare by positioning the screen at a right angle to windows and adjusting the vertical angle of the screen, position documents from which you are typing directly in front of you between the monitor and the keyboard, place your telephone within easy reach, and use headsets and speaker phone rather than cradling the phone between your head and shoulder. Step 4 is pausing and taking breaks. Take short 1-2 minute stretch breaks every 20-30 minutes, rest and refocus your eyes periodically to avoid eye fatigue, and use correct posture when working. The American Physical Therapy Association (APTA) also released a video that addresses the appropriate ergonomic positioning for desk work. This video can be viewed here.

In general, your body is programmed for movement, so make sure that you get up and move around, even for very short amounts of time. Ultimately, it can make a huge difference on your level of pain. If you have any questions on this topic or any others in which you are interested, feel free to leave any questions, comments, or suggestions. Thank you for reading and stay active.

Resources:

Move Forward PT

Automotive Illustrations

Add a comment (0)

What Is The Difference Between A Physical Therapist and a Chiropractor?

Published on Wednesday, 24 April 2013 14:22
Written by Ann Dennison

By Kateri Kane, PT, DPT

Despite physical therapy’s long history formally dating back to the 1910’s, most people do not truly know what a PT can do or how they are different from other health care professionals. One particular profession that seems to constantly be confused with PT is the chiropractic field. This blog will shed some light on the difference between a physical therapist and a chiropractor.

According to the PA Chiropractic Practice Act, the term chiropractic refers to “a branch of the healing arts dealing with the relationship between the articulations of the vertebral column, as well as other articulations, and the neuro-musculo-skeletal system and the role of these relationships in the restoration and maintenance of health.” The full Pennsylvania definition can be viewed here. Different states have different scopes of practice, which means that practitioners in some states can perform more or less treatment tasks than those from another state. Chiropractors can perform “manipulations” to treat musculoskeletal conditions in all 50 states. Other treatment methods such as modalities, myofascial work, acupuncture, and nutritional therapy vary from state to state.

Physical Therapy is defined as, “Rehabilitation concerned with restoration of function and prevention of disabilities following disease, injury, or loss of body part. The therapeutic properties of exercise, heat, cold, electricity, ultraviolet, and massage are used to improve circulation, strengthen muscles, encourage return of motion, and train or retrain an individual to perform the activities of daily living,” according to Taber’s Cyclopedic Medical Dictionary. The PT scope of practice covers “examining (history, system review and tests and measures) individuals with impairment, functional limitation, and disability or other health-related conditions in order to determine a diagnosis, prognosis, and intervention… alleviating impairment and functional limitation by designing, implementing, and modifying therapeutic interventions… preventing injury, impairment, functional limitation, and disability, including the promotion and maintenance of health, wellness, fitness, and quality of life in all age populations… engaging in consultation, education, and research.” There are too many specific tests and measures as well as therapeutic interventions that a PT can do in order to list them all in this blog, but a list can be viewed here and the specific Pennsylvania scope of practice can be viewed here.

There has been some contention between the chiropractic and physical therapy professions due to overlap in treatment techniques between the two. According to PA statutes, “Chiropractors cannot advertise or hold themselves out as being able to practice physical therapy unless they are licensed as physical therapists pursuant to the PA Physical Therapy Practice Act”, though chiropractors are licensed to practice chiropractic procedures and may be certified to perform adjunctive procedures, many of which are also performed by physical therapists. Exercise which is a mainstay of physical therapy treatment is not typically part of the chiropractic care. In PA, the respective practice acts state that physical therapists perform mobilizations or passive movements of joints, and chiropractors perform manipulations or adjustments which are a form of mobilization in which the speed and magnitude of the motion is such that the patient cannot stop the movement.

The primary area of overlap between the professions is in the orthopedic and manual therapy realm with treatment of the spine. Physical therapists treat many injuries and ailments of the body that do not have any overlap with the chiropractic field as well. The important thing to note is that there are significant differences between the two professions. For a clearer understanding of the differences, you can read over the PA chiropractic and physical therapy practice acts. If you have any questions on this topic or any others in which you are interested, feel free to leave any questions, comments, or suggestions. Thank you for reading and stay active.

Resources: