Do you ever get dizzy when rolling over or sitting up in bed? Experiencing a room-spinning sensation may be a sign of Benign Paroxysmal Positional Vertigo, or BPPV for short. Onset can occur at any age, but may be more common over the age of 50. Onset in earlier ages is likely due to a head injury and can be overlooked when treatment is occurring for concussion since dizziness may be a side effect of the concussion.
So what is BPPV? BPPV is a condition in which particles (otoconia) have invaded the semi-circular canal, causing bothersome vertigo as the particles move through the canals and stimulate the inner ear system. Side effects can include nausea and vomiting and symptoms are typically worse in the morning.
The Epley’s Maneuver is over 90% effective at treating posterior canal BPPV and can be done in a single physical therapy treatment session. Some patients experience nausea and even vomiting during treatment because the treatment does require moving the head into the most symptomatic positions so it is recommended to take prescribed medication for nausea and bring a driver for any residual dizziness following treatment.
A typical treatment duration for patients suffering from BPPV is one or two visits over the course of a week or two. I’ve experienced a high success rate for full resolution with patients, often in only one visit. Less common types of vertigo can also be treated with physical therapy, but may require a higher frequency or duration of sessions and a physical therapist will determine a recommended course of treatment during the initial evaluation.
So, when the room starts spinning, talk to your doctor about physical therapy right away. I’d love to answer any questions you may have about your vertigo here at Pacific Physical Therapy.
Alicia Gilfoy PT, MPT has been treating patients with vestibular conditions for 9 years and has taken additional coursework to ensure a comprehensive diagnosis and treatment plan for her patients.
Patellofemoral Pain Syndrome (PFPS for short) is a common condition where pain is present behind and/or around the knee cap. It is twice as common in women as men and has a high occurrence in those who are involved in athletic activities. Physical therapy is an effective treatment to reduce this type of knee pain. Initially, it was theorized that the weakness in the quadriceps, specifically the vastus medialus oblique fibers were to blame for the symptoms because the kneecap would not track correctly and be pulled too far towards the outside of the knee by the rest of the quadriceps muscles. A research article published in Journal of Orthopaedic & Sports Physical Therapy1 tested the theory that hip weakness may actually play a greater role in the prevalence of pain in the affected knee. The kneecap is located in a groove at the lower part of the long femur bone in the upper leg. Rotation of the femur is controlled by muscles at the top of the hip. The author’s theory suggests that the lack of control of the femur bone during functional activities is what causes the inflammation and pain.
In the study mentioned above, patients were divided into two groups: Group A performed 4 weeks of quadriceps strengthening and Group B performed 4 weeks of hip abduction and external rotation strengthening. The group that performed the hip strengthening activities showed lower pain scores at 4 weeks than the group that performed quadriceps exercises. Both groups were then transitioned into a functional strengthening program that included both quad and hip strengthening and both groups saw additional improvement from 4 weeks to 8 weeks.
Here at Pacific Physical therapy, we understand the importance of getting pain relief sooner. It is our responsibility as physical therapists to form our treatment plans around relevant research to give our patients the results they want as soon as possible. Call or stop by today to find out what you can do about your knee pain.
Alicia Gilfoy, PT, MPT is a physical therapist who has been treating in the outpatient orthopedic setting since 2007.
“Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females with Patellofemoral Pain Syndrome: A Randomized Clinical Trial” (J Orthop Sports Phys Ther 2011;41(8):560-570.