Do you experience pain in your knee during or after activities such as running, squatting, or climbing stairs?
If so, you may have patellofemoral pain syndrome (PFPS). PFP accounts for 11-17% of all knee pain presentations to general practice, and it typically occurs in physically active people aged <40 years.
It is a very debilitating condition in jumping athletes, with previous research indicating that 1/3 of athletes presenting with the condition were unable to return to sport within 6 months.
Patellofemoral pain syndrome is a common problem that can, fortunately, be effectively managed with physiotherapy.
So if you are experiencing pain in and around your knee cap, you should consult a physiotherapist for a professional biomechanical assessment and treatment plan.
What is Patellofemoral Pain Syndrome?
Patellofemoral pain syndrome (PFPS) refers to pain in the front of the knee, around or behind the kneecap.
This pain is typically caused by contact between the kneecap and the thigh bone (femur), which can affect the joint surface over time.
PFPS, also known as “runner’s knee,” is common in active people who participate in sports but can also occur in non-athletes.
The pain and stiffness caused by PFPS can make walking, kneeling, squatting or running difficult.
This knee pain is aggravated by jumping, landing and kicking and is almost always alleviated with the cessation of the aggravating activity.
Common symptoms of patellofemoral pain syndrome
- Patellofemoral pain syndrome is characterised by a dull, aching pain in or near the kneecap.
- There may also be a reduction in knee range of motion.
- Running, jumping, hopping, squatting, and kneeling are frequently painful motions for people with PFPS.
- There may be some swelling and a loss of muscle strength around the knee.
- The onset of pain is usually gradual rather than abrupt or traumatic.
- Structures around the knee, especially on the outside, may feel restricted.
- The pain symptoms are most noticeable during exercise and weight-bearing activities that involve knee bending.
- Pain can also be felt after sitting with the knees bent for long periods.
Common causes of patellofemoral pain syndrome
Patellofemoral pain syndrome is caused by the patella failing to track properly on the femur when the knee is bent and straightened.
Muscle imbalances – thigh or buttock weakness, hamstring or ITB tightness.
Overuse – abrupt changes in activity level or intensity.
Biomechanics – excessive pronation of the feet/ankles, hip and knee joint angle.
Recent evidence suggests that hip weakness is the underlying cause of the dysfunction. Research also shows that poor hip abductor strength was a risk factor for future PFP pain in novice runners.
The truth is that there is likely no single mechanism causing PFPS but rather several dysfunctional biomechanical patterns that may overload tissue in this area.
These patterns can develop for various reasons, including weakness of the lower limb’s stabilising muscles or simply adopting poor gait patterns.
The 4 fundamental principles to ensure effective PFPS management
1) PFPS is a multifactorial condition requiring an individually tailored program.
2) Immediate pain relief should be a priority.
3) Patient empowerment by emphasising active over passive interventions is essential.
4) Good patient education and activity modification are essential.
Physiotherapy treatment for patellofemoral pain syndrome (PFPS)
An individualised treatment plan will be designed and implemented based on the information obtained during your physiotherapy consultation. This will consider the irritability of your patellofemoral joint and the deficits identified during your physical assessment.
Patellofemoral pain physiotherapy treatment includes:
- Taping techniques for reducing the g load on the patellofemoral joint.
- Mobilisation of the knee cap.
- Modification of activities and load management.
- Orthotics are used to improve foot posture and biomechanics.
- Muscle strength is gradually increased, focusing on the glutes, quads, and calves.
- To increase the flexibility of the tissues surrounding the patellofemoral joint and treat pain, we use manual therapy techniques like soft tissue massage and dry needling.
- Training for movement patterns and gait will help correct any compensatory movement patterns that exacerbate knee pain and retrain the body’s proper biomechanics for walking and running.
Most people will have noticeable improvement in their pain and function within 6-12 weeks of starting a multi-modal approach, as described above. Still, older people with a long history of pain need to expect a more extended recovery period.
Final Thoughts on Physiotherapy Management For Patellofemoral Pain Syndrome (PFPS)
Education, orthotics, dry needling, and load management are essential features of PFP management.
Exercises to strengthen the gluteal and quadriceps musculature, manual therapy, and taping possess the most substantial evidence.
Combined, hip and knee strengthening exercises are superior to knee exercises for treating PFP in the short and long term.
Enhance Physiotherapy’s skilled physiotherapists can thoroughly examine you for specific deficits causing your PFP and implement a treatment program to get you feeling and performing better.
Book an appointment with one of our highly qualified physiotherapists at Enhance Physio before starting a rehabilitation program. We can advise you on the best course of action for your condition.
(Crossley, et al. 2016) Patellofemoral pain. Crossley KM, Callaghan MJ, van Linschoten R.
(Malliaras, et al. 2015) Knee Movement Characteristics of Basketball Players in Landing Tasks Before Onset of Patellar Tendinopathy: A Prospective Study.
Feng R, Best TM, Wang L, Gao W, Liu H, Yu B.
(Barton, et al. 2015) The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’: incorporating level 1 evidence with expert clinical reasoning
(van der Heijden RA, et al. 2015)Exercise for treating patellofemoral pain syndrome: an abridged version of Cochrane systematic review
(Ramskov D, et al. 2015) High eccentric hip abduction strength reduces the risk of developing patellofemoral pain among novice runners initiating a self-structured running program: a 1-year observational study
Scaphoid fractures are common injuries that affect the wrist accounting for 70-80% of all carpal bone fractures. They usually occur after a fall onto an outstretched hand. The fracture heals poorly and requires quite significant immobilisation and rehabilitation.
Unfortunately, scaphoid fractures are common and often go misdiagnosed. We’ll discuss the anatomy of the wrist and the mechanism of injury, as well as the diagnosis and treatment options.
What is a scaphoid fracture?
The scaphoid bone is one of the eight carpal bones in the wrist and the foundation of the wrist. It’s the largest proximal row of carpal bones and forms the radial portion of the carpal tunnel.
The scaphoid is made up of three parts:
- Proximal pole – The end nearest to your thumb.
- Waist – This is the curved middle portion of the bone beneath the anatomical snuffbox.
- Distal pole – The end closest to where your forearm meets your hand.
A scaphoid fracture is a fracture of the scaphoid bone, commonly caused by a fall on an outstretched hand where the wrist is forced too far backwards or possibly forcefully bent forward.
Around 80% of scaphoid fractures occur at the waist, 20% at the proximal pole, and 10% at the distal pole.
These can be difficult to differentiate from a distal radius fracture but are essential to diagnose due to the possible severe implications of a missed diagnosis.
Common symptoms of a scaphoid fracture
- Swelling around the painful area.
- Chronic pain in the back of the hand, especially at the base of the thumb.
- Pinching your thumb to your index finger while your palm is facing downward causes pain.
- Reduced grip and pinch strength.
- A weak wrist.
- Restricted range of motion.
- Pain on the thumb side of the wrist.
Scaphoid fracture treatment
The scaphoid has a poor blood supply even without injury. Therefore, if not managed appropriately with a specific immobilising cast or brace, they can result in avascular necrosis. In this condition, the bone does not receive enough blood to heal correctly, resulting in non-union and possible death of the fractured areas of bone.
Numerous ligaments attach to the scaphoid bone to provide intrinsic support for the wrist. A scaphoid fracture can also cause damage to these ligaments, which can cause scapholunate instability or dissociation. Without appropriate treatment, this can result in long-term wrist instability, loss of range, strength and decreased function.
Scaphoid fracture management can be non-surgical or surgical. Non-surgical management is used for stable scaphoid fractures and involves cast immobilisation using a specific short-arm cast. Surgical management is typically only required for unstable and displaced fractures and needs a screw or pin insertion to stabilise the fractured area.
Do you need physio after scaphoid fracture?
Yes, physiotherapy treatments will focus on reducing pain and swelling initially. In order to help strengthen and stabilise the muscles around the wrist joint, your physiotherapist will gradually introduce exercises. Further exercises will be provided to improve fine motor control and hand dexterity. You will also receive advice from your physiotherapist on how to perform your activities to avoid further strain on your wrist joints.
A scaphoid fracture must be allowed to heal properly with the appropriate physiotherapy for the appropriate amount of time.
What is the fastest way to heal a scaphoid fracture?
Prompt diagnosis is the fastest way to heal a scaphoid fracture. Since the carpal scaphoid bone plays a critical role in wrist function, pathologic abnormalities can have serious consequences. Physiotherapists use specific clinical tests to determine if a scaphoid fracture has occurred, such as palpation and the scaphoid compression test. If a scaphoid fracture is a potential diagnosis, a referral will be made for a CT scan to confirm the injury, as these injuries are often missed on a standard wrist X-Ray.
How long does it take to recover from a scaphoid fracture?
Your recovery time from a scaphoid fracture will differ depending on the type of procedure you have, as well as how fast your body heals. The healing time of a scaphoid fracture is typically longer than that of other types of fractures.
Typically, the union of the scaphoid takes 12 weeks, but you might have to wear a cast or splint for up to 6 months.
Both conservative and surgical treatment for scaphoid fractures may result in complications. These include delayed union, osteonecrosis, pseudo-arthrosis, associated instability, arthrosis, and carpal joint collapse.
These complications may cause significant functional limitations in mobility and grip strength. Malalignment, failure to place the screw, re-operation, infections, and soft tissue injuries are all possible complications during surgery. It should also be noted that scaphoid non-union is still a complex issue to solve.
Early detection and optimal treatment will reduce these problems and prevent late complications.
Book an appointment with one of our physiotherapists at Enhance Physio to accurately diagnose your wrist injury.
While there is no cure for spinal stenosis, several treatments can help you manage the symptoms and improve your quality of life. One such treatment is physiotherapy. Physiotherapy can help relieve pain, improve mobility and function, and reduce the risk of complications. If you’re considering physio for spinal stenosis, here’s what you need to know.
What is spinal stenosis?
The spinal cord, nerves and arteries are housed by the spine, which acts as a hard-electrical casing to support and protect these vulnerable structures. The spine has a hollow column that allows the spinal cord to run from the brain to the rest of the body. At each spinal segment, nerves exit the spine and supply the body’s tissues. An intricate network of small veins and arteries provides blood to the spinal cord and vertebrae, providing them with the nutrients needed to operate.
Spinal stenosis is characterised by narrowing the spaces that house the spinal cord, nerves, and blood supply. Many factors can cause spinal stenosis; however, it is caused by degenerative changes to the spine as we age. Many people over the age of 60 will have spinal stenosis; however, not all will have pain. Clinically, spinal stenosis is used to describe the painful symptoms of this condition rather than just the narrowing itself.
What are the symptoms?
Pain with walking or standing that radiates into the hips, thighs and even feet is the hallmark of spinal stenosis. Usually, this pain will be reduced with rest and forward movements of the spine. Spinal stenosis is a progressive condition, and symptoms will gradually increase over time. The pain is often described as a deep radiating ache and can be associated with fatigue, heaviness, weakness and numbness. It can affect just one leg; however, it will be felt in both legs more often. There will often be associated back pain; however, leg pain is usually the most severe complaint.
Does physiotherapy help spinal stenosis?
Physiotherapy can be highly beneficial for mild to moderate cases of spinal stenosis. Your physiotherapist can help you manage your pain through hands-on techniques and provide a targeted exercise program based on biomechanical assessment. They can also help you understand and manage your day in a way that helps reduce flare-ups and maintain muscle strength.
Many conditions need to be excluded from a diagnosis. Your physiotherapist can conduct a thorough examination and accurately diagnose this condition. Many people have stenotic spinal changes without symptoms. Surgery to decompress the restricted nerves and stabilise the spine are used in very severe cases.
If surgery is the right choice for you, your physiotherapist can guide you through this treatment pathway, helping you prepare and recover from surgery to get the best outcome possible.
What exercises are good for spinal stenosis?
Exercises that improve range of motion, strength, endurance, and stability are typically part of a successful exercise program for patients with lumbar spinal stenosis. Spine specialists generally advise people with lumbar spinal stenosis to engage in flexion exercises and back-rounding stretching activities. Bending-forward activities/exercises for lumbar stenosis are frequently reported as more comfortable by patients.
Exercises that are low or no impact are good for spinal stenoses, such as:
- Thai Chi
Some exercises are more beneficial to people with spinal stenosis than others. Therefore, it is best to consult with a physiotherapist to help you develop a fitness program tailored to your specific needs. Your physiotherapist can also teach you which exercises and activities to do and those to avoid based on your circumstances.
What activities should be avoided with spinal stenosis?
Patients should avoid high-impact activities such as jogging, contact sports, as well as prolonged standing or walking. Avoid remaining in postures that compress the spine. Additionally, extension exercises (arching your back) should be avoided since they can aggravate spinal stenosis by pinching your spinal nerves.
You should not perform any exercise in the presence of pain or other symptoms. If the activity causes or worsens the symptoms of spinal stenosis, stop immediately and consult with your physiotherapist.
Unfortunately, back pain does tend to return. The primary reason it is thought to reoccur is a lack of rehabilitation. A lack of compliance with exercises targeting deep abdominal and core muscles is especially problematic. Your physiotherapist will help you determine which exercises are best to continue indefinitely. We highly recommend routinely performing these exercises a few times per week.
If you live with lumbar spinal stenosis, know that there is help and hope. A physiotherapy program specifically tailored to your needs may make all the difference in managing your condition and improving your quality of life. Give it a try!
Book an appointment with one of our physiotherapists at Enhance Physio to determine if you’re a good candidate for a spinal stenosis treatment program.
Pregnancy is an amazing time in a woman’s life, but it can be difficult for some women to cope with the physical changes that occur. One of these changes is Pelvic Girdle Pain or PGP.
Women often experience pelvic pain during pregnancy, but it can be hard to know when the pain is normal and when you should seek help. Women who are overly concerned about the pain may need to be referred to a Women’s Health Physiotherapist for diagnosis and treatment.
Women who engage in early treatment with Women’s Health Physiotherapy are more likely to recover well, be able to manage pain, and will have made significant gains in strength and flexibility.
Women experiencing mild cases of PGP will be able to manage their symptoms at home with self-management techniques.
Many of these issues don’t go away entirely until the baby is born.
What is Pelvic Girdle Pain?
Pelvic Girdle Pain or PGP is a common condition experienced by many women during their pregnancies. It is estimated around 50% of women will experience some degree of PGP during pregnancy. Thankfully, around 90% of women will experience recovery from PGP within the first 12 months following birth.
What causes pelvic girdle pain during pregnancy?
PGP often occurs due to an increase in pressure around the pelvic region caused by her growing baby as well as changes in the mother’s centre of mass and load transfer.
As the baby grows, the abdominal muscles begin to stretch and as they do, they become less effective at contracting and stabilising around the pelvis. The pelvic floor muscles also start to take more load and may also become less able to support structures and efficient load transfer as the pregnancy and growth progresses.
What does pelvic girdle pain feel like in pregnancy?
PGP is typically characterised by pain in the back of the pelvis or low back, pain on either side of the pelvis, and/or pain in the pubic symphysis at the front of the pelvis. Pain may even radiate into the gluteal area, lower abdomen, inner thigh, around the groin, and even into the back of the thigh and leg (which can be mistaken for sciatica).
This condition is often misrepresented as instability or laxity in pelvic joints; while there is some degree of increased movement in the pelvic joints during pregnancy to facilitate birth, in the vast majority of PGP cases, there is no ‘instability’ around those extremely stable pelvic joints.
In many cases, simple modifications to a woman’s daily activities, footwear, environment as well as addressing strength deficits or areas of weakness can help to make PGP more manageable.
How can I reduce pelvic girdle pain?
Most women who experience mild cases of PGP will be able to manage their symptoms at home with self-management techniques.
Women should focus on spending time mobilising and stretching in positions of comfort, such as: Rocking the hips (back and forth) and pelvic tilts (pressing the small of the back into a firm surface or pillow); Spending time doing gentle exercises that support the pelvis; Knees to chest stretch – pulling both knees to your chest at once can feel great; Groin stretches – gently stretching away from your body is also pleasant (for example, leaning over a bed or sofa to reach something on the floor).
Is walking good for pelvic girdle pain?
Women with PGP often find it difficult to walk. Walking can put a lot of strain on the joints, especially if you do it for an extended amount of time. For many pregnant women, walking might make their joints sore at any point during or after their walk.
Walking in a shopping centre is the same as going for a walk for exercise. Your physiotherapist will be able to advise you on whether you can go for walks and how much walking is appropriate for you.
When should I be concerned about pelvic pain during pregnancy?
Early diagnosis is key to avoiding long-term discomfort. If you notice pain around your pelvic area, tell your midwife, doctor or obstetrician. Women should also seek advice if their pain does not improve after 3-4 weeks of self-management. Women who are overly concerned about the pain may need to be referred to a Women’s Health Physiotherapist for diagnosis and treatment.
Ask a member of your health team for a recommendation for a physiotherapist that is knowledgeable in treating pelvic joint disorders.
Many of these issues don’t go away entirely until the baby is born, but treatment from an expert can significantly decrease discomfort during pregnancy.
Can a physio help with pelvic girdle pain?
Your Physiotherapist can assist you to find the solution to reducing your pelvic girdle pain and help you to maintain your strength and fitness while pregnant. Women who engage in early treatment with Women’s Health Physiotherapy are more likely to recover well, be able to manage pain, and will have made significant gains in strength and flexibility.
Final Thoughts on Pelvic Girdle Pain
Women who get treated early by a physiotherapist are more likely to recover, be able to manage pain, and experience substantial improvement in strength and mobility.
A Women’s Health Physiotherapist can assist you in finding solutions that reduce your pelvic girdle pain as well as help you maintain strength and fitness while pregnant by engaging in early treatment.
Pelvic Girdle Pain is common during pregnancy but it doesn’t have to hinder the quality of life or mobility throughout this wonderful time!If you’re experiencing pelvic girdle pain during your pregnancy, don’t suffer in silence. Make a booking today and start your treatment with one of our Women’s Health Physiotherapists. You’ll be glad you did!
*** SPORTS TAPING COURSE ***
Saturday the 4th of November
9.00am – 11.00am
Located at the Enhance Physiotherapy Clinic: 550 Smollett St Albury.
Ideal for sports trainers heading into preseason.
Please contact the clinic on 02 6041 3609 to secure your place.
Learn from physiotherapists working in the sports field!
As physiotherapists who work closely with sports teams and the Australian Defence Force, a fair proportion of our work consists of loading issues.
“The Envelope of Function” is a great analogy, when discussing injuries related to loading. If the load fits within your “Envelope of Function”, you will have a normal loading and tissue response, which adapts quickly without injury. However, occasionally the load can go outside your level of function resulting in injury. This typically occurs in two ways.
NORMAL CAPACITY = NO INJURY
The first way involves increasing your load quickly. There is no change to your functional capacity (or Envelope of Function), however you may have increased your load beyond this capacity. An example of this is doubling gym or running sessions to make up for missed sessions.
EXCESSIVE LOAD = INJURY
The second way is maintaining the same load, however your “Envelope of Function” has decreased. Factors that contribute to this decrease include; pain, stress, poor nutrition, fatigue, insufficient recovery or poor sleep. These factors can often explain why an overuse of loading injury has occurred when you have not altered your load.
If you have any loading injuries, please contact Enhance Physiotherapy Albury-Wodonga. We will fully assess your injuries and get you training back at your peak.
Headaches are one of the most prevalent conditions in society! They cause missed days at work, unproductive days due to clouded judgement and thinking, irritability, low moods, and most importantly, negatively affect your quality of life.
It’s common for headache sufferers to bounce between various disciplines, often struggling to get any answers or any relief. Even more commonly, the person never seeks any help, instead of masking their headaches with pain relief medications because they are unaware that physiotherapy is available for headache sufferers.
Types of headaches
Since there are numerous types of headaches, determining the location and nature of your pain can determine the cause.
Tension headaches cause pain to spread across both sides of the head, often beginning in the back and progressing forwards. This is the most common type of headache discomfort. Tension headaches are frequently caused by eyestrain, stress, and lack of food, and they can be persistent.
Sinus headaches are caused by sinus passage swelling, which causes pain behind the cheeks, nose, and eyes. When you first wake up in the morning and bend forwards, the pain is usually at its worst.
These headaches are usually excruciating and occur in “clusters,” meaning they occur several times each day for months, usually around the same time. They are caused by the dilation of blood vessels in the brain due to the release of serotonin and histamine. Physical exertion, bright lights, and altitude are all known to trigger them.
Migraines are a common neurological disease involving nerve pathways and chemicals. Changes in brain activity have an impact on blood flow in the brain and surrounding tissues, resulting in a variety of symptoms. It could last for at least four hours and possibly even days.
Migraines cause a variety of symptoms, the most common of which is a throbbing, pulsing headache on one side of your head. Migraine sufferers may also experience the following symptoms in addition to severe headaches:
- Extreme exhaustion.
- Sensitivity to light, sound, or smell has increased.
The most common type of headache
A tension headache, also known as a muscle-contraction headache, is the most common type. Tension headaches occur when stressed-out head or neck muscles contract too tightly.
Tension headaches are usually caused by poor or prolonged postures that lead to overworked muscles in the neck and shoulders, which refer to pain in the head and create tension on the fascia, which makes up most of our scalp. These are the types of headaches that office workers & truck drivers get after-hours seated in the same position.
Postural correction and strengthening are required for long term relief. However, your physiotherapist can provide short term relief from your headache with manual therapy.
Cervicogenic headaches come from the neck. These can be diagnosed very quickly by your physiotherapist. They are caused by C1-3 (top 3 vertebrae) because they share the same nerve pathways as your face and scalp. With manual therapy, your physiotherapist can treat these headaches quickly and easily.
Why do you suffer from headaches?
The majority of headaches are caused by:
- Certain foods such as alcohol, cheese, nuts, pizza, chocolate, ice cream, fatty or fried food, lunch meats and hot dogs, yoghurt, aspartame, and MSG.
- Blaring music.
- Sleep deprivation or abrupt changes in sleep patterns.
- Watching TV or using a computer.
- Meal skipping.
- Sustaining a head injury.
- Caffeinated beverages, people who drink a lot of caffeinated drinks might get caffeine-withdrawal headaches.
- Vision issues.
- Taking a long journey by car or bus.
- Hormonal changes can also cause headaches in some teenagers. Some girls, for example, experience headaches right before their periods or at other regular times during their monthly cycle.
- Some medications, headaches can be a side effect.
- Strong odours, such as perfume, smoke, fumes, or a new car or carpet.
- Infections such as ear infections, viruses like the flu or a cold, sore throat, meningitis, or sinus infections.
Common symptoms of a tension headache
- It is possible that both sides of the head will experience mild to moderate pain.
- A tight band of pain around your head, a dull ache, or pressure may be felt.
- The frequency varies greatly.
- It is possible that this will happen more than 15 days per month.
- May occur on rare occasions.
- The duration can range from 30 minutes to a week.
Headaches can be caused by dehydration, neurological deficits, increased sensory input, tight muscles, and stiff neck joints. Some common headaches which can be helped quickly by physiotherapists are “Tension” and “Cervicogenic” headaches.
Headaches can be debilitating and can lead to a loss of productivity and income. If you have recurring headaches, it’s essential to see a physiotherapist figure out what’s causing them rather than just putting up with the discomfort.
Book an appointment to discuss your headache symptoms with one of our professional physiotherapists at Enhance Physio today!
Imagine if the room started spinning every time you moved your head. For people with vestibular problems, this is a reality. But there is good news: vestibular rehabilitation therapy can help!
This type of physiotherapy helps to retrain the brain and restore balance. It can be life-changing for people who suffer from vertigo, dizziness, and other vestibular problems.
What is the vestibular system?
When you get out of bed or walk over rough terrain, a link between your inner ear and your brain helps you maintain your balance. This is referred to as your vestibular system.
Information from your inner ear organs is processed by your brain. Furthermore, it receives information from other senses such as vision, joints, muscles, and tendons throughout your body, hearing, touch, and even functions such as memory and emotion.
These nerve impulses are then sent to muscles in your eyes, trunk, and limbs, allowing you to respond appropriately to each situation.
What causes vestibular problems?
Head injury, ageing, and viral infection are the most common causes of vestibular dysfunction. Other diseases, as well as genetic and environmental factors, can cause or contribute to vestibular disorders.
Types of vestibular disorders
- Benign Paroxysmal Positional Vertigo (BPPV)
- Cervicogenic Dizziness
- Vestibular Neuritis/Labyrinthitis
- Unilateral Vestibular Hypofunction (UVH)
- Mal de Debarquement (MdDS)
- Vestibular Migraine
- Post Concussion Syndrome (PCS)
- Meniere’s Disease
- Neurological conditions (i.e. stroke, traumatic brain injury)
- Vestibular deconditioning from ageing or inactivity
- Persistent Postural Perceptual Dizziness (PPPD)
Common vestibular symptoms
- Problems with vision, double vision, shaky vision with head movement, difficulty focusing, and poor tolerance to screens.
- Vertigo, a sense of spinning.
- Imbalance and walking difficulties.
- Nausea, vomiting, and exhaustion.
- Tightness, stiffness, and pain in the neck.
- Dizziness or lightheadedness in general.
- Falls that occur frequently.
What is the most common vestibular disorder?
Benign Paroxysmal Positional Vertigo (BPPV) is the most common vestibular disorder. BPPV causes short, intense bouts of dizziness or vertigo associated with quick head movements, rolling over in bed, or getting up in the morning. Most people report acute episodes of nausea during or shortly after these dizziness attacks.
BPPV occurs when tiny calcium carbonate crystals (otoconia) become dislodged and travel around the canals of the middle ear. These crystals stimulate the nerves that detect head rotation. The brain receives the message that the head is spinning even when the head has only moved position slightly.
BPPV can come and go for no apparent reason. It is more common in ageing as there is degeneration of the vestibular system in the inner ear. 70% of people over 70 suffer from the condition at least once in their lifetime. Other causes include post head injury and during bouts of colds/flu.
The diagnosis of BPPV is based on:
- Your medical history
- Dizziness symptoms
- Results of balance assessment
- Physical examination
What is vestibular rehabilitation therapy?
Vestibular rehabilitation therapy (VRT) is a type of physiotherapy used to treat and improve the symptoms of vestibular disorders. It frequently entails manual head movements and a progressive programme of exercises to reduce vertigo and dizziness, imbalance, visual issues and falls.
When the vestibular system is injured, the central nervous system can compensate for the decreased function of the inner ears. To maintain vestibular balance, the brain adapts to the imbalanced signals from the vestibular system by learning to rely more heavily on alternative signals from other systems in the body.
When this brain compensation occurs, the patient’s symptoms are relieved, allowing them to resume normal function.
Benefits from vestibular rehabilitation therapy
- Improve your focus or concentration, as well as your memory.
- Improved ability to stabilise gaze or vision and track or focus on near and far objects.
- Dizziness symptoms have been reduced.
- Reduced risk of falling.
- Less nausea or vomiting.
- Balance is improved when standing or sitting.
How long does vestibular rehabilitation take to work?
Vestibular rehabilitation therapy generally takes six to eight weeks, with one or two sessions per week. On the other hand, some patients can successfully address their balance or dizziness issues in just one or two therapy sessions and experience results in as little as 48 hours.
However, this depends on the patient’s diagnosis, the severity of their symptoms, and their response to therapy.
The effectiveness of the exercise programme is determined not only by the exercises selected by the physiotherapist but also by the patient’s compliance with the program. Inconsistent performance of the prescribed exercises is the most common cause of a delay in recovery.
Variables that affect vestibular rehabilitation
- The stage at which treatment is initiated.
- Psychogenic Factors.
- Symptom severity.
- Visual and somatosensory inputs.
- Duration of daily exercise.
- The age of the patient.
Vestibular rehabilitation is an exercise-based program designed by a vestibular physiotherapist to improve balance and reduce dizziness-related problems.
The length of time it takes to recover from a vestibular disorder is highly variable and can range from a couple of visits to a chronic condition that is managed over time.