Understanding Vestibular Physiotherapy

Vestibular physiotherapy is a specialized form of physical therapy that focuses on addressing issues with the vestibular system—the inner ear and brain structures that help control balance and eye movements. When the vestibular system is affected, people may experience dizziness, vertigo, and unsteadiness, which can significantly impact their life. Vestibular Physiotherapy offers targeted exercises and strategies designed to alleviate these symptoms, helping individuals regain confidence in their movement and balance. 

Who Should Seek Vestibular Physiotherapy?

Anyone experiencing dizziness, vertigo, balance disorders, or unexplained feelings of disorientation should consider seeking Vestibular Physiotherapy. Specialized physiotherapists are trained to diagnose vestibular conditions, though it is recommended to consult a doctor if symptoms come on suddenly or without explanation. If you’ve already been diagnosed with a vestibular condition like BPPV, vestibular neuritis, or Meniere’s disease, you can often directly book an appointment for treatment. In many cases, a referral is not required to start treatment.

What Conditions Benefit from Vestibular Physiotherapy?

Vestibular Physiotherapy can be effective for a variety of balance-related conditions. Some of the most commonly treated conditions include:

1. Benign Paroxysmal Positional Vertigo (BPPV): The most common cause of vertigo, often triggered by changes in head position.

2. Vestibular Neuritis or Labyrinthitis: Inflammation of the vestibular nerve or inner ear structures can lead to sudden, intense dizziness and imbalance.

3. Meniere’s Disease: Characterized by vertigo, hearing loss, tinnitus, and fullness in the ear, Meniere’s disease can disrupt balance and coordination.

4. Concussion and Post-Concussion Syndrome: Head injuries often affect balance, coordination, and vision, making vestibular therapy a critical part of concussion recovery.

5. Persistent Postural-Perceptual Dizziness (PPPD): A chronic dizziness condition that can develop after a vestibular disorder.

What to Expect During a Vestibular Physiotherapy Session

In a vestibular physiotherapy session, a trained vestibular physiotherapist assesses your symptoms, including dizziness triggers, balance, and coordination. Sessions often start with a thorough examination that evaluates your vision, balance, and gait. Based on this assessment, your therapist will design a personalized exercise program, which may include:

• Balance and gait exercises: These exercises improve stability and coordination.

• Vestibular habituation exercises: These help your brain adjust to movements that trigger dizziness, gradually reducing the symptoms over time.

• Vision stability exercises (gaze stabilization): These exercises train your eyes to stay focused while your head is moving, minimizing blurred vision or dizziness.

• Canalith repositioning maneuvers (for BPPV): If you have BPPV, specific maneuvers can be performed to help move the displaced crystals in your inner ear back into place, effectively relieving vertigo.

Consistency and follow-up are essential for optimal results, and your therapist will adjust your program as you progress. Depending on the origin of our diagnosis, most people find significant relief from their symptoms after a few sessions, but some may need ongoing therapy depending on the severity of their condition.

Book Your Vestibular Physiotherapy Session

If you’re experiencing symptoms of dizziness, vertigo, or balance issues and think vestibular therapy may help, Port Alberni Physiotherapy is here to support you. Our vestibular therapist, Natasha Prokop, specializes in assessing and treating a wide range of vestibular conditions. You can book an appointment online at www.portalberniphysiotherapy.ca or call us at 250-723-5112.

Understanding Shin Splints: Causes and Recovery

As Marathon season approaches, many people are excited to begin their long-distance training. However, one of the most common concerns among runners is how to prevent shin splints. Shin splints are a common injury that can occur during long-distance running. Unfortunately, many people are unaware of what shin splints are, how they develop, how to treat them, and most importantly, how to prevent them. In this blog, we will discuss the two different types of shin splints, what causes them anatomically, effective treatment options, and how to prevent them if you plan to start a running program. We aim to help you stay healthy and keep you moving. 

First, let's start with the two types of shin splints: anterior or posterior. The difference between them is the location of pain, which is caused by the specific muscle group affected. 

Anterior Shin Splints: 

Anterior Shin Splints tend to be more common and involve pain along the front (anterior) part of the shinbone, typically on the outer edge.

Anterior shin splints affect the muscles at the front of the lower leg, primarily the tibialis anterior muscle. This muscle is responsible for dorsiflexion of the foot (bringing the toes upward) and is heavily involved in activities like walking, running, and jumping.

Posterior Shin Splints: 

Posterior shin splints involve pain along the inner (posterior) part of the shinbone, closer to the calf muscles.

Posterior shin splints primarily affect the muscles and connective tissues at the back of the lower leg, including the posterior tibialis muscle and the flexor hallucis longus muscle. These muscles play a role in controlling the movement of the foot and stabilizing the arch.

Now that we know the two different types, what actually causes shin splints? 

Shin splints are caused by repetitive stress on the shinbone and the tissues that attach muscles to the bone. For instance, during long-distance running, the muscles on the front and back of the shin bone contract every time your foot hits the ground. This can lead to irritation or inflammation where the muscles of the shin connect to the bone. The irritation and inflammation cause sharp pain during physical activity and impact, and sometimes a dull ache after exercise. The area of pain is usually a couple of inches and can be sore to touch. However, it typically improves with rest and doesn't usually show signs of swelling.

If you do notice any swelling or if rest doesn’t improve your symptoms, it is important to speak to your GP or physiotherapist. Sometimes, shin splints can be mistaken for a stress fracture and requires different treatment.

So what are the major contributing factors causing Shin Splints? 

• Overuse or Overtraining: Rapidly increasing the intensity, duration, or frequency of exercise, particularly high-impact activities like running, can strain the muscles, tendons, and bone tissue in the lower leg.

• Biomechanical Issues: Flat feet, improper footwear, or irregularities in running or walking gait can lead to uneven distribution of stress along the shinbone, increasing the likelihood of shin splints.

• Muscular Imbalances: Weakness or tightness in certain muscles, particularly the calf muscles and those surrounding the shinbone, can disrupt proper biomechanics and contribute to shin splints.

• Hard Surfaces: Exercising on hard surfaces, such as concrete or pavement, can exacerbate impact-related stress on the lower legs.

How Do I Prevent Shin Splints? 

Strength Training: If you're someone who runs long distances, it's important to start a strength training program that includes ankle and calf strengthening exercises. This is your first line of defense, as building strength will make you more resilient and better able to handle stress and strain without getting injured.  For injury-specific exercises, we recommend speaking with your local physiotherapist as exercises can vary depending the type and severity of your shin splints.

Soft Surfaces: Mix things up by running on softer surfaces such as trails instead of just on concrete or pavement. Trails provide more cushioning and put less stress on the lower leg muscles. You can also try using a treadmill, although for longer distances this isn’t always everyone's favourite. 

Good Footwear: Invest in good footwear that provides proper arch support, especially if you're prone to shin splints. Visit a local running store to get fitted for shoes that are best suited for you. 

Insoles: Consider using insoles if you have flat feet and have experienced shin splints in the past. Insoles can support the arch of your foot and reduce the load on the muscles in the posterior shin, lowering your risk of developing shin splints.

Running Assessment: Consider getting a running assessment to check your technique. Most physiotherapy clinics offer assessments where they record you running on a treadmill and review the components of your gait and any biomechanical factors that may be contributing to your shin splints. This typically results in a treatment plan and exercises to address the underlying issues.

What happens if I already have shin splints? How Should I treat them? 

Recovery from shin splints requires patience and usually a multifaceted approach:

• Rest: This is the most important but everyone’s least favourite option. You must reduce the volume and load on the lower leg muscles to allow them to recover. This may be reducing your running distances to a more manageable level or temporarily halting impact activity to reduce pain. Your physiotherapist will help explore options with you to decide what path will work best for you and your training. 

• Ice Therapy: Applying ice packs to the affected area can help alleviate inflammation and pain. Aim for 15-20 minutes of ice therapy several times a day.

• Strength Training: progressive strength training for your calves, the muscles of the anterior shin, arches of your feet and outer hip are beneficial while you “rest”, they can help increase resiliency of the injured muscle groups so return to activity doesn’t result in another flare up.  For injury-specific exercises, we recommend speaking with your local physiotherapist as exercises can vary depending on the type and severity of your shin splints.

• Gradual Return to Activity: Once the pain subsides, gradually reintroduce activity, paying attention to proper form, footwear, and surface. A Return to Run Program is always a smart choice, there are great ones all over the internet and your physiotherapist should be able to guide you. Slow progressions are key! 

If you or someone you know is struggling with shin splints, or have had shin splints in the past and want more prevention tips, book an appointment with one of our physiotherapists. You can book online at www.portalberniphysiotherapy.ca or call us at 250-723-5112. 

The Physical and Mental Benefits of Therapeutic Massage

Massage was once only available at high-end spas or considered a luxury. However, it is now included in many employee health benefits packages, widely available, and an important tool for promoting mental and physical health.

If you haven't had a massage before, it involves techniques such as pressing, kneading, and manipulating the skin, muscles, tendons, and ligaments of the body. The pressure used during a massage can range from light strokes to deep pressure. 

Massage is increasingly being offered as part of a standard treatment routine for injury rehabilitation, injury prevention, pain management, and is beneficial for a wide range of medical conditions. It is worth considering as part of your health routine if you haven't tried it yet.

One big misconception about massage is that it is only for indulgence and relaxation. While this may be true in some situations, massage is much more than that. Many massage therapists and body workers have a range of knowledge in strength training, home-care strategies, flexibility, and mobility exercise prescription, among other unique areas of interest.

In this blog, we will discuss the many benefits of massage.

Mental Benefits of Massage

Stress Reduction:

Massage is a powerful remedy for stress, as it promotes the release of endorphins - our body's natural stress-fighters. The gentle kneading and rhythmic strokes performed by skilled therapists work at easing tense muscles, leaving you with a sense of relaxation.

Taking time for yourself, be it 30, 60, or 90 minutes, can help you destress and improve your mental and physical health. Whether you spend this time in silence or casual conversation, just setting aside this time can be a significant stress reducer.

Improved Sleep Quality:

Sleep can be improved by massage as it helps induce relaxation, leading to deeper and more restful sleep. This can be particularly helpful for those who struggle with insomnia or irregular sleep patterns. Massage has been found to increase the levels of serotonin, which is a neurotransmitter associated with feelings of relaxation. In addition to this, massage can also reduce the levels of the stress hormone cortisol. These hormonal changes can create a better physiological environment that is more conducive to sleep.

Decreased Anxiety:

Massage can have a balancing effect on the autonomic nervous system. By promoting both the parasympathetic (rest and digest) and sympathetic (fight or flight) branches, massage helps the body maintain equilibrium, reducing the overall stress response and reducing anxiety. Studies have suggested that massage can lead to a reduction in cortisol levels, which are associated with stress. Lowering cortisol levels contributes to a more relaxed state and a reduction in anxiety.

Physical Benefits of Massage

Muscle Tension Relief:

A massage therapist or body worker directly manipulates muscles and soft tissues to help release knots, tightness, and adhesions, which allows the muscles to relax. As the therapist works on specific areas of tension, the muscle fibers are encouraged to lengthen, and the nervous system responds by signalling the muscles to let go of their contracted state. The overall result is a reduction in muscle tension.

Enhanced Circulation & Recovery:

During a massage, the gentle pressure applied to your body helps to stimulate blood flow, which in turn improves the delivery of oxygen and nutrients to different parts of the body. This improved circulation can help promote healing and recovery by delivering nutrients to your muscles and tissues more efficiently than before.

Pain Relief:

According to the Gate Control Theory of pain, non-painful input (such as the sensation of massage) can block the transmission of pain signals to the brain. The tactile stimulation from massage may help override or modulate pain signals, reducing the perception of pain.

Enhanced mental and physical relaxation is a benefit of massage (as seen above) which helps reduce pain. Massage also stimulates the release of endorphins, which are the body's natural painkillers. These neurotransmitters can create a sense of well-being and act as analgesics, diminishing the perception of pain.

Improved Flexibility:

Massage improves muscle flexibility by relieving tension, tightness, and restrictions in the muscles and tissues. Massage techniques like targeted pressure, passive stretching, and myofascial release help muscles relax and promote a wider range of motion. Massage releases trigger points, prevents adhesion formation, and addresses muscular imbalances, improving muscle function and flexibility. It alleviates stiffness and prevents future restrictions, promoting greater freedom of movement and enhancing physical well-being.

Massageis an excellent way to relax and recover from physical and mental stress. It's not a luxury but a vital health tool that helps with injury prevention, the healing process, and overall well-being.

If you are looking for a therapeutic massage experience book with our Body Worker, Taylor Christensen, online or by calling our clinic at 250-723-5112. 

The PEACE Method - The New Approach to Injury Management

After an injury, we often resort to the RICE or PRICE method, which involves resting, icing, compressing, and elevating the injured area. However, recent evidence-based updates suggest that avoiding anti-inflammatory medication is crucial during the first few weeks of healing. The acronym PEACE is now being used in injury management, and here is what it’s telling us:

Protection: The protection aspect of the PEACE method emphasizes the importance of protecting the injured area without completely immobilizing it. This may involve using braces or splints, which provide stability without restricting all movement.

Elevation: Similar to the RICE method, elevating the injured area can help reduce swelling and improve blood flow.

Avoid Anti-Inflammatory Agents: Unlike RICE, the PEACE method advises against the use of anti-inflammatory medications during the initial stages of injury, as inflammation is considered part of the natural healing process. Using anti-inflammatories may interfere with the body's ability to repair itself.

Compression: The PEACE method recommends a modified approach to compression. Instead of tight compression that might restrict blood flow, gentle compression may be used to provide some support without inhibiting the body's healing mechanisms.

Education: Educating the individual about the nature of their injury, potential recovery timelines, and the importance of active management is an essential aspect of the PEACE method.

Even though injury management techniques are constantly changing as new research is being conducted, it is important to put the newest methods into practice. At this point in the medical literature, if you use the PEACE method you are giving yourself the best chance at a full and healthy recovery.

Watch this video on the PEACE Method to learn more: