Treating as a Vestibular Physiotherapist
By Tori Etheridge, Physiotherapist & Rehabilitation Supervisor
My Road to Vestibular Rehabilitation
My interest in vestibular rehabilitation started when my first lecture on the vestibular system had me intrigued and hooked to want to learn more. It was just so complex and fascinating!
After graduating with my Master of Physical Therapy degree from UBC, I started working as an on-site physiotherapist in hospitals. While working in the Emergency Department, I would often get calls to see clients who reported symptoms of being dizzy, and as a result, were unable to walk or function in other ways.
Dizziness can negatively impact your life more than someone realizes, and unless you experience symptoms of dizziness, it’s hard to understand how debilitating it can be. I quickly realized how much more training and education I needed to help understand why people experienced dizziness and how physiotherapy could help. I started taking continuing education vestibular courses, and the more I learned, the more I realized how much there is to learn. This led me to my vestibular certification training through Emory University in Atlanta, Georgia.
Dizziness and Vertigo
Once a significant medical cause for dizziness such as a stroke is ruled out, many people are left with no direction or guidance from their treating doctor. I have many clients who have been off work or stuck at home because of their dizziness. Being dizzy is terrifying, especially when you don’t know why it’s happening, when it’s going to come on, and how long it will last. Educating my clients to help them understand why they are dizzy, providing them with treatment to ease their symptoms of dizziness, and teaching them self-help strategies and techniques to help improve on their own lets me aid them in getting their life back, which is so rewarding.
Dizziness really can take over your whole life. It can cause you to isolate from family and friends and impact your ability to work or play with your kids. Sometimes the causes of dizziness can be something we are able to fix right away (such as BPPV), and other times it takes time and consistent physiotherapy treatment to teach the brain how to listen to the vestibular system again and self-regulate. I want to do everything in my power to help people get back to living their lives.
Vertigo and dizziness are not the same thing, even though they are sometimes used interchangeably. Vertigo is often a sensation of movement, whereas dizziness can be feeling off, light-headed or being off balance. Our vestibular system is located in our inner ear, and any issues with the vestibular system can cause both symptoms of dizziness and/or vertigo, which is why one can often be misdiagnosed for the other. There are many causes for dizziness, and sometimes the wrong treatment is being prescribed, leading to little to no improvement for the clients and increasing their frustration levels.
Assessment and Treatment
A comprehensive assessment with a certified and experienced vestibular physiotherapist is so important in mitigating the misdiagnosis risk.
For example, with BPPV (benign paroxysmal positional vertigo), people often have symptoms of vertigo. BPPV is a condition where calcium carbonate crystals enter the semicircular canals and affect how the fluid in there moves. Imagine small rocks inside a hose. When the fluid can’t move properly on one side of the vestibular system, the information from one side versus the other does not match. This mismatch can lead to nystagmus of the eyes and symptoms of vertigo reported by the individual.
Other conditions, such as a unilateral hypofunction, result when one side of the vestibular system is not working as well as the other side. This can be caused by many things such as a cold, an ear infection, medication or a brain injury. When this occurs, people can have symptoms of dizziness and/or vertigo.