(Kelly Burch, PT, Vestibular & Balance Specialist)

Vestibular rehabilitation is a type of physical therapy that addresses patients who are limited by dizziness, imbalance, and/or vertigo.  The vestibular system consists of the inner ear and the brain which work together to process information from our senses, such as our vision and sense of touch.  Using this input from our senses, the inner ear and brain control a person's balance and eye movements.

If problems occur with these processing centers, a vestibular disorder can be the result and a person could experience the following most common symptoms:

• Feelings of dizziness (lightheadedness, wooziness, spaciness) that can be constant or come and go during activities.
• Room spinning vertigo, severe dizziness and/or a loss of balance sensation with certain head and body positions. 
• Imbalance, feelings of unsteadiness, difficulty walking a straight line, with or without dizziness.
• Difficulty performing standing activities due to imbalance.

These symptoms may occur without a known cause, could come on after being sick with a cold/flu, or when a person gets into certain positions.  Symptoms for some may be constant, while others may experience fluctuations based on their activities. 

Imbalance, dizziness, and vertigo can come from many conditions.  The most commonly treated in vestibular rehabilitation are vestibular hypofunction, cervicogenic dizziness, and BPPV (benign paroxysmal positional vertigo). 

Vestibular hypofunction occurs when one of the patient's inner ears is not functioning at the same rate as the other.  Information collected by the senses to keep a person balanced and oriented in their environment is slower to reach the brain for processing.  This can be caused by several factors, but when the problem occurs, it puts the patient into a state of disorientation causing dizziness, vertigo, or imbalance.

Cervicogenic dizziness is caused by a problem within the cervical spine or neck.  If range of motion is limited at the neck or weakness in the neck muscles is present, dizziness can come on with head movements.  This commonly occurs during or after prolonged forward head positions involved with tasks such as computer work, reading, or knitting.

BPPV (benign paroxysmal positional vertigo) is a condition that causes a person to have positional vertigo or dizziness.  There are small calcium carbonate crystals that can become dislodged from their normal location and move into the semicircular canals of the inner ear.  Once in the canals, they bump into sensitive structures that trigger vertigo.  The loose crystals start moving when a person puts their head or body into a certain position, such as looking up high, bending over, and/or rolling over in bed.  Treatment for this condition is extremely effective and involves moving the crystals back to where they belong through specific head and body positioning techniques.  

Although the symptoms of a vestibular disorder can cause anxiety; getting treatment can be very effective.  The length of treatment depends on the condition, but a compliant patient will get good results. Once therapy is complete, patients can return to their normal lifestyle without symptoms of dizziness or fear of falling.

If you think you need to be seen for any of these conditions, please contact our Blue Ash Center, 513.745.9877, to schedule an appointment with our vestibular and balance specialist.

Training for an endurance event, such as a marathon, should be an enjoyable experience, while at the same time providing you with many health benefits both mentally and physically. There are several important areas to understand in order to participate in a well-rounded, injury free program.

Keep in mind, you are asking your body to perform an activity that is new or more challenging than it is accustomed to. Aches and pains are normal, but should not be persistent. The most important thing to remember when training for any endurance-based event is to listen to your body. If an ache or pain lasts longer than one week, please seek medical attention from a qualified health care professional.

One of the most challenging aspects of any endurance based training program is the long run. So how does one attempt to prevent an injury? Here are a few tips to keep in mind...

1. Safety first. Make sure you check the weather, plan a safe route and wear reflective gear. If you have the option, run on a softer surface for part of your run to help decrease the high impact through your joints.
2. Schedule your run appropriately, if at all possible, mimic the time and day of the actual race and give yourself time to recover before the next training run and the busy workweek begins.
3. Hydration and nutrition are vital. A good guideline to keep in mind: drink one quart of fluid for every half hour of running. You may not feel the effects of dehydration until the middle of your next work out. Replenish energy lost but avoid refueling with items that put too much sugar in your system. Practice both hydrating and refueling during your training.
4. Mental preparation will help get you through your long runs. Break down your mileage in to smaller, more manageable goals. If needed, take a walk break to give your running muscles a quick rest or get a drink of water...and do not feel guilty. Also avoid trying anything new on race day. Joining a running group or having a running partner also helps keep you motivated and breaks up the long runs.
5. Pace yourself in training. Progress should be slow. Implement the 90 percent rule and go for quality over quantity. Pushing too hard all the time will leave you mentally and physically fatigued and at a greater risk for injury.
6. Proper equipment: Make sure to wear attire (socks, shirts, shorts, pants, undergarments) that wick away moisture to help avoid chafing. The use of some type of anti-chafe balm will also help decrease harmful friction. It is also very important to get properly fit for running shoes.
7. Try to stay loose. During your run, make sure to stay loose while running, especially when you begin to get fatigued. Relax your shoulders and arms and stop to stretch if needed. And remember, try to have fun.


(Article written by Julie Rigling, PT, DPT, featured in the Cincinnati Enquirer on April 12, 2012)

Alter-G Anti Gravity Treadmill

For those of you who want a different way of training, check out the Alter-G Anti Gravity Treadmill!

The latest addition to Cincinnati Fitness Running is the NASA-developed Alter-G Treadmill. Currently there are only approximately 150 of these treadmills throughout the country, with the next closest being located at the Cleveland Clinic.

By means of a plastic air pressurized "bubble" around the user's lower body, this treadmill lifts up to 80 percent of the user's body weight, removing the effects of gravity on the spine and lower extremity joints. It is similar to the effects of buoyancy in water but there is no resistance inside the bubble, allowing for the first ever anti-gravity treadmill with normal running mechanics and range of motion (unlike the aquatic treadmills that impeded normal running technique). This technology has already begun revolutionizing the rehabilitation field and may become a standard piece of equipment at all top-notch facilities in the US.

Some of the most prestigious universities and medical institutions, including the University of Southern California Medical College and the aforementioned world class Cleveland Clinic in Ohio, have demonstrated excellent Alter-G Treadmill results with patients suffering from Parkinson's disease, spinal stenosis, and orthopedic conditions of the spine, hip, knee and foot.

For more information on the Alter-G treadmill, please contact:

HealthStyle Fitness

4325 Red Bank Rd.

Cincinnati, OH 45227

513.407.4665

 http://www.cincinnatifitness.com/running-injury-alter-G-treadmill.html