The Therapist is In...Balancing Act: Overcoming Dizziness and Imbalance

The Therapist is In...
Balancing Act: Overcoming Dizziness and Imbalance
by Shannon Murphy, MPT

Keeping the body balanced in space is a complicated task. All movement requires a sophisticated process of input (evaluating the environment via sight, touch, etc), processing (interpreting that information in the brain) and output (sending a series of instructions to the muscles, nerves, etc to react to environment). Usually, all of that happens without conscious knowledge of our complicated grace.
When some part of that elegance breaks down, however, you can become unsteady. Or feel dizzy. Or simply notice that you have grown less agile over time. The consequences range from minor inconvenience to major incapacitation. The good news is that balance can be trained, and many forms of dizziness can be reduced or eliminated with exercise.
While most systems respond to training, specific deficits must be identified first. Some of the more common impairments include:
1. Poor flexibility. A loss of extensibility means that your tissues do not absorb forces or adapt to changes in the environment as quickly as they need to. Think about the difference between trees in a windstorm - the ones that fall tend to be the older, more rigid varieties ... not the supple pines or young saplings.
2. Decreased proprioception. "Proprioception" refers to your awareness of position, a perception that relies on receptors in your skin, ligaments, tendons and joints. People with sensory changes related to diabetes and peripheral neuropathy receive weaker signals than their normal counterparts. Patients who have had recurrent sprains or recent surgeries (like joint replacement) also have more difficulty with position sense.
3. Poor posture. Your body is designed to be vertical, such that the head and shoulders remain positioned over your center of gravity (in the middle of your abdomen). When you develop rounded shoulders, hunched back or a forward head (from osteoporosis, arthritis, or bad habit), it gives gravity an advantage in pulling you to the ground. It also changes muscle function, which can lead to various problems--including the development of trigger points that can create dizziness in some people.
4. Orthostasis. "Orthostasis" refers to a drop in blood pressure that can create temporary unsteadiness with changes in head position (like getting up from bed, or standing from a chair). Unfortunately, it is a side effect of many medications, as is general dizziness.
5. Vestibular problems. The inner ear is one of three "major" systems that contribute to your sense of balance (vision and proprioception being the other two). It functions like a gyroscope to maintain your sense of orientation. The brain interprets information from both sides, however, and if one side is malfunctioning -it can get confused and make you feel dizzy. Sometimes this happens after a virus, a blow to the head, or simply waking up.
Fortunately, the right treatment can improve mobility in your joints, sensitivity in your position receptors, and strength in your postural muscles. Some orthostatic conditions respond to conditioning (being sedentary or bedridden affects blood pressure receptors in a negative way), and many vestibular problems respond to eye exercises, repetitious movements, or specialized head maneuvers.
So, if you find yourself dizzy - do not delay! Agility and grace are not exclusive to the young.
* See your doctor (to check for cardiac problems, brain disease, vascular disorders, anxiety, vitamin deficiencies, medication problems, etc),
* Get your eyes checked (the wrong prescription can contribute to problems)
* Schedule a "tune up" with your local physical therapist!

This series of columns are by Shannon Murphy, MPT, Owner/Director of BodySense PT. 9 Saint Paul St, 3rd Floor, Boonsboro, MD 21713. 301-432-8585 phone, 301-432-1987 fax,