Ask A Physio (COVID Edition): Why Is My Dizziness Worse?

The unexpected effects of COVID seem to be never ending. From toilet paper shortages to Clorox winning the stock market, we are living in a reality none of us could have predicted. It was impossible to buy yeast for months -that’s weird!

A big unexpected effect for me and my vestibular clients has been a sharp increase in dizziness. Almost daily, I'm seeing clients from months and years past saying the same thing:

My symptoms are coming back and I don’t know why.

Here’s my break down of why I think this is occurring and what you can do to combat it.

The success of vestibular rehabilitation relies on three key components:

1. Appropriate exercises that target the right problems - when working with someone with a vestibular disorder, it’s important to zero in on the cause of the problems and give the right exercises (learn more about that here).

2. Getting enough activity and stimulation to keep everything firing - it’s the classic 'Use It or Lose It’. For any brain to learn and retain anything, it needs to be used. This is one of the principles behind neuroplasticity (learn more about that here).

3. Managing stress and fatigue - these two things are the biggest inducers of vestibular symptoms. When stress or fatigue increase, symptoms typically aren’t far behind.

For most people, this pandemic has thrown two of the three components right in the trash. Stress is way up and activity levels are way down. Since the beginning of the year, there’s been a well documented rise in stress, anxiety and depression in the general population. This has spilled over into every area of our lives including the vestibular system. Combine that with less movement in our days - no exercise classes, working from home and staring at a screen for waaaaay longer than normal - and you have a recipe for a vestibular disaster.

So how do you combat this? How can you avoid this system crash?

1. Get outside. For your brain to be happy and stimulated, you need unpredictable stimuli. You need to see the birds swooping in the air and the cars driving by you. You need to navigate curbs, potholes and other people. You need to get outside the four walls of your home and let your brain experience something else.

2. Try something new. I know this is hard to do in a pandemic, but there are lots of pandemic-friendly activities that are also great for your vestibular system. Online exercise classes, diving headfirst into more complex recipes in the kitchen and dragging your bike out of the garage for a 10 km ride are all great ways to give your brain a real work out.

3. Go for a walk with a friend. This is very much a Dr. Bonnie Henry-approved activity and a great one for your vestibular system. Not only will it help you lower your stress levels but the activity of turning your head to talk to your friend as you walk is a great vestibular exercise!

4. Meditate. The research behind mindfulness practice and meditation is staggering in its breadth. It has been shown to decrease the symptoms of anxiety and depression, lower blood pressure, improve sleep, help control pain and improve quality of life. If you’re not sure how to get on the meditation train, guided meditations are a great starting point - you can find several on Youtube or through apps like Calm and Headspace.

5. Practice your vestibular exercises. If you’re a client of ours, you likely have a maintenance program you were given on your last day with the instructions to practice them three times per week. If you’ve fallen off the vestibular exercise wagon, it’s time to climb back on.

6. Get the right help. If your symptoms are skyrocketing, reach out! It may be that a vestibular therapist is the right person for you or it may be a counselor or psychologist is your best bet. A conversation with your family doctor is also a great place to start.

Whatever the reason for your symptom increase, know these two things: you are not alone and there are things that can help get your symptoms back under control. Reach out to us at (778) 630-8800 or by email. Through in person or virtual appointments, we are here to help!

Joy

I am starting to love the ritual of Sunday mornings. It usually goes like this: we have a lazy breakfast (this morning, it was poached eggs on toast), then the kids go play outside while I sip a London fog and and peruse the New York Times.

I opened up the Times this morning to a special section simply titled “JOY”. It was filled with articles about finding joy in forgotten and unexpected places (acronym included!): “The Joy of Consuming an Obscene Number of Calories Before Noon (J.O.C.A.O.N.O.C.B.N)”, “The Joy of Picking a Fight (J.O.P.A.F.)” and 12 others that brought many a smile to my face.

“The Joy of Jogging Very, Very Slowly”? This one very much spoke to me.

This got me thinking: what has brought me joy in these times? What may bring you joy, if you haven’t found it already? Here’s my list of things that have brought me hidden and unexpected joy.

The Joy of Getting Dirty in the Garden (J.O.G.D.I.T.G.)

My garden! Carrots and radishes and spinach, oh my!

I’ve never been a gardener. It’s not that I wasn’t interested necessarily - I’ve always loved a burst of colour amongst a sea of green. But it’s never been something I did. At the beginning of this whole thing, I asked my husband to build me some planter boxes so I could try my hand at growing things. He was skeptical - the only thing I’ve managed to keep alive are the kids, plants be damned - but he acquiesced and built two beautiful raised beds for me to plant anything I wanted.

Turns out: I’m a gardener! I love it. I love training the peas and tomatoes up the trellis. I love the science of it, the art of it. Learning what to plant with what, what foods they need, what to plant where and why. It’s soul filling in a way I didn’t know it would be.

The Joy of Terrible Yoga (J.O.T.Y.)

The more I practice physiotherapy, the more I’m turning to yoga postures to stretch, to activate, to control a movement I need my clients to focus on. It could be a simple Child’s Pose for someone with a stiff shoulder or back or a flow between Downward and Upward Dog for those suffering from dizziness.

Full disclosure: I’m terrible at yoga. TERRIBLE. My balance sucks, my grace in movement is… graceless? Is that a word?

But I’m loving it. I love doing it. It FEELS good. The worse I am at it, the more I laugh at my terrible-ness and the more joy I find in it. The best is doing it with my kids - there’s something particularly enjoyable about learning something from scratch with your mini-mes. (We’re really into Cosmic Kids Yoga - Jamie is awesome!!)

The Joy of The Aimless Drive, Bike Ride and Walk (J.O.T.A.D.B.R.W.)

Like most of you out there, I’m busy. I have a full time job, a partner, two kids and responsibilities. A seemingly endless list of responsibilities. I usually try to pair movements with extra function - going up the stairs? Take this laundry basket! Going for a walk? Pick up some lettuce! The more efficient I can be, the more time I have for myself… right? Although, it never seems to end up that way.

We have gotten into the habit of a bike ride after dinner. My kids take turns leading. Where are we going? Who cares! We’re having fun! It’s freeing in a way I forgot about and so happy to have experienced again.

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What are your New Joys? What has brought you happiness during these past few months? We would love to hear it!

Ergonomics: The At Home Edition

So you’ve found yourself working from home all of a sudden. Kids are underfoot, you don’t have a proper office or even a desk to claim for yourself and the online video meetings seem to be endless. Chances are, you’ve had to improvise. Maybe you’ve been waking up, staying in your PJs, and curling up in bed with your laptop. Or maybe you find yourself sitting cross legged on the couch, laptop down on the coffee table.

I saw an article recently compiling “unglamourous” photos of people’s at home workstations. There were photos of people balancing their laptops on recycling bins, using ironing boards in their bathrooms – there are definitely some very creative people out there. This may have all been fine for the first couple of days, but now that it’s been a few weeks, I’m guessing you’ve probably started noticing some new aches and pains that only seem to appear after a day working from home. Is your neck starting to throb? Low back feeling angry?

The good news is, that doesn’t have to be your new reality! And no, you don’t need to order the fanciest ergonomic chair, or that automatic sit-stand desk! The great news is that even if you don’t have access to a desk at all, there are simple ways that you can make your own ergonomic work station at home, using things you probably already own!

Why Is An Ergonomic Set Up So Important?

Let’s start by quickly reviewing why an ergonomic set up is important at all. You’ve probably already noticed that your body doesn’t react well to sitting cross legged with your body hunched over, neck curled down while you work on your laptop for 5 hours. But why is that?

First of all, our bodies were not designed to be in any one static posture for hours on end, so even if you are in a so-called “perfect ergonomic set up” it is still very important that you change your position and take moving breaks regularly. But when we are in a prolonged poor posture, the effects are worsened as some muscles remain in a shortened position while others are overly stretched. Therefore, we want to remain in a relatively neutral position. (For more information, check out our previous blog on the physics behind ergonomics.)

How do you do that? Focus on these three things:

1. Screen Height: The top line of your screen should be just around eye level or slightly below and within arm’s reach so that your neck can remain in a neutral position rather than constantly looking down or craning forward. If you don’t have an external monitor you can adjust, you can stack books under your laptop or monitor until you attain the correct height. Don’t have a ton of books? You could use an upside down laundry hamper, tupperware, shoe boxes, old boardgames - the options are endless!

2. Keyboard and Mouse: If you are using a laptop, the keyboard height may now be too high for your wrists/arms. This is where getting an external keyboard and mouse can be so pivotal. While external monitors are often quite pricey, an affordable keyboard and mouse are much easier to find. You can now set up the keyboard and mouse in a way that your wrists are not curled up or down, with your elbow bent at around 90-100 degrees by your side, and arms supported. The position of your keyboard/mouse should also be close enough to you that you are not having to reach to use them.

3. Chair Set Up: If you’re going to be sitting, you want your hips and knees to be bent to around 100-120 degrees, with your feet supported – no dangling feet! Find a box, books, anything that can support your feet while maintaining a height that will allow the above set up to happen. You can also use a rolled up towel or small cushion to support your lower back, and maintain your natural lumbar curve.

Change Your Position Frequently

So now that you know the basics of how to set up your work station ergonomically, you can change it up, while maintaining the essentials. This is important as the best posture is a changing posture. This means you can stand or walk on the spot while working, while maintaining all of the above elements. And if you don’t want to have to keep adjusting your work station, take short but frequent stretch breaks (every 30 minutes or so). Get up and do a quick lap of your room, move your neck, do a few lunges.

Some Big No-Nos

• Clutter: If there’s a lot of clutter under your work area, there won’t be any space for your legs and feet to sit comfortably. If there’s a lot of clutter around your work area, you’ll be constantly reaching over things to get to what you need, resulting in unnecessary repetitive strain. Place what you need close by, and remove what you don’t need.

• Poor Lighting: Glare, or light reflected off of your work surfaces into your eyes, can be not only irritating, but can also result in more aches and pains if you end up in a poor posture trying to avoid the glare, or leaning to see your work better. To avoid this, position yourself so that you are either sitting beside or parallel to the window, and between lights in your room. If you have overhead lighting, make sure your screen is at a right angle to the work surface.

And there you have it - easy and simple ways you can make working from home way easier on your body. And most importantly...don’t forget to keep moving! Check out our blog on fun ways you can keep moving while in quarantine.

Looking for some individualized tips to tweak your own at home workstation? We are here for you! Book online, email us at clinic@ladnervillagephysio.com or call us at (778) 630-8800.

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RESOURCE LINKS:

1. WorkSafeBC [Internet]. Worksafebc.com. 2018 [cited 7 April 2020]. Available from: https://www.worksafebc.com/en/resources/health-safety/books-guides/how-to-make-your-computer-workstation-fit-you?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23q%3Dcomputer%2520workstation%26sort%3Drelevancy

2. Office Ergonomics: Practical solutions for a safer workplace [Internet]. Lni.wa.gov. 1995 [cited 7 April 2020]. Available from: https://www.lni.wa.gov/IPUB/417-133-000.pdf

Quarantined? Keep Moving!

If you’re anything like me, the world is an anxiety-producing place right now. Every company I have ever given my email to is sending me their COVID-19 updates. I understand why but it’s not helping my mind calm down.

There is a huge body of research showing how exercise helps with a whole assortment of mental health conditions. As gyms, pools and public spaces shut down, several companies are stepping up and offering their services online, often for free.

Down Dog owns a series of online apps, all of which they are providing for free during the COVID-19 outbreak, helping people to stay as healthy as they can in their own homes. You can find their apps on iOS or Android. Here’s what they do:

• Down Dog Yoga - yoga from home! You can chose your practice type (restorative, flow, hatha, gentle, etc), your level (Beginner 1 on up) and how long you want your practice to be.

• Yoga For Beginners - completely useless at yoga? Try this one!

• HIIT Workouts - for something more intense, try this one. Again, you can choose your level of difficulty, your focus (total body? arm workout or glutes?) and how long you want to go for. The best part? NO EQUIPMENT REQUIRED. Just turn it on and GO.

• 7 Minute Workout - same idea as HIIT with a little bit less intensity. And hey, who can’t give 7 minutes a day for a little sweat?

• Barre Workouts - are you caught up in the barre obsession? This is a great way to get at home! I’ll probably break this one out with my kids too - they’ll love practicing their ballerina moves. Once again, it’s the same idea - pick your focus and your time, then go for it!

The Washingtonian, an online publication out of the states, published a list of fitness studios offering their classes (some for free!) by online stream. Take a look and see what strikes your fancy. They’ll also be updating their list as the days go on.

One of my favourite meditation apps is Headspace, available on iOS and Android. In response to the outbreak, they have created a “Weathering the Storm” category with free meditations, sleep stories and more! If meditation is something you’ve been meaning to get into, now is definitely the time and Headspace is a great way to get started.

Finally, one of my favourite home exercises is an oldie but a goodie: Twister with my kids. The pretzels I twist myself into are certainly a good workout!

As of March 16, 2020, the biggest rule is social distancing. That leaves all kinds of things available for us - a lovely bike ride on the dyke! Walking among the tidal flats at Centennial Beach! Going for a jog in the gorgeous sunshine! Get outside for now and stay moving for the long haul.

Do you have a favourite website, app or idea for this outbreak? Let us know and we will add it to the list!

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As always, if you’d like to book in with a physiotherapist, give us a shout at (778) 630-8800 or clinic@ladnervillagephysio.com. We are also now offering Telehealth services for those unable to come in person.