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!

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