Tackle The Root Cause of Your Vertigo
Kara Gordon Palley 
Over the years many treatments have been identified to manage this debilitating and terrifying condition. But none try to tackle the root causes.
Introduction: WHY THIS FITNESS PROFESSIONAL WENT ON A DEEP DIVE ON VERTIGO
(Update of previous blog post, including new evidence)
If you've ever had vertigo, there's no mistaking the sensation. If you are close to someone who has had it, you have a good idea how terrifying and debilitating it can be.
The main symptom is severe dizziness, like an extreme sense that the world is spinning around you. Other symptoms include nausea, vomiting, double vision, decreased hearing, ringing in the ears, sweating and migraines. Depending on the cause, an episode can last for a few minutes, or for hours, days, or even weeks!
I have a few clients and friends that suffer from vertigo.
Early on in my fitness career I sought to understand what might pre-dispose these very busy women, mostly mothers and grandmothers to vertigo, and more importantly, what I might be able to do to help them.
Most of the information I found on the internet was repetitive, analyzing and describing the various types of Vertigo, explaining who is most at risk, identifying possible triggers, and listing treatments/remedies geared towards short-term relief.
None of it touched on possible underlying cause(s). Since It becomes more common with age and affects women two to three times more often than men, this was very hard for me to swallow.
I thought, how can we:
1) simply tell them to gently ride out the storm,
2) perform a few maneuvers/adjustments,
3) suggest dietary restrictions,
4) advise stress reduction or even
5) prescribe anti-depressants and then send them on their merry way?
Unfortunately I had to put it aside, thinking "what do I know?" I am not a doctor or a scientist. My sample size is small and my fitness coaching practice isn't exactly a controlled peer-reviewed study.
In our one-size-fits-all, treatment focused world, no one talks about prevention. There are many good ways to treat an episode but wouldn't you love to have fewer episodes, or never have one?
Going down this rabbit hole left me optimistic! You definitely can reduce your risk of the most common form of vertigo through better lifestyle choices.
Let's see how it is all tied together.
Background on Vertigo
Although it can be caused by a virus or a tumor, what I am talking about here when I refer to Vertigo is BPPV, or Benign Paroxysmal Positional Vertigo. It accounts for around 20% of all vertigo diagnoses and is thought to be idiopathic - meaning there is no known cause or origin.
These idiopathic episodes are triggered when our central guidance system is, well, out of whack. We rely on this system to help us determine and read our gravity field, or our relationship to the ground - all day every day.
We can read our gravity field in three ways, through:
1) Vision - seeing where you are walking helps you keep your balance.
2) Proprioception - this is an inner sense, like your body always *just knows* where it is in relation to the ground.
3) The Inner Ear - there are three interconnected semicircular canals located deep in the inner ear. They are filled with a fluid called endolymph. This fluid flows freely when when these three systems are in sync.
But the inner ear can't see, it registers the field of gravity by the position of the head, and whether the ears are perpendicular to the ground (aligned) or angled (out of alignment). If the head is out of position, the reading of the inner ear is at odds with the other two systems. Then these systems begin to have an argument, so to speak, which may lead to false movement signals to the brain, which could then trigger an episode.
How Does Fitness Tie In?
My rabbit hole investigation started to look up when I enrolled in Dr. Sarah Ellis Duvall's Postpartum Corrective Exercise Specialist (PCES) certification course in 2018. Scientific studies are a major part of the curriculum.
As I was reading one of the studies: "Tempromandibular Disorder and Dysfunctional Breathing" (all links at end of post), included in the Postural Alignment part of the course, this quote practically lept off the page at me:
"The effects of the forward cephalic position for a long period are: alterations of proprioceptive pulses (with space disorientation, dizzies, nauseas and vertigo) due to sternocleidomastoideus hyperactivity and shortening, which commits nervous structors, cephalic pain, occlusal alteration, more posterior dental contact, more compression of TMJ due to mandibular replacement, with consequent cranium-facial pain. It is concluded that TMD, as well as cephalic pain, dizziness, vertigo, nistagmo and the swallowing difficulty, can have extrinsic origin in the system stomatognatic."
Translation: poor posture, in this case forward head syndrome and mouth breathing (whichever came first) might be putting you at risk for Vertigo.
Quick Anatomy Review, And What Posture Has To Do With It
The postural system of the body incorporates the following complexes: cerivcal (head), thoracic (mid-upper back), and lumbo-pelvic-hip (low back, pelvis and hip).
Vital activities such as breathing and movement depend on proper integration and coordination of these systems. The system is operating efficiently and safely when all muscles are doing the jobs they are supposed to do, in the right position, at the right time and with the right amount of force.
Dysfunction anywhere in the system will lead to compensations elsewhere, which will multiply, causing more compensations, eventually leading to a breakdown of the system.
Upper thoracic and mouth breathing patterns have a variety of causes, but they always result in the overuse of what's known as the accessory breathing muscles in the shoulders, head and neck (the sternocleidomastoid mentioned above) rather than the primary breathing muscles (the diaphragm and the muscles that run between the ribs) to facilitate easier breathing. The same goes for forward head posture.
The result of these dysfunctional patterns can be seen throughout the postural and nervous system. The effects include:
- rounding of the upper back,
- forward head syndrome,
- TMJ,
- headaches,
- neck and shoulder pain,
- forward rib flare (and the appearance of a bulging belly),
- low back pain,
- decreased diaphragm expansion,
- poor neuromuscular control of the intrinsic core stabilizers (including the diaphragm),
- poor proprioception,
- tension/anxiety, and
- DIZZINESS (including Vertigo)
So, forward head syndrome, and the continuous compensations of the body can put you in a vicious cycle. Even though it is that very compensation that helps most vertigo episodes to resolve on their own within a day or two, compensation will also keep making things worse.
Not only will it keep moving your head position forward, which can trigger new bouts of vertigo (and more compensations), it may cause a thickening of the inner ear fluid which then can cause microscopic calcifications to form and attach to the cilia of the inner ear, further impeding the flow of fluid.
This is what may contribute to long-term bouts of vertigo that can last weeks or even years!
New Study - Unhealthy Lifestyle Is an Important Risk Factor of Idiopathic BPPV
Researchers in Hangzhou, China found that the number of BPPV diagnoses increased more rapidly during the COVID lockdowns than in the same period in 2019. So they investigated the risk factors of BPPV; and hypothesized that the onset of BPPV was associated with people's unhealthy lifestyles - namely "poor physical activities and prolonged recumbent position time" - meaning lack of movement and excessive sitting.
They found that The BPPV group had "unhealthy lifestyles such as poor physical activities, prolonged recumbent position time, and low rate of calcium or VD (vitamin D) supplementation"
Further:
"Through this clinical study, we hypothesized that the broken otolith of the endolymph in healthy people may be continuous, which may be absorbed and dissipated due to regular exercise and suitable recumbent position time. For those who have prolonged recumbent position time or poor regular physical activities, the deposition is affected by gravity, and when they move position such as getting up from a resting position or turning over, it may result in BPPV......The movement of the body and head may promote the circulation of the endolymph in the semicircular canal, and the degenerative otolith also dissolves and dissipates with the circulation. However, prolonged recumbent position time or poor regular physical activities will slow down the circulation. The otolith particles in the membranous labyrinth will also increase due to the unhealthy lifestyle. The three-dimensional movement of the body and head may promote the formation of the normal structure and functional remodeling of otoliths on the utricle. However, an unhealthy lifestyle may lead to otolith structural disorder, which may lead to the otolith falling off easily."
In other words, regular movement and minimized sedentary time keeps the fluids flowing and the inner structures working properly. Lack of regular movement and excessive time sitting interrupts this process.
This means that even if you DO have forward head syndrome, you can still reduce your risk through better lifestyle choices.
Conclusion: GET UP AND GET MOVING!
Full circle - what does this have to do with my clients? Well, life has thrown them a perfect storm of events that often leads to worsening posture, breathing dysfunction and a sedentary lifestyle. These events are pregnancy, childbirth and (eventually) pre-menopause and menopause!
(Please note: I am NOT recommending avoiding medical professionals. It is vital to visit your doctor if you're experiencing symptoms of Vertigo to rule out more serious disorders. But you owe it to yourself to have a complete breathing and postural analysis by a competent professional, even if you've never had any Vertigo symptoms. Because if you're a mouth breather and/or have forward head posture, you are likely confronting other health issues besides possibly setting yourself up for disorders like Vertigo.)
Sources:
https://www.rd.com/health/vert...
https://doi.org/10.1055/s-0029...
https://www.coreexercisesoluti...
http://www.academia.edu/131866...
https://www.frontiersin.org/ar...
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Categories: Move