Epley Maneuver - How To Do It & How It Works (VERTIGO FIX!)

Welcome back to Movement project pt Tim Rementer  doctor of physical therapy and if you're   experiencing spinning type dizziness or vertigo  you're going to want to try the Epley maneuver   to effectively treat it. This maneuver was  first described in 1980 by Dr John Epley.   Before we do the Epley maneuver we need to  find out which side our problem is truly   coming from. Typically your involved side will be  the side that causes you symptoms when you roll   or turn in that direction. But that's not always  the case so that's why we want to jump into the   dix hall pike test. To do the dix hall pike  maneuver grab yourself a pillow and place it   a few inches from the end of your bed then  you turn your head to the right 45 degrees.   Lift the chin 30 degrees and bring yourself  down so the head hangs over the pillow. if this is your involved side it's going  to bring on tremendous amount of dizziness   you want to stay there until the dizziness  subsides and then we know that we can move forward   with the Epley maneuver to the right in this case  whichever direction your head is when you go down   that's the side that your problems are. Same  thing on the left if the right was not a problem.   lift the chin head turn 45 degrees we go down and  hang off of the pillow now if neither of these   sides produce your symptoms chances are you do not  have positional vertigo and you want to reach out   to your physician or movement specialist to try to  get to the bottom of your problem. Now let's say   for the sake of the video that our problem is on  the right side/the right inner ear canals. we're   going to leave our pillow just like we did for  the dix hallpike test and we're going to get into   the same start position with our back facing the  pillow and our legs straight out in front of us.   again we'll go 45 degrees to the right 30 degrees  extended with the chin up and we go down over   the pillow extending our head typically in the  physical therapy office we'll have someone's head   hang off of the table but since you'll be doing  this yourself you don't have that luxury so you   can just use the pillow now you want to stay here  until that significant strong dizziness goes away   plus 30 seconds so you should be completely  symptom free before moving on to the next step   once you feel that you're back to baseline  plus 30 seconds you're going to keep the   chin up 30 degrees and you're going to turn  your head 45 degrees to the other direction. this may produce dizziness. in fact, every  position of this treatment could cause dizziness   as we move the crystal around from one part of the  canal in our inner ear to the other - eventually   back to the central region. same deal...wait till  symptoms are gone plus 30 seconds. Then we move   to the next phase of the test which is to  roll to your left side keeping the head in   the exact same position relative to your  body so we tell patients to be prepared   to look to the floor when they're on their left  side and you want to keep that chin over toward   that shoulder bend your right knee which is  going to help you roll start to move your butt   get your hand there so you feel  protected and roll all the way over. Again wait till your symptoms are gone plus 30  seconds and then you can move on to the next   part of the test which is going to be coming to a  sitting position we want to maintain this position   of our head relative to our body so that we don't  allow that crystal to go backward in the canal   drop the legs off the edge  keep chin over to the shoulder   sit straight up if it produces dizziness again  wait 30 seconds before straightening your head out   and you're all done now from there we can rest  typically five to ten minutes and possibly try a   second treatment and even up to a third treatment  i typically do two treatments on the first day   and it usually gets us the results we're looking  for now typically we tell patients for the next 24   hours after doing this test you want to avoid  doing anything that may produce symptoms or   bring that crystal back into the canal this would  include lying down flat so make sure the evening   after you do your test you try to sleep elevated  at least 30 degrees now research is somewhat   controversial on this topic and has shown that  there's not a real significant difference between   doing those activity changes or  modifications and not doing them   but better safe than sorry often people  wonder how this little maneuvering of   our head and body around can cure what seems  to be such a horrendous problem like vertigo   the way it works is we have these  buildup of crystals that break off   in our inner ear and provide a false stimulation  to your brain telling you that your head is   spinning there's a tight connection between your  inner ear and your eyes which is what causes that   nystagmus or that eye jumping back and forth  movement that occurs when we're examining you   in the centers that also produces that sensation  that things are spinning around as your eyes jump   so you have this crystal that's stuck in your  canal and the goal is to get it over to this other   side but you can't get there in this fashion so  we need to go all the way around we lie back down   on our right side it brings the crystal down to  this part of the canal then when we turn our head to the left in the case of a right-sided  crystal it goes to that part of the canal   and when we roll to our side it brings it over  we keep our head turned that way when we sit up   and then we are back where we want to be and  hopefully all your symptoms are resolved if you're   having more difficulty and this does not solve  your problem make sure you reach out to your PCP   for a referral to a movement specialist that  focuses on treatment of vertigo and the vestibular   system now one thing i found in practice is that  the neck is extremely stiff for a lot of these   folks suffering from vertigo so that can be an  issue when you're trying to do the Epley maneuver   because your neck simply doesn't extend to the  30 degrees required to get an optimal result   so what we will do in therapy is spend several  weeks working on improving neck mobility first   and then we're able to typically get the results  that we desire at the Epley. Please comment if you   found this video helpful especially if it helped  eliminate some of your dizziness! Don't forget to   subscribe to my channel to help me on the mission  to cut out unnecessary surgery and opiate use!

Channel: Movement Project PT

Views: 495,865

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Id: DEkkhBP71aE

Length: 6min 51sec (411 seconds)

Published: Sun Nov 01 2020