- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together, we are the most famous
physical therapists on the internet.
- Well, in our opinion, of course, Bob.
- It's always our opinion, Brad,
and we're always right.
Today we're gonna talk about top three signs
your vertigo is benign, paroxysmal,
positional vertigo, or BPPV.
- That's a mouthful either way.
- I'm not sure if I'm even saying it right
to be honest with you, Brad. It probably is wrong.
But this is the most common source of vertigo.
Vertigo is when you put your head in a certain position
and you start getting spinning.
- Right.
- And by far the most common cause of that is BPPV.
So we're gonna show you some signs and some tests
that you can do to see if it is there.
- Sure.
- So, now obviously this isn't something
you're gonna diagnose yourself.
But you know, at least it gives you some weapons
when you go see your doctor to talk about what,
you know, I think this might BPPV.
- Right, and everything's not a big surprise.
You kind of have an idea of what may be coming at you.
- Right.
Very disturbing when you start getting that dizziness,
isn't it? So. - Right.
And actually sometimes it may not be dizziness.
It might be lightheadedness and other symptoms
that in your head that just don't feel-
- And we're gonna talk about that, 'cause but quite often
some of the things that tend to set it off are
like rolling over in bed, getting out of bed,
washing your hair. - Right.
- Like in the shower, putting it back,
gardening. - Right.
- Also like this one happens to me.
When I go in the dentist chair, they take me back.
- Yep.
- Or when you're in the beauty parlor.
- Right. - So.
- Yeah, not getting your haircut gets it,
but the position changes basically.
- Now, if it's BPPV, generally what happens is
you're gonna first get the the vertigo,
which usually comes on you know,
when you go in a certain position,
when you put your head in a certain position.
It may take up to 40 seconds to start.
Brad and I have found most cases, it starts right away.
But it won't last more than 60 seconds.
- And if it lasts more than 60 seconds-
- It's something else.
It may be a different type of vertigo,
It may be Ménière's disease.
I mean, it could be a lot of other things.
- Sure.
But it's unlikely to be BPPV.
- Okay.
- Now, after the dizziness, after you have the episode,
after that goes away, you may have balance issues
that may last you know, up to a couple hours,
up to a couple days.
Right. You may fall down.
- Yep. You might have a lightheadedness.
People talk about floating.
I had a couple people on the internet
that talk to me about this. - Headache.
- I don't know about a headache.
- Mkay. - 'Cause somebody asked me
about that and I didn't see that as a sign.
I haven't.
- Right.
- So nausea obviously, too.
All right, so that'd be step or sign number one.
If you have all those things
or you have a lot of those things.
- Right.
- The next sign is we're gonna
actually gonna do a couple tests here.
This is called the Dix-Hallpike.
I think you gotta be a little bit further back, Brad.
Okay.
You start off in what we call a long sitting position here,
just like he is.
We're gonna test both sides.
Now the first side we're gonna test is the right.
So you go 45 degrees to the right.
45 degrees is, this is 90 all the way over,
so halfway in between.
Okay. Does that make sense, Brad?
- Yes, it does.
- All right. Halfway in between.
And now I'm gonna have you come back quickly, Brad.
Ready? Come back quickly.
And I have his head now in 20 degrees of extension.
So he's just tilted back a little bit.
- Yep. - 20 to 30.
Eyes are open.
And if this right away brings on dizziness
and after about 60 seconds, you know, it stops or,
that's a pretty good sign that you probably
have some involvement on the right side.
Mkay.
- And when he says right side,
they're talking about within the ear,
we really don't need to get into detail.
- Yeah, we didn't really talk about what causes this.
You know, there's little particles that are
floating around in your canals, inside your inner ear.
There's three canals.
This is testing two of those canals.
Testing one canal on the right side,
one canal on the left side.
So, either way it doesn't,
you really don't need to know that,
but that's what we're doing.
We're testing all the canals.
Same thing. Now we're gonna go to the left 45 degrees.
Come on back, Brad.
Same thing, 20 degrees, his eyes.
You know, if this, he has BPPV,
he's gonna feel the spinning.
If you look at his eyes,
his eyes are gonna be quivering.
- Right.
They might, depending on where the problem is,
they're gonna quiver a little bit differently each way.
The other one now, go ahead
and scoot down a little bit, Brad, that way.
Come back again.
Now this isn't part of the test.
All you have to be down like this.
And all you're gonna do when you're in this position,
is you're gonna have turn him his head.
This is the third sign possibility now that you have BPPV.
If let's say you did the other two,
the Dix-Hallpike and nothing happened on either of those,
then you would try this one.
Turn to the right real rapidly.
And the same thing, we're gonna wait for...
Your eyes are actually a little quivery there, Brad.
- Yeah.
- You're gonna wait for at least 60 seconds
and see if anything happens.
Slowly go back to the middle
and then you're going to the left real rapidly.
And again, look for signs.
Now, if you find, why don't you sit up, Brad?
Let's say you did the Dix-Hallpike
and it brings on symptoms when you go to the right,
then you're gonna want to do the
Epley maneuver to the right.
If you find symptoms going to the left,
you're gonna wanna do the Epley maneuver to the left.
- Sure.
- I'll put those down below in our description, Brad.
- Right. - Which you know those videos.
- Right.
- If you do the horizontal one,
the one where you do the roll,
then you'd wanna do the horizontal roll,
which I also have a link.
I can put a link down below.
- This part here, it's-
- It's probably getting too much for you.
- It's probably you would have the therapist
diagnose this part. - Yeah, a therapist
or the doctor. - Right.
- I mean, it's a good sign you have BPPV
and that you need to get,
and luckily it's very easily treatable.
- Right.
- And a lot of times it can go away within a session or two,
but we need to get those particles back
in the right spot you know, from the inner ear.
- Right, and like Bob says,
we got other videos that explain this.
We got the right side, the left one,
all the treatments for it.
And we have one video that just talks about
the particles in some models and how that works.
- The one that is most likely to be positive
is the first test where we did the Dix-Hallpike.
- Where you're going- - Yep.
'Cause that's the one most common source of BPPV by far.
76% in that posterior canal, so.
- Which is nice, 'cause that's
the easier treatment, I think.
- Yeah, it is. It is.
So, all right.
You have any questions, put 'em down below
and just remember Brad and I are not just pretty-
- We're pretty ugly.
(laughs)
- No, we're pretty handy.
- Pretty handy. - Or helpful.
- Yeah, that's right. - All right, thanks.
We can help ya, subscribe.