♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- If you have dizziness, answer this one simple question
and it can lead to a cure.
- Oh!
- And I'm not kiddin'!
- Oh, say no more, Bob! And I know you're not!
- By the way, if you're new to our channel,
please take a second to subscribe to us,
we provide videos on staying healthy, fit,
pain-free, and we upload every day,
and by god it's your lucky day,
'cause if you go to bobandbrad.com.
- Right here.
- Go to the giveaways section,
this week we're giving away a knee glide!
- Oh yes!
- Lightweight rehab device.
Brad, do you wanna show a little bit
or can't you reach the floor?
- Well I can reach the floor, Bob,
I don't know if the camera can go that low!
- I'll put it down like this.
So, if you go to bobandbrad,
go to the giveaways section
or go to Bob and Brad on Facebook,
it'll be pinned to the top of the page
the contest that is,
go to Twitter or Instagram,
or TikTok if you want a 60-second version of our program.
- [Brad] Totally free!
- Great device if you're having a knee replacement
or preparing to have a knee replacement.
Also or if you're having any type of knee surgery.
- Right.
- Very, very helpful.
All right. The most common cause of dizziness and vertigo.
Vertigo is the spinning.
- Sure.
- Is actually what is called BPPD.
- That's the abbreviation.
- Yeah. And Brad and I are,
I don't know if we say this differently?
Not really, I think we say this close.
Benign proximal.
- Positional!
- Positional vertigo. - Right.
- And that's a mouthful,
but if you have it,
you probably have been diagnosed with it,
you're probably very aware of what it is.
- Oh, it's devastating.
If you got a severe case,
it puts you right out.
You cannot function.
- Right.
So it's caused by loosened or displaced crystals
in your inner ear.
One of them, there's three canals in your inner ear.
And you have it on both sides.
- Right.
- Three canals on each side.
And those get loosened off,
and they destroy your whole balance off,
and they give you the spinning sensation, everything.
So that's the most common cause of dizziness!
So--
- But it's not the only cause!
- It's not the only cause.
There's a lot of other things that could be causing it,
but this is the most common cause.
So there was a study that was just done.
It was done by Ellen Lindell,
and she's an ENT doctor, ear nose and throat.
Ear nose and throat.
And she had 149 patients.
96 women, 53 men.
They had dizziness.
They answered 15 questions.
And if they answered yes to this question,
almost invariably they had BPPV.
- So there was one question.
- One question.
- That they narrowed it down to.
- Yup. So if you, you're gonna answer
this question right now.
Does lying down or turning in bed make you dizzy?
- That's it.
- That's it!
- It's a yes or no question.
- Yes. And if you write yes, there is a good chance
you might have BPPV.
So this, you're gonna wanna go to your doctor and say,
"Hey. Do I have BPPV?"
What's nice about this one problem,
it's the most common diagnosis as I said,
but it also is very treatable.
- Without medication.
- Without medication! Right! - Exactly.
And only with, a lot of times,
one visit to the therapist.
- Quite often I have done it with one visit.
- And you can self-treat once you've been taught.
Not everyone, but some people can,
depends on your ability and how mobile you are.
- Right.
- And how severe of a case you have.
- So yeah, there's, basically three types of BPPV.
It depends on which canal it's in.
- Sure.
- So the most--
- We should clarify, 'cause I think most people
call BPPV vertigo.
- Sure.
- It's just their, you know,
it's not really-- - We'll just say vertigo.
- Yeah, it's not technically correct,
but that's what everyone calls it.
Most people call it.
- So the most common canal that you have with vertigo,
that is involved in the inner ear,
is the posterior canal.
That's the one that's in the back.
- Right.
- 85 to 90% of the cases of,
I'm sorry I gotta say it one more time,
BPPV, are from the posterior canal.
- Which is good news too,
because it's not that hard to treat
with positional treatment.
- Yeah, we use the Epley maneuver.
- Mhmm.
- Now, if you wanna, I'm gonna show you one more test
you can do, to see if you have that canal involved.
- Right.
- Now normally what we do,
by the way this may make the person sick,
so you do wanna have a bucket for nausea.
I got my hat.
- Yeah.
- Near so, if you wanna throw up in that, Brad.
- Yeah, it can get you, yeah, nausea and then you--
I've never had anybody do this in the clinic,
but I've had people say they feel like it.
- Oh I've had people get close!
- But not actually--
- Not up to it, no, I've never had one.
- So that's good news for us.
- So, Brad, do you wanna sit?
What you would do is, I guess you could actually
do this on the floor, or you could do it on the bed.
But you wanna long sit, Brad?
- Yep.
- [Bob] Yup. This way. So this is the starting position.
- So this is long sitting, with your legs out.
- And it's again, called the Dix-Hallpike maneuver.
And what you're gonna do, you want a couple pillows
so that when Brad does lean back,
his head's gonna actually go into at least 20 degrees--
- Can you see?
- 20 degrees of extension.
- So-- - You probably don't need--
- It's not this far. - Right.
- It's a little bit.
- Yeah. So you probably wouldn't need this many pillows,
you can probably get by with one pillow, Brad.
- Sure.
- Why don't you go back now once you're--
- This particular technique,
usually is done by a therapist.
- Yeah.
- You may not feel comfortable doing this,
and it's not even necessary.
- Right. This way you'll know what the doctor's doing to you
or the therapist's doing to you.
So what you do, I'm gonna check his,
it'd be your right side, Brad, first.
So you're gonna turn the head 45 degrees.
That's halfway between all the way, and yeah.
And the starting point.
45 degrees, and then we take him down quite fast actually,
and I hold onto his head,
I'm not gonna hold onto your head, Brad.
Why don't you go ahead and go back?
- Right, it'll interrupt with my--
- Yeah.
- My mic, and I don't like him holding onto my head anyways.
So yeah, so it's back here,
and it is pretty quick, and then I'm back like this.
And, you know, with the therapist holding onto your head
it feels more comfortable.
- More supported.
And the thing is, what often is the eyes start moving.
Now they might go up and down,
they might go side to side.
- Nystagmus.
- Nystagmus, and that kind of gives a clue where the,
what canal is involved.
- Right.
- And, I mean it definitely can bring on symptoms
and the symptoms usually go away after about
60 seconds or less.
And it might make you nauseated.
- Right. In the clinic they'll put on,
oftentimes put on these glasses that blow up your eyes
so it's easier to see the eye movement.
- I see it on a screen.
- Yeah. - Right.
So, Brad, that would be checking the right side.
For the left side, you turn 45 degrees that way,
and go again, 20 degrees of extension.
So that's another test, you know,
if that's, that's the gold standard for me.
Like if that's positive then we're gonna go ahead
and do what is called the Epley maneuver.
- Sure.
- Look it up, go to Bob and Brad on YouTube,
our channel, and then just type in Epley,
E-P-L-E-Y.
And that'll give you to the maneuver, and we'll show you.
- We actually have two videos on the Epley.
- Sure.
- An updated one.
- We did one on a live patient!
- Oh yes!
- You remember? That was our,
one of our office aids,
and she had a pretty severe case,
and she was one of those that just magically
one treatment took care of it.
- I would say, 80% of my cases, one treatment.
- I've had some, recently--
- You had some come back?
- Yeah, I've recently-- - For the second?
- Yeah, recently I haven't been having as much luck.
In fact, a lot of times, I'll do it several times
the first time even.
- Oh, right, yeah.
- And then I did it several times,
and then I had to repeat it even.
- Have you had any patients that wanted to
actually do it themselves that,
"I think I can do this myself," and then--
- No, the ones I've had lately have been very elderly.
- Sure.
- In fact it's, I almost need two people even
to do it with them
because they don't turn very easily.
While you're turning and stuff with the Epley maneuver,
you worry that they might roll off the bed
and it's fairly simple,
but it involves a lot of turns and such.
But it can be very dramatic how well it works.
- Yeah! Right.
- I mean it's all ...
- It's so much better than other options, I think.
- Yeah.
- It's very simple.
- All right. Remember, Brad and I can fix
just about anything.
- Except for--
- A broken heart, but we're workin' on it!
Day and night.
- And we won't stop until we get there!
- Yeah.
- Well, we'll take a rest.
- All right. Thanks for watching.
(funky jingle)