Can pilates help vertigo?

Introduction

Can pilates help vertigo?, is often asked by clients. Most people will tell you that there has been a moment where they are just feeling dizzy and need to sit down in order to right themselves. There can be many reasons, the most obvious being that Chris Hemsworth has just walked past you on the beach, but if that’s not the case then it may be due to other factors. I have had many clients ask me “can pilates help with vertigo”? In this article, we will explore some of the reasons for dizziness and ideas for managing the condition in a movement class.

What is the difference between dizziness and vertigo?

There are many ways a person can experience dizziness.  For instance, the person can describe a sensation of movement either of themselves or in their external environment. A sense of feeling faint or lightheaded is another way of describing dizziness.  A person can also describe themselves as being unsteady on their feet and losing their coordination (ataxia).

Vertigo is a type of dizziness in which the person feels that their surroundings are spinning.

None of the descriptions of dizziness sound pleasant, particularly when you consider some of the symptoms that can accompany dizziness. Such symptoms include:

// Headaches

// Nausea and vomiting

// Tinnitus

// Unusual eye movements (nystagmus) 

// Sensory disturbances or loss eg visual or hearing 

// Loss of coordination

Some of the causes of dizziness and studio strategies?

Inner ear problems

Most dizziness is caused by the inner ear and includes benign paroxysmal positional vertigo (BBPV), migraine, and inflammation of the inner ear balance apparatus (vestibular neuritis).

In these cases the problems are associated with the inner ear or the way the crystals and hair sensors of the ear are organised, You can learn more about this in our course Chucking a Wobbly. 

Studio Strategy:

// Refer the client to a Physiotherapist or Allied Health Practitioner who specialises in vestibular disorders. There are some specific treatments that can assist the client with these conditions.

// Check with the client if there are specific triggers for the dizziness, for example lying on the reformer or side bending. Avoid the trigger exercises and replace them in the program with other exercises with a similar purpose

//Work with the client to slowly incorporate habituation strategies so that they can work on moving their head in different directions. An example of a simple idea is in this little video we recorded in the studio ( see below)

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Blood pressure

Low and high blood pressure can make people dizzy. In such cases, this sort of information should be collected when you undertake your initial client assessment or reviews. 

Studio strategy:

// Make sure that the client has clearance from their doctor or Vascular Specialist for exercise and any specific contraindications

// Be careful about exercises that require a rapid change of position, for example, step up on the wunda chair or reformer. In these cases, make sure that the person doing the exercises is spotted by a teacher and they can grab onto something to steady themselves, for example, the handles on the Wunda Chair.  If I have a client who is regularly challenged by these types of dizziness I might give them a modification like a step up prep so that they can still achieve the exercise but in a safer manner.

// You can also address this in a class by reducing the amount of times a person has to get up and down from the equipment or the mat.  This can be achieved through planned programming.  One of the tricks I like to do is to incorporate a controlled sit-to-stand movement as part of their transitions. This way they can practice the movement in a controlled manner and strengthen their body in this very functional movement pattern. An example below is from our online course Re-setting the Table

Thyroid Function

A number of studies have shown that problems in thyroid function can result in vestibular disturbances, and this is often not picked up by practitioners. (Brenner, Hoistad, Hain., 2004)

Studio strategy:

As a movement teacher it is not my role to diagnose but rather refer clients to their doctors for follow-up tests.  In the Hashimoto’s Disease blog I discuss the implications and some of the points raised in that blog may prompt clients to follow up with their doctor.  For those interested in this topic Ig presented a workshop about this condition at the PAA 2021 conference and will be recording a specialist workshop about this topic to be released later in 2021.

Anxiety

Anxiety, depression, panic disorder, and various somatoform disorders have all been associated with vertigo and should prompt referral to a mental health practitioner should the suspicion arise that comorbid psychiatric illness is at play. Eckhard et el, 2008; Samane et al, 2013)

Studio strategy:

Strategies for clients experiencing anxiety include:

// Incorporating diaphragmatic breath work into a class. This is not hard given that breathwork is a key element in Pilates, Yoga, Gyrotonic, and most movement modalities. To better understand breath and movement refer to the Anatomy Dimensions Breath course.

// Manage your studio environment to reduce noise and fluorescent lighting which could overwhelm clients and compound their anxiety.

References

Batu ED, Anlar B, Topçu M, Turanlı G, Aysun S. Vertigo in childhood: a retrospective series of 100 children. Eur J Pediatr Neurol. 2015;19:226–32.

Bhatia PL, Gupta OP, Agrawal MK, Mishr SK. Audiological and vestibular function tests in hypothyroidism. Laryngoscope [Internet]. 1977;87:2082–2089. Available from: http://www. ncbi.nlm.nih.gov/pubmed/926972.

Brenner M, Hoistad DL, Hain TC. Prevalence of thyroid dysfunction in patients with

Ménière’s disease. Arch Otolaryngol Head Neck Surg [Internet]. 2004;130:226–228.

Available from: http://www.ncbi.nlm.nih.gov/pubmed/14967756.

Eckhard-Henn A, Best C, Bense S, Breuer P, Diener G, Tschan R, Dieterich M. Psychiatric comorbidity in different organic vertigo syndromes. J Neurol. 2008;255:420–8.

Gliddon CM, Darlington CL, Smith PF. Activation of the hypothalamic-pituitary-adrenal axis following vestibular deafferentation in pigmented guinea-pigs. Brain Res. 2003;964:306–10.

Saman Y, Bamiou DE, Gleeson M, Dutia MB. Interaction between stress and vestibular compensation: a review. Front Neurol. 2012;3:116.

Santosh UP, Rao MSS. Incidence of hypothyroidism in Meniere’s disease. J Clin

Diagn Res [Internet]. 2016;10:MC01-3. Available from: http://www.ncbi.nlm.nih.gov/

pubmed/27437251.

To learn more about the topics raised in this article: