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Evaluation and treatment of Vestibular and Balance Disorders

Vestibular disorders can cause dizziness, vertigo, imbalance, problems with hearing, nausea, fatigue, anxiety, concentration, and other symptoms. These symptoms can deeply affect a person’s day-to-day functioning, ability to work, social relationships, and quality of life.

If you have experienced these symptoms, a trained physical therapist can help determine the cause and treat your problems. Using infrared goggles, the physical therapist is able to watch your eye for movement to determine if you have a disorder, such as Benign Paroxysmal Positional Vertigo (BPPV). BPPV is one of the most common causes for dizziness and vertigo. Other common causes for vertigo include: Meniere’s Disease, Hydrops, Perilymphatic Fistula, medications, age related changes to the central nervous system and cervicogenic (coming from the neck).

Tim Gibbs, PT, OCS, Cert. MDT, CCTT, CMTPT has had extensive training in the evaluation and treatment of Vestibular and Balance Disorders. He completed the American Physical Therapy Association’s clinical competency course in Vestibular Rehabilitation at Emory University and the Advances in Vestibular Rehabilitation at Duke University as well as numerous other related courses. Tim teaches continuing education courses in the evaluation and treatment of Cervical, Temporomandibular, and Vestibular Disorders. He serves as adjunct faculty at the University of Montana School of Physical Therapy and Rehabilitation Science, where he teaches a course in differential diagnosis and treatment of vestibular and cervical disorders.

Tracie Schroeder, PT, DPT, ATC, CMTPT has completed the clinical competency course in Vestibular Rehabilitation at Emory University. She co-teaches the Vestibular and Balance Course with Tim Gibbs at the University of Montana School of Physical Therapy and Rehabilitation Science.

Together, Tim and Tracie make a great team working hard to accurately evaluate and treat people limited by dizziness and vertigo.

If you have any of the above symptoms, you may want to contact your primary care physician to get a referral to our clinic.

What to Expect?

We ask that you refrain from eating several hours prior to your first appointment. Some of the procedures may provoke your dizziness and nausea and you will feel better with an empty stomach. On your first visit, you will be asked a detailed history of your symptoms. We will then perform some basic screening exams to rule out any issues beyond our scope of practice. You will be taken through a series of positions to determine the best treatment for you. The evaluation and treatment are performed concurrently.

You should have someone available to drive you home in case your symptoms have not completely resolved. Your plan of care will be determined based on the findings of your evaluation. The treatment may be quick, with only 1-2 visits, or may require more visits to address your balance or more complex problems.

Our comprehensive fall risk reduction program helps people with balance issues improve their mobility and decrease their risk for falling. This is important to people with a history of falls as they are at risk for complications including fracturing bones, head injuries, and the inability to live alone.

Our physical therapists enjoy working with patients with a wide variety of neurological challenges that affect mobility, balance and coordination. Lynnell Finley, PT has a focus of helping people with balance disorders by establishing appropriate exercise programs and educating them on how to manage their symptoms. Lynnell utilizes a structured program and her advanced training for patients with Parkinson’s disease.  This program allows patients to manage symptoms including difficulty walking, difficulty initiating movements and balance concerns.  Lynnell is a certified LSVT BIG and PWR!(Parkinson’s Wellness Rehab) Clinician.

Our physical therapists are highly skilled to evaluate spinal pain to help determine the best method for treatment. The physical therapists often include the McKenzie Method for Mechanical Diagnosis and Treatment to help restore you to your normal function. We are able to work with you to help stabilize your back pain and dysfunction so that you can return to your every day life, including work, family, and sports hobbies. We have developed a dynamic exercise program that fosters good back health and improves your overall strength and flexibility.

All of our therapists are currently going through the University of St. Augustine’s Manual Therapy Certification. This certification includes 200 hours of advanced training in manual therapy to help patients return to their fullest capacity.

Trigger point dry needling (TPDN) involves inserting a thin solid monofilament needle directly into a muscle at the myofascial trigger point. This causes a local twitch response, in which the muscle fibers contract. This results in relaxation of the muscle and release of the shortened muscle fibers. As a result, there is an increase in blood flow and oxygen delivery to the involved area, eliminating pain producing chemicals. TPDN can be used to treat a variety of musculoskeletal problems where muscles are thought to be a contributing factor to the symptoms. Such conditions include, but are not limited to: back, neck and shoulder pain, decreased range of motion, rotator cuff, frozen shoulder, arm pain (tennis elbow, carpal tunnel syndrome), headaches, jaw pain, and leg pain, bursitis, sciatica, hamstring strains, calf tightness and cramping. TPDN has also been found to be extremely helpful in the treatment of chronic pain and movement disorders.

Tim Gibbs, PT, OCS, Cert MDT, CCTT has been treating people with TMJ problems and headaches for the past 23 years. He has had extensive training in this area and recently became a Certified Cervical and Temporomandibular Therapist (CCTT) through the Physical Therapy Board of Craniofacial and Cervical Therapeutics. He is an associate member of the American Academy of Orofacial Pain. He works closely with area dentists to help patients recover from TMJ dysfunction. Our other therapists are mentoring under Tim to help more people with these problems. Tim Gibbs and Brian Miller are Orthopedic Certified Specialists (OCS) and treat headaches that are associated with neck and jaw pain.

Our physical therapists work as a multidisciplinary team to help people with chronic pain manage their symptoms and live full and productive lives. We evaluate each individual patient and set achievable goals to help control symptoms through a self-managed program of stretches and exercises.

Lynnell Finley, PT, CMTPT, Cert. LSVT BIG completed her certification in October 2012. LSVT Big is an intensive amplitude based exercise program to help improve mobility and function safety of people with Parkinson’s Disease.

In our pelvic floor physical therapy program we evaluate the man and woman’s health across his or her lifespan, and evaluate the role it plays in his or her current health status. We also determine what we can do to promote his or her health and wellness immediately and in the future. The following diagnoses are treated: urinary, bowel and gas incontinence, urinary urgency, constipation, coccyx dysfunction, pelvic pain, post-prostatectomy incontinence, chronic prostatitis, pudendal neuralgia, interstitial cystitis, osteopenia/osteoporosis, pelvic organ prolapse, pelvic floor dysfunction (myalgia), pelvic pain syndrome, vulvodynia, sacroiliac joint dysfunction, dyspareunia, and obstetrics related issues.

Brian Miller, PT, OCS, CMTPT works with athletes of all ages and abilities to help them improve their running form and efficiency. He combines his physical therapy skills with his knowledge base in running techniques to help people achieve their goals. Please see www.runflathead.com for more details on upcoming running clinics in the area.

Being an aging athlete himself, Brian Miller, PT, MS, OCS has a special interest in keeping you competing at the highest level possible in sports such as paddling, biking, and running. He teaches a Running Clinic to help you develop the most efficient form that not only makes you faster, but reduces the risk of injuries. Contact him for more information on his next clinic, or schedule a visit for him to analyze your form and help you manage injuries you may have sustained from problems related to form.

Our therapists enjoy working with young and old children with neurological disorders, sports injuries and congenital problems. We work with high school athletes to help them successfully return to sports after injuries.