Jenna McLane PT, DPT, Author at WWSPT.Com

Headaches

February 14, 2023 By Jenna McLane PT, DPT Leave a Comment

We have all experienced headaches at some point or another in our life, whether it was a headache from a cold or a more significant debilitating migraine event. The WHO states that half to three-quarters of adults aged 18-65 have experienced headaches in the last year, and among those, 30% reported experiencing a migraine.

Headaches are classified as primary or secondary. Primary headaches include migraine, tension headaches, and cluster headaches. Secondary headaches include those experienced as the result of another underlying medical condition, such as a sinus infection, where the swelling and discomfort from the inflammation process cause head pain.

In our WWS Physical Therapy practice, we see individuals with various headache types. Our goal is not only to help reduce symptoms but to teach our clients life-long strategies to manage their symptoms better and reduce the frequency of recurrence. This may include exercises for the neck and shoulder region, sleep hygiene and stress management education, and working with patients to identify their personal headache triggers, which vary by individual.

Tension Headache:

Tension headaches are the most common primary headache disorder. They tend to be bilateral and often feel like a band around the head that is non-throbbing. Pain tends to be mild to moderate but not severe. Stress and muscle tension tend to be the driving factors behind these symptoms. Tension-type headaches typically do not cause photophobia (sensitivity to light), nausea, or vomiting.

Cluster Headache:

Cluster headaches are more common in males than females, at a reported ratio of 6 to 1. They cause severe pain on one side and tend to be localized behind one eye. This type of headache may cause the pupil to constrict on the involved side and cause the eye to water. Individuals may also experience sinus congestion or a runny nose on the involved side. These headaches also can be nocturnal, starting 1-2 hours after falling asleep.

Migraine Headache: Migraine is considered a neurological disease. During this neurological event, abnormal electrical activity may occur in the brain leading to changes in nerve activity and blood flow in the head. It is believed that inflammatory substances are released during this time. Attacks can include headache, usually unilateral, which is throbbing or pulsing. Nausea, vomiting, light sensitivity, and visual symptoms can also occur. Some individuals experience changes in speech, coordination, and even numbness associated with their episodes. Other migraine sufferers don’t experience the classic headache as their primary symptom and may experience dizziness, ear pain, or head fullness during an attack.

Females are 3x more likely to experience migraine than males. Migraines tend to run in families, and if one parent experiences a migraine, their child has a 50% chance of having one. If both parents have them, that risk increases to 75%.

Migraines occur in four phases that can take 8-72 hours to complete. These phases include the prodrome, which can cause irritability, depression, muscle stiffness, increased urination, sensitivity to light and sound, and other symptoms. The next phase is the aura. Not all migraine sufferers experience an aura, but when present, it can last from 5-60 minutes and may include visual changes, a “funny feeling,” changes in speech, tinnitus, and vision loss. Headache is the third phase, associated with the throbbing pain experienced. The headache can spread from one side to both and can be associated with depressed mood, anxiety, fatigue, and sensitivity to light and motion. Following the headache is the postdrome, which can last for a day or two after an event. This phase can cause feelings of depression as well as euphoria and difficulty concentrating.

Many patients are referred to our Vestibular Therapy practice for complaints of vertigo. Still, during our discussion and evaluation, it is often discovered that these patients also experience signs and symptoms consistent with migraine. A neurological screen is always completed as part of our dizziness evaluations; a headache questionnaire may also be completed when a migraine is suspected. When a headache is suspected, treatment may not be just positional maneuvers for BPPV but can also include migraine symptom management. This treatment plan in physical therapy can involve cardiovascular exercise, habituation exercises to desensitize the nervous system to various movements, and education regarding lifestyle modification. Education can include improving sleep hygiene, modifying screen use, stress management, and learning about common dietary triggers. For some patients, medication is necessary to manage their symptoms fully. We try to work with patients as they navigate their medication journey with their physicians.

If you suffer from headaches and want to manage your symptoms better or have questions about improving your activity tolerance, please consider contacting our physical therapy office for an evaluation. We would be happy to help you get started on your headache management journey, no matter where you are in the process.

Dr. Jenna McLane, Pt, DPT,
WWS Physical Therapy and Vestibular Rehabilitation
Doylestown, PA.

(215) 489-3234

Finding the Balance in Your Balance System

September 22, 2022 By Jenna McLane PT, DPT Leave a Comment

Is it uncomfortable for you to stand still while having an unexpected conversation? Are you looking for something sturdy to rest your hand on? Perhaps you second-guess invitations to picnics or sporting events because walking on the grass is challenging. Maybe you find yourself parking closer and closer to the shopping cart corral so that you have something to lean on to get into the store.

These are all typical behaviors reported in our physical therapy clinic. Not all patients come to us because they have vertigo or are spinning. Many people who arrive at our clinic report limiting their social activities and the hobbies they enjoy due to feeling less confident on their feet. Not all have fallen; some just experience stumbling and tripping at times.

Balance, your body’s ability to keep your center of mass over your support base, is something we often take for granted until we struggle with it. Physical therapy can be beneficial in restoring your balance when it is compromised.

Our bodies rely on peripheral feedback systems to give the brain the information it needs to stay upright and avoid falling. The three sensory systems include our vision, proprioception, and vestibular systems.

First, let’s discuss the role your vision plays in balance. Your brain relies on this to learn how your body fits in the surrounding environment. For example, if you see people coming toward you or the ground is uneven up ahead, adjust accordingly.

Next, you rely on information from your proprioceptors. These are the sensors in your joints, muscles, and skin that provide information to your brain about where your body is in space. Let’s pretend you are walking down a slope right now. Pressure from your shoe against your foot, a stretch to the muscles in front of your lower leg, and a slight bend in your knee inform your brain that you are on a decline. Someone with peripheral neuropathy, an artificial joint, or an injury can have impaired proprioceptive feedback.

Lastly, the vestibular system also provides your brain with information about your movement in space. This is found in your ear, beyond the eardrum. The system has five end organs, including the utricle, saccule, and three semicircular canals. The utricle and saccule have small hair cells that detect horizontal and vertical acceleration, such as riding in a car or going up an elevator.

The fluid-filled semicircular canals detect rotational movement in different planes. When your head turns, the left and right vestibular systems generate an impulse based on the fluid shift. This impulse travels to the brainstem and directs the appropriate muscular and visual responses that keep you moving smoothly. When both the left and right vestibular systems are healthy and work together, these adjustments are typically not noticed. But people with damage or weakness in one or both vestibular systems may feel unsteady on their feet, dizzy, or disoriented (as if their eyes are bouncing).

When patients arrive at WWSPT with complaints of unsteadiness, we look at their whole medical picture. We thoroughly review their history to identify variables that may be influencing their balance. Do they have chronic back pain or diabetes that may impair their sensation? Have they been on medications that may impact the function of their vestibular system? Are they smokers, have they experienced migraines, and have trouble multitasking? These are just a few questions we may ask that are extremely helpful in identifying possible contributing causes to patients’ imbalance.

After reviewing their history, we evaluate how they move. Is one hip weaker than the other? Are stairs difficult? Is there a difference when walking on a smooth indoor surface and going outside? Do busy environments suddenly make them reach for support?

Next, we thoroughly evaluate their vestibular system and how the vestibular ocular reflex or VOR reflex works. We screen them for benign paroxysmal positional vertigo and evaluate their balance statically and dynamically.

First-time patients may feel intimidated by the “strange” exercises they see other patients doing in the gym. Our expertise in balance training allows us to incorporate patients’ individual goals into their therapy. Patients who struggle with talking to their friends while on a walk may be asked to walk, turn their heads, and simultaneously list their weekly grocery items. A hiker, who misses walking in the woods, may find him or herself stepping across our river rocks while wearing a weighted vest. We like to keep it interesting!

If you have noticed something doesn’t quite feel right in your movement, do not simply accept imbalance as a part of aging. If left untreated, this could lead to a fall. Falls are the leading cause of fatal and nonfatal injuries in adults over 65. Enhancing your balance system through physical therapy can help you maintain your independence and the quality of life you enjoy. Be your advocate. Please get in touch with WWS Physical Therapy and Vestibular Rehabilitation, Doylestown, PA., for your balance assessment and treatment plan!

Dr. Jenna L. McLane, PT, DPT,

Overuse Injuries Are A Common Part of Training

October 4, 2021 By Jenna McLane PT, DPT Leave a Comment

The fall is a wonderful time for outdoor sports. The air is cooling off, the mornings are crisp, and the leaves are beginning to change to beautiful autumn colors. The improved weather conditions often lead to a lot of increased outdoor activities such as running, hiking, biking, and long walks for many who spent the dog days of summer in the comfort of their air conditioner.

Increased movement is a great way to improve overall health. Unfortunately for some; the good intentions of going the extra mile can at times lead to pain. Pain is a very normal part of life and is not always something to be afraid of but when pain interferes with your daily function and ability to participate in your preferred form of exercise it is time to see your physical therapist.

Most of the time pain with exercise develops when we begin training either too much, too fast, or a combination of both. We have a timeline to prepare for an event and we want to get to that finish line, literally.

Often the first response, when pain is present, is to rest. In some instances, rest is appropriate, but our ultimate goal is to keep our bodies moving as they heal. If your pain persists or alters your movements then an evaluation with your physical therapist is warranted before these altered mechanics become another source of pain altogether.

Many are familiar with the term tendonitis or tendinosis. The mechanism of injury for these inflammatory type conditions often results from a small discomfort that we try to work through to some extent. With this pain comes changes in how we move and often asymmetry in muscle partnerships around the irritated area putting increased stress or burden on one region, which can lead to inflamed tissue. When this inflammation is acute we use the term tendonitis. When it is more chronic, we prefer tendonosis.

Our job as physical therapists is to assess this area of pain and try to reduce the discomfort first and foremost. At the same time, we also are looking at the muscles and joints surrounding the area in order to identify what factors may have predisposed this issue to become painful in the first place.

An example of this might be a runner who complains of low back pain. We want to give those individuals strategies to decrease their pain both in therapy and at home when the pain is present. During that evaluation, we may also identify that this pain is stemming from the increased load at the spine during impact due to weak hip extensors and tight hip flexors, or tight hamstrings and a weak core.

Once the problem is identified we come up with a plan for that person. Our goal is to teach the individual exercises and strategies to mitigate their pain. We also try to reduce the recurrence of their pain through specific strengthening and stretching exercises as they increase their activity levels. This plan may also include education about their technique for certain tasks such as squatting, stairs, running, etc.

It is also important that we set very realistic expectations with our patients. We want to help them to be better connected to their body’s signals. If a patient is new to exercise or athletics it may take him or her, time to realize that some degree of discomfort is normal as they push their exercise routine further and work toward their goals.

We also want them to learn what their red flags are, and when to back off and modify what they are doing so that they can find a way to stay active without feeling like they are taking two steps backward.

One major motivator for movement this time of the year is all of the great charity races and fundraising runs that come up. These events push many of us out of our comfort zones and onto the pavement. Every year our WWS physical Therapy and Vestibular Rehabilitation practice, Doylestown, PA., look forward to participating in the Travis Manion Foundation’s 9/11 Heroes Run.

Hearing the stories of our Veterans and the family members of those honored on that day is enough to make us all want to push a little harder. Witnessing the tremendous amounts of perseverance and determination by all on that day is truly inspiring and part of why we keep coming back to Honor The Heroes and participate in the 5k run for 9/11 Heroes.

This event is a perfect example of the determination of the human spirit and obstacles overcome.

We hope to see all of you out there for this wonderful cause, whether walking, running, or cheering on friends and family, and if you are feeling your body talk to you as race day approaches, or even afterward then visit us for an assessment at WWSPT.

Dr. Jenna McLane PT DPT,
WWS physical Therapy and Vestibular Rehabilitation,
Doylestown, PA.
(215) 489-3234

Imbalance Impacts Our Lives!

September 24, 2021 By Jenna McLane PT, DPT Leave a Comment

It’s Balance Awareness Week at WWSPT and a time for us to acknowledge the impact #imbalance has on our lives. Many people know very little about #dizziness and #vertigo until they suffer from it themselves. It can be quite unnerving to suddenly feel off #balance.

The truth is #balance is achieved through input from our visual system, feedback from our proprioceptors, and our #vestibular system. Many of our patients come to us feeling #unsteady and they don’t know why. We often find that these patients may have some visual impairment and diminished proprioception at baseline that they have been able to compensate for until they suffer from a new-onset vestibular issue that suddenly magnifies the deficits that they were already coping with.

Most individuals assume that if they have #vertigo they must have “crystals out” or #BPPV. The fact is, many things can cause #dizziness including but not limited to issues with the #vestibular system. Unsteadiness and or vertigo can be caused by displaced otoconia (BPPV), infection or vascular damage of the inner ear (neuritis/labyrinthitis), migraine, and more. This is just a very short list of common vestibular disorders. In addition, one can also be unsteady due to cardiac issues, peripheral neuropathy, and disorders of the brain and brainstem.

Not all dizziness is due to crystals and not all unsteadiness is due to aging, as so many of our patients assume. If you are struggling on your feet with your balance, please give us a call at WWS Physical Therapy and Vestibular Rehabilitation, Doylestown, PA.

Dr, Jenna McLane, PT, DPT,
WWS Physical Therapy and Vestibular Rehabilitation,
Doylestown, PA.
215-490-3234

Do you suffer from Unsteadiness on your Feet?

September 23, 2021 By Jenna McLane PT, DPT Leave a Comment

September 19-25 is the Vestibular Disorder Association’s Balance Awareness Week!

Do you suffer from #unsteadiness on your feet? Do you feel like you are on ice skates for the first time? Do you find it difficult to maintain your #balance when walking in an unfamiliar or busy visual environment? Perhaps you notice that mom or dad can’t seem to get from their favorite chair to the kitchen table without reaching for a piece of furniture to steady themselves. If so, this week is dedicated to you!

Our goal this week is to increase the general population’s awareness of how difficult it can be for those with balance disorders to function. Simple tasks such as grocery shopping, stepping up a curb, working in the yard, and getting dressed can all lead to huge challenges for those suffering from balance disorders. The activities that we often do without a second thought often require a great amount of planning and foresight for individuals with balance disorders.

This can mean leaving early for an appointment to ensure a parking spot close to a ramp or railing, shopping at odd hours, avoiding certain places with either low or very bright lighting, and purchasing only certain types of clothing that are easy to put on.

Balance disorders can really impact someone’s pride. All too often our clients view using an assistive device or asking for help as a sign of aging or weakness that is ok for others but they themselves are not ready to accept. Most of these people express a desire to not be a burden, however many fail to realize that if they have a fall because they don’t address their balance issues that can create an even larger burden for their loved ones and decrease their own independence that they cherish.

Our goal at therapy is not to turn your life upside down and change the way you do everything. Our goal is to empower you to achieve the things you enjoy in the safest way possible with greater confidence.

If you feel in any way that your balance is compromising your quality of life, do something about it now! Just like when you work a weak muscle, working on your balance can strengthen it and reduce your risk of falling or having an injury. If you find yourself avoiding situations or reaching for furniture everywhere you go then please call us at WWSPT for an evaluation of your balance.

Dr. Jenna McLane, PT, DPt,
WWS Physical Therapy and Vestibular Rehabilitation
Doylestown, PA.
215-489-3234

Headaches

Finding the Balance in Your Balance System

Overuse Injuries Are A Common Part of Training

Imbalance Impacts Our Lives!

Do you suffer from Unsteadiness on your Feet?

Our Mission at WWSPT

WWSPT Mission 2.0

Contact WWS Physical Therapy

Ask About WWSPT Professional Associations

Our Mission at WWSPT

WWSPT Mission 2.0

Connect With WWSPT:

Contact WWS Physical Therapy

Ask About WWSPT Professional Associations