People hear about traditional vestibular rehab therapy - VRT -
fairly frequently when there is discussion about non-surgical treatment. You also hear about VRT as an alternative to
medication. VRT works well for some
people, but not everyone. I feel it's
really important to find whatever treatment is a good fit for YOU. Vestibular disorders tend to be very
individual, so treatment is NOT one-size-fits-all.
My MAV and CI caused, and can still cause, similar symptoms:
dizziness and disequilibrium (being off balance). When I got sick, I
developed - as do many people - coping and compensating mechanisms. Unfortunately, the compensating isn't always
good in the long run. Some of my compensating habits were obvious and
conscious - like how I sat when I first got sick - but a lot of it happened on
a neuromuscular level. So I'm sharing some info about Feldenkrais Therapy
- FT - since that's the therapy (in addition to VT) that works for me.
I work with a certified OT, Joyce, who is trained as a Feldenkrais
Practitioner. The Feldenkrais that Joyce
does with me works on the neuromuscular level I just mentioned, re-training
neuromuscular habits. I found out about her from a friend of mine;
Feldenkrais was never mentioned by any of the doctors I saw. This is unfortunate. I feel strongly that
those who are suffering should be made aware of all treatment options, both
traditional or conventional, and otherwise.
Patients should be given info and allowed to make the choice of what
works best for them. NOTE: this is what I've learned and experience thru FT, and is not meant to be a full neurological explanation
of FT.
FT involves movement; I am in the process of relearning/retraining
my body/brain how to do things with better balance. I think that all the
movements send new, good messages to my brain, and my brain absorbs it over
time, and with repetition. Some FT movement is done by Joyce, sometimes by me
under her guidance. When people think of movement, they tend to think of
large, or obvious movement: bending over, sitting down or getting up, walking,
etc. But movement can be very
small. Joyce often says that for
therapy, small movements are better because you can notice things that are easy
to miss with large movements. I have found
this to be true. If you think that small
movements aren't relevant, picture a set-up of dominoes. One very slight touch to knock one over
starts a whole chain reaction. The same
is true for your body - there is a domino effect all throughout your body when one
thing moves.
Joyce works with me on a low, slightly padded table. I
either sit, or lie down, and sometimes at the end of a session I walk around a
bit. Just as with Ann, I give Joyce an update before we begin. I
talk about how to do things, how to be functional. Joyce often reminds me
of how everything in my body is connected. She looks for basic
things like how well I'm aligned, how I move (or don't move), how I'm holding
myself . During the session, I tell Joyce how something feels, or ask a
question, but there is usually less general conversation during my sessions
with her. At the end of a session, she may ask if anything feels
different, about my visual resting point, and horizon.
FT is also about body awareness.
For me, part of this is muscle tension. I want everything serving
its' intended purpose. The key for muscles is to be holding, functioning, but
not over-working and tight. Muscle tension affects my posture while I'm
looking at the computer, which can make visual tasks more difficult. My
posture while standing can also be impacted by tension, which can affect my
ability to maintain my balance, and my line of vision. Muscle
tension is also, I think, a trigger for migraines; in addition to my diet, FT
has helped control my migraines.
Breathing is another element of body awareness: important for
oxygen (brain function), and muscle tension, which impacts balance. Joyce
talks with me, and works with me re breathing, and Ann sometimes reminds me to
breathe while I work. When I'm concentrating on a task, I may tense up,
and not breathe well. I'm slowly improving at noticing muscle tension
before I feel really tight, or even pain. I have also
learned through FT that sometimes movement NEAR the source of pain rather than
exactly where the pain is can be beneficial. Because everything is
connected, movement as low as your hips can produce movement in your jaw, and
impacting the area less directly can be easier on your system.
Finally, a few tips I've learned:
1) Re breathing - do a body check, and think about how you're
breathing and where there's tension - if I notice something, I make a change,
2) Try to sit gently, using your legs to help you,
3) Standing can also be done using your legs - I'm steadier
if I pay attention to how I stand
4) Don't hurry; I'm more likely to miss something in my
periphery or have some other problem if I start moving quickly. We live in a fast paced world, but moving
slowly, with purpose is really OK.
5) Lastly, a bit of sway is OK; it's actually more natural to
let yourself have some movement, than to try to be completely static. Obviously you don't want to fall down, but I
find it's easier to stay balanced if I don't try to be totally still. If I feel like I'm working too hard, I try to
touch something, or find a place to sit down.
http://www.feldenkrais.com/
Basic explanation of Feldenkrais - see Wikipedia link below - not the best explanation, but some interesting pictures... Though it says "it is not known if FT is safe or cost effective," I see no way it could be harmful... it is far less intrusive than surgery, and the movement is far more gentle than most PT. Insurance coverage would depend on the company and policy you own.
