Talk Dizzy To Me

Balancing Act Rehab
  • 5.0 (5)
  • MEDICINE
  • UPDATED SEMIMONTHLY

We’re just two vestibuloholics excitedly bringing you a comprehensive view into the complex field of dizziness. Made for both clinicians and patients, we’re aiming to provide you with endless resources, tips & tricks, interviews with experts, and so. much. more. Hosted by Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT

  1. FEB 4

    Functional Neurological Disorder (FND) Explained: What It Is and How It Overlaps With Dizziness

    Functional Neurological Disorder (FND) is often misunderstood... but it’s real, common, AND treatable. In this episode of Talk Dizzy To Me, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Carly Lochala, PT, NCS sit down with Dr. Julie Hershberg, PT, NCS to explain what FND is, why it’s been minimized in healthcare, and how it overlaps with dizziness, migraine, dysautonomia/POTS, hypermobility/EDS, and vestibular disorders. They break down brain networks like the default mode network and salience network, discuss common clinical clues (variability, attention-related shifts), and explain how treatment often starts with nervous system regulation, trust-building, and whole-person care—not just exercises. If you’ve been told your symptoms are “all in your head,” this episode is for you. Guest: Dr. Julie Hershberg / Reactive PT Instagram: @reactivept Resources: FND resources hub, reactivept.com/FNDresources Hosted by: 🎤 Dr. Abbie Ross, PT, NCS 🎤 Dr. Carly Lochala, PT, NCS For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Connect with Us: → ⁠⁠⁠⁠⁠⁠Book a free call with us⁠⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠⁠Get free resources straight to your inbox⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠Join The Dizzy Reset™ for FREE⁠ → ⁠⁠⁠⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠⁠Follow us on Instagram⁠⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠⁠Follow us on TikTok⁠⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠⁠Follow us on Facebook⁠⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠⁠Disclaimer⁠⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠⁠Enjoying the podcast? Leave us a review!⁠⁠ Timestamps 00:00 Welcome to Talk Dizzy To Me (intro)01:42 What is Functional Neurological Disorder (FND)? How to explain it to patients02:08 FND as a brain network dysfunction (function vs structure)03:32 Why education improves outcomes in vestibular care + FND04:02 Why FND has been misunderstood/minimized in healthcare04:12 From “hysteria” and “conversion disorder” to modern neuroscience06:05 Harmful stigma: being told symptoms are “fake” + medical trauma08:19 What to look for when you suspect FND (clinical clues)09:13 Variability, attention-related shifts, symptoms “moving”10:35 Screening for other diagnoses + doing a thorough neuro screen11:04 Common comorbidities missed: migraine, EDS/hypermobility, POTS/dysautonomia, vestibular disorders12:53 What you’ll hear in the subjective history that suggests FND15:13 Why “one test” (like Hoover) isn’t enough + signs vary by symptom type16:54 Diagnostic criteria: what exists, what’s lacking, what needs improvement19:12 Risk factors & triggers: sex differences, pain, sleep, physical injury/illness21:01 Dizziness in FND: how common is it + vestibular system connection21:59 Autonomic + sensory overlap (vestibular sympathetic reflex, otolith sensitivity)24:44 Treatment approach: why there’s no one-size-fits-all protocol25:38 Whole-person assessment + “pie chart” contributors + education foundation29:00 Building trust, validation, and safety (especially after medical trauma)31:18 Why play, fun, and salience matter for nervous system regulation + motor learning32:45 Default mode network vs salience network explained simply37:48 Social media + FND: what we think vs what research shows41:26 Adapting vestibular rehab when FND is part of the picture44:26 Safety + motor symptoms: when you prioritize regulation over exercise48:18 Sensory inventory & building a regulation toolkit (OT-informed strategies)51:00 Not everyone needs “calm”—some people need safe movement to regulate52:18 “Mic drop” messages for people who feel stuck55:21 Where to find Dr. Julie Hirschberg’s FND resources

    58 min

  2. JAN 21

    Vestibular Migraine, POTS, and the Road to Recovery with Laura Ehlers

    In this episode of Talk Dizzy To Me, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman sit down with Laura Ehlers to share a powerful, real-life story of chronic dizziness, plus the long road to obtaining answers in a healthcare system that often defaults to “it’s BPPV” or “it’s anxiety.”Laura walks us through how her symptoms evolved after being hit in the head and what her life looks like living with dizziness. She also shares the layered diagnoses that often show up together in complex dizziness cases—vestibular migraine, PPPD (Persistent Postural-Perceptual Dizziness), dysautonomia/POTS (Postural Tachycardia Syndrome), and hypermobility/EDS (Ehlers-Danlos Syndrome), as well as the strategies that have helped her rebuild capacity.You’ll hear practical, experience-based advice on:- How to advocate for yourself when you’re not being believed- Why the right healthcare provider can be a game-changer- Medication realities: from sensitivities to finding what works Guest: Laura Ehlers Instagram: @laurasnaturallife Hosted by: 🎤 Dr. Abbie Ross, PT, NCS 🎤 Dr. Danielle Tolman, PT For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Connect with Us: → ⁠⁠⁠⁠⁠Book a free call with us⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠Get free resources straight to your inbox⁠⁠⁠⁠ → ⁠⁠⁠⁠Join The Dizzy Reset™ for FREE → ⁠⁠⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠Follow us on Instagram⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠Follow us on TikTok⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠Follow us on Facebook⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠Disclaimer⁠⁠⁠⁠⁠ → ⁠⁠⁠⁠⁠Enjoying the podcast? Leave us a review!⁠ 01:11 Laura’s background: chronic migraine, holistic health, and early dizziness tools02:37 Early warning signs: highway driving issues, tunnel vision, “is it anxiety?”03:05 Vision therapy → severe spinning vertigo onset04:33 Current symptoms: nonstop rocking/boat sensation + visual flow triggers04:59 Life impact: driving intolerance, travel limits, parenting challenges06:27 The advocacy problem: being believed, speaking the “right language”07:52 Misconceptions in healthcare: “If Epley didn’t work, you’re anxious”09:47 Resources that helped: clinicians online + vestibular education on social media10:42 Why primary care matters: getting treated even without a supportive specialist11:09 Diagnoses explained: vestibular migraine + PPPD + dysautonomia/POTS spectrum12:07 Layering issues: infections, mold gene, mast cell activity13:06 Clinician perspective: frustration when patients get conflicting medical input14:31 Hope vs acceptance: living in the chronic illness “seesaw”15:59 Biggest mindset tool: document wins to prove progress is happening17:35 “Early whispers” of symptoms20:58 What helped most: rehab principles + sensory integration focus21:20 Proprioception strategies: weighted inputs, holds, stomps, boots, blanket22:46 Hyperbaric oxygen: regaining ability to read23:15 Scaling exposure: “one sidewalk square at a time”24:14 Breakthrough: walking on grass increased capacity25:14 Histamine/mast cell stabilization: Zyrtec and sleep/sensory benefits26:35 EDS/hypermobility: why screening matters in the “triad” conversation28:40 Daily habits: caffeine consistency, electrolytes, potassium vs sodium insight29:10 Nervous system work: somatic therapy + staying committed to movement31:10 Mindset during flares: you’re not at square one; you’re stepping off the path36:19 Encouragement for beginners: slow progress still adds up37:45 Identity shift: grief + reinventing life (reading, painting, new interests)39:06 Community: why 1:1 connections can beat unmoderated groups41:30 Medication journey: fear, hesitancy, and why meds became a useful tool44:55 Rescue meds (Ativan): pre-treating to participate in life moments45:54 Micro-dosing approach: ultra-low starts + pharmacist check-ins46:52 LDN + Zyrtec wins; sensitivity to other meds48:40 Mic drop moments: what clinicians must understand + patient hope message

    53 min

  3. JAN 7

    How to Treat BPPV, Neuritis, and VM/PPPD: A Practical Guide for the Vestibular Therapist

    If you’re a physical therapist treating dizziness (or a patient trying to understand what’s going on), this episode is packed with practical, clinic-ready guidance. Dr. Abbie Ross, PT, NCS and Dr. Dani Tolman, PT welcome Dr. Sara MacDowell, PT & Dr. Sydney Duhe, PT from Dizzy Diagnostics to break down real-world vestibular cases—including BPPV with lingering symptoms, acute vertigo after the ER (vestibular neuritis / hypofunction), and the common overlap of vestibular migraine (VM) + Persistent Postural-Perceptual Dizziness (PPPD) with visual motion sensitivity. You’ll learn how to think beyond textbook presentations, how to avoid missing multi-canal or bilateral BPPV, how to build patient buy-in with education, and how to dose and progress VOR/gaze stabilization and visual desensitization exercises for busy environments like grocery stores. Episode Resources: -Follow Dizzy Diagnostics on Instagram: @DizzyDiagnostics -Advanced Neurotherapy Education (ANTE): advancedneurotherapyed.com⁠⁠ Hosted by: 🎤 Dr. Abbie Ross, PT, NCS 🎤 Dr. Danielle Tolman, PT For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠ Connect with Us: → ⁠⁠⁠Book a free call with us⁠⁠⁠ → ⁠⁠⁠Get free resources straight to your inbox⁠⁠ → ⁠⁠Join The Dizzy Reset⁠ → ⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠ → ⁠⁠⁠Follow us on Instagram⁠⁠⁠ → ⁠⁠⁠Follow us on TikTok⁠⁠⁠ → ⁠⁠⁠Follow us on Facebook⁠⁠⁠ → ⁠⁠⁠Disclaimer⁠⁠⁠ → ⁠⁠⁠Enjoying the podcast? Leave us a review! ⁠ Timestamps00:15 - Meet the guests: Sydney & Sarah (Dizzy Diagnostics) + their vestibular journeys05:18 - Case 1: BPPV treated… but lingering dizziness/imbalance remains06:39 - “First check: is BPPV truly resolved?” (all canals + short arm considerations)07:36 - Fear avoidance + habituation: getting patients moving again safely09:56 - Look beyond BPPV: hypofunction, migraine, cervicogenic contributors12:45 - Multi-canal BPPV: why it’s tricky + how to prioritize treatment14:36 - Treating multiple canals in one session19:49 - Do you always schedule a follow-up after “straightforward” BPPV?21:46 - Teaching self-treatment + “seeing is believing” re-check visits24:08 - Case 2: ER “vertigo,” meclizine, lingering unsteadiness weeks later25:35 - Full vestibular exam even with “negative imaging” 27:26 - What you expect in unilateral hypofunction: oculomotor, HIT/VHIT, balance, gait29:14 - Treatment: education first, then VOR + balance + functional head movement32:03 - Anxiety/fear avoidance: reframing dizziness as a “learning opportunity”33:59 - Time-crunched HEP: “stacking” exercises into daily life 36:47 - VOR progression: dosing, symptom monitoring, advancing complexity39:10 - The future of gaze stability: more specific dosing, unilateral work, wearables42:37 - Case 3: Mid-30s postpartum, floaty dizziness + visual motion sensitivity (VM + PPPD/3PD)44:03 - VM education: migraine features without head pain; hormonal shifts as triggers45:28 - PPPD/3PD overlap + early prevention 51:49 - Treating visual motion sensitivity: patterns, videos, salience, real-world exposure58:00 - Where to find Dizzy Diagnostics + resources

    1h 1m

  4. 2025-12-03

    Stump the Clinicians: Vestibular Trivia with Dr. Jeff Walter PT, NCS

    In this special episode of Talk Dizzy to Me, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Dani Tolman, PT sit down with two giants in the vestibular field: Jeff Walter, PT, DPT, NCS and Helena Esmonde, PT, DPT, NCS (Vestibular First). Jeff tries to stump the group with vestibular questions covering: -The history of John Epley and his contributions to the field -Alexander’s law, Brun’s nystagmus, and the origin of the word nystagmus -A precise definition of vertigo -Advanced use of the bow and lean test for horizontal canal BPPV -What happens when BPPV maneuvers go “wrong” (short arm, conversion, retesting) -Practical use of the Rinne test, recruitment, and tuning forks in vestibular practice -How to interpret CT scans that “show” superior canal dehiscence (SCD) -A rare case of cough-induced nystagmus -The reality that some dizzy patients don’t fit neatly into any diagnosis—and why that’s okay Whether you’re a vestibular therapist, audiologist, ENT provider, or someone with dizziness hungry for answers, this episode is packed with clinical pearls, red flags, and pattern recognition tips for vertigo, BPPV, nystagmus, and beyond. Episode Resources: Jeff Walter, PT, DPT, NCS -https://www.vestibular.today -MedBridge Courses: https://www.medbridge.com/educate/instructors/jeff-walter-dpt-ncs Helena Esmonde, PT, DPT, NCS -https://vestibularfirst.com -Journal Club: https://vestibularfirst.com/education/journal-club/ -Educational Resources/Handouts: https://vestibularfirst.com/education/resources/ -Vestibular First 's Journal Club- Clinical Pearls from an Unusual Case of Vertigo: https://youtu.be/ASjx5Yet1So?si=3qu5LkiD_pEDagHq For more FREE resources, click ⁠⁠⁠here⁠.⁠⁠ Hosted by: 🎤 Dr. Abbie Ross, PT, NCS 🎤 Dr. Danielle Tolman, PT For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠ Connect with Us: → ⁠⁠⁠Book a free call with us⁠⁠⁠ → ⁠⁠⁠Get free resources straight to your inbox⁠⁠ → ⁠⁠Join The Dizzy Reset⁠ → ⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠ → ⁠⁠⁠Follow us on Instagram⁠⁠⁠ → ⁠⁠⁠Follow us on TikTok⁠⁠⁠ → ⁠⁠⁠Follow us on Facebook⁠⁠⁠ → ⁠⁠⁠Disclaimer⁠⁠⁠ → ⁠⁠⁠Enjoying the podcast? Leave us a review! Timestamps 00:00 – Intro 00:15 – Meet the Hosts & Guests 02:09 – Education Resources & Journal Club 03:08 – History Lesson: Dr. John Epley 06:21 – Alexander’s Law Explained 09:39 – Gustav Alexander’s Shocking Death 11:10 – Origin of the Term “Nystagmus” 13:31 – Brun’s Nystagmus & CPA Tumors 15:10 – Defining Vertigo (ICVD-Based) 18:22 – Bow & Lean Test: Angles, Mechanics & Clinical Pearls 23:24 – Short Arm / Anterior Arm BPPV & Tricks to Get Crystals Moving 27:34 – Retesting Posterior Canal BPPV: When You Re-Create the Problem 32:23 – Short Arm Debris & “Wimpy” Persistent Torsion 35:08 – Maneuver Names, Variations & Confusion in the Literature 38:53 – Tuning Forks in Vestibular & ENT Practice 45:19 – CT & Superior Canal Dehiscence: Might vs Definitely 49:22 – Cough-Induced Nystagmus 51:39 – Pattern Recognition, Edge Cases & Not Knowing Everything 56:15 – Reassuring Patients & “Doing the Next Right Thing”

    59 min

  5. 2025-11-05

    Understanding Cervicogenic Dizziness: Diagnosis and Treatment Explained

    Vestibular physical therapists Abbie Ross, PT, DPT, NCS, and Danielle Tolman, PT, DPT, sit down with Rob Landel, PT, DPT, FAPTA, to unpack cervicogenic dizziness (CGD) — what it is and isn’t, how to tell neck-driven dizziness apart from inner ear causes, and the clinical tools that actually make a difference. They dive into the head–neck differentiation test, cervical joint position error (JPE) testing with a laser, and why CGD rarely causes vertigo or spinning. You’ll also hear how concussion, whiplash, BPPV, and migraine can overlap with neck-related dizziness — plus practical insights on manual traction, cervical strength and endurance training, “pain-first” strategies, and when a short-term collar might help (despite its bad reputation). Episode Resources: Website: skillworks.biz Email: rlandel@me.com For more FREE resources, click ⁠⁠⁠here⁠.⁠⁠ Hosted by: 🎤 Dr. Abbie Ross, PT, NCS 🎤 Dr. Danielle Tolman, PT For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠ Connect with Us: → ⁠⁠⁠Book a free call with us⁠⁠⁠ → ⁠⁠⁠Get free resources straight to your inbox⁠⁠ → ⁠⁠Join The Dizzy Reset⁠ → ⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠ → ⁠⁠⁠Follow us on Instagram⁠⁠⁠ → ⁠⁠⁠Follow us on TikTok⁠⁠⁠ → ⁠⁠⁠Follow us on Facebook⁠⁠⁠ → ⁠⁠⁠Disclaimer⁠⁠⁠ → ⁠⁠⁠Enjoying the podcast? Leave us a review! Timestamps: 00:00 – Welcome & show open 00:45 – Dr. Lindell’s background & early vestibular days 03:01 – How far vestibular rehab has come 03:58 – Defining CGD clinically 05:26 – Symptoms CGD 06:26 – CGD with vestibular or central issues; trauma link 07:25 – Secondary CGD from guarding & “moving in blocks” 08:31 – Is CGD over- or under-diagnosed? 12:11 – BPPV + trauma: when to probe the neck 14:10 – Migraine, vestibular migraine, cervicogenic headache—untangling overlap 16:26 – How neck input feeds spatial orientation 19:43 – Mismatch analogy: why CGD feels like seasickness 21:10 – History taking: get precise about “dizzy” 22:38 – Traumatic vs. atraumatic onset; red flags & neuro screen 26:28 – Exam flow once central/peripheral causes are ruled down 27:22 – Head–Neck Differentiation Test (separating head vs. neck motion) 30:17 – Cervical Relocation / Joint Position Error (JPE) Test with laser 33:27 – Testing extension: stabilizing neck vs. moving head in block 35:03 – Treatment blueprint: mobility, pain, motor control, strength/endurance 37:26 – Laser tracing progressions 38:20 – Timelines: why strength/endurance take the longest 46:18 – Why one therapist managing vestibular + MSK is ideal 49:18 – Evidence & experience with traction/manipulation for CGD 50:43 – “Heavy-headedness” 53:22 – Fatigue → increased sway; training normalizes it 54:48 – Wrap-up & future part 2 ideas

    58 min

  6. 2025-10-01

    Rewiring the Dizzy Brain: Insights on Neuroplasticity, Dual Tasking, and Fear

    In this Talk Dizzy to Me episode, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Dani Tolman, PT sit down with Dr. Mike Studer, DPT, MHS, NCS, CEEAA, CWT, CSST, CSRP, CBFP, FAPTA to unpack neuroplasticity—what it is, how it works, and how to apply it in vestibular rehabilitation. We cover dual tasking, prediction error, fear-avoidant vs. fear-adapted movement, motivational interviewing, and patient-directed dosage using the OPTIMAL theory of motor learning. Mike shares practical clinic and real-life examples (driving, grocery stores, cooking), mic-drop lines you’ll quote to patients, and how to talk to insurers using objective measures. If busy visuals or movement bother you, consider listening on Apple Podcasts/Spotify. -Neuroplasticity = learning. It’s not just more pathways; it’s stronger, faster, better-fed pathways that consolidate during sleep. -Dose the meaningful. Intensity, repetitions, salience, and task specificity drive consolidation (“put a post-it on that memory”). -Exposure works. Habituation/adaptation creates prediction error (“that wasn’t as bad as I expected”), reinforcing change via dopamine. -Fear shows up in movement. Beyond fear-avoidant behavior, watch for fear-adapted movement (reduced head turns, co-contraction, slow/over-intentional strategies). -Dual tasking is two goals, not ‘think-and-move’ toward one goal. Use cognitive+motor or visual+motor loads that are personally salient. -Autonomy accelerates progress. Let patients choose dosage (keep, dial down, or push), using motivational interviewing and OPTIMAL theory. -No expiration date. Neuroplastic change remains possible well beyond 1 year—set expectations and use objective measures to justify care. Episode Resources: Email: mike@mikestuder.com Website: mikestuder.com Instagram: @MikeStuderDPT Book: The Brain That Chooses Itself For more FREE resources, click ⁠⁠⁠here⁠.⁠⁠ Hosted by: 🎤 Dr. Abbie Ross, PT, NCS 🎤 Dr. Danielle Tolman, PT For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠ Connect with Us: → ⁠⁠⁠Book a free call with us⁠⁠⁠ → ⁠⁠⁠Get free resources straight to your inbox⁠⁠ → ⁠⁠Join The Dizzy Reset⁠ → ⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠ → ⁠⁠⁠Follow us on Instagram⁠⁠⁠ → ⁠⁠⁠Follow us on TikTok⁠⁠⁠ → ⁠⁠⁠Follow us on Facebook⁠⁠⁠ → ⁠⁠⁠Disclaimer⁠⁠⁠ → ⁠⁠⁠Enjoying the podcast? Leave us a review! Time Stamps: 03:29 Neuroplasticity defined 05:21 Core principles: intensity, repetitions, salience, task specificity, sleep consolidatio 09:35 Zooming into vestibular reha 10:06 VR as proof of neuroplasticity; predictive processing 11:32 Habituation/adaptation as exposure-based therapy; links to pain & psycholog 13:32 Fear, expectations, and patient education 14:28 Therapeutic alliance: precision starts with the person 17:42 Treating fear: exposure-response prevention & prediction error (dopamine wins) 20:05 Dosage variables + motivational interviewing + OPTIMAL theory 21:27 Threat perception, amygdala, and “roadblocking” fear pathways 24:13 Fear-avoidant vs. fear-adapted movement (new concept in progress) 26:11 Cognitive load, exhaustion, and dual-task intolerance 29:32 Building alliance between sessions (check-ins) 30:00 What dual tasking is (and isn’t): two separate goals 31:32 Clinic examples: cognitive+motor; visual+motor with busy backgrounds 34:51 Real life: driving with kids, grocery stores, cooking; task switching vs. dual tasking 38:40 Overtraining in clinic to empower life outside 39:10 Progression: patient-controlled dosage (autonomy) 43:27 Neuroplasticity at any age; caveats for degenerative conditions 45:26 “Road crew at night” metaphor; why sleep matters 47:13 The “1-year” myth; talking to insurers with objective measures 49:27 Mic-drop lines ⁠⁠

    55 min

  7. 2025-09-03

    Dizziness in the ED: An Inside Look from PT and Physician Perspectives

    Dizziness in the emergency department is common... and complicated. Today, we talk with Dr. Peter Johns (MD) and Dr. Rebekah Griffith, PT about what actually works in the ED: using the HINTS exam correctly, avoiding unnecessary imaging and meclizine-only discharges, knowing when to call the stroke team, and why physical therapists in the ED can transform safety, outcomes, and costs. You’ll hear about how to triage dizzy patients, spot posterior circulation stroke red flags, treat BPPV efficiently, and keep patients safe when answers aren’t immediate. We also cover topics such as orthostatic hypotension, POTS, rapid-access dizzy clinics, and practical discharge planning. Episode Resources: Peter Johns, MD — Emergency physician and vertigo educator (creator of “Spin Class” vertigo course and a popular YouTube channel). Dr. John's "Spin Class" CourseDr. John's YouTube Channel Rebekah Griffith, PT, DPT — Emergency Department physical therapist and educator advocating for PT/OT presence in EDs nationwide. Dr. Griffith's website Instagram Key Takeaways: Use HINTS to rule in peripheral vestibular dysfunctionBPPV is common and under-treated—confirm with positional nystagmus and treat with the correct maneuvers.Assess gait and orthostatics upright, not just vitals in bed; orthostatic hypotension is frequently missed.Embedding PTs in EDs improves safety, reduces unnecessary imaging and admissions, and boosts patient/provider satisfaction.Upstream PT access (outpatient/telehealth) prevents many ED visits and fear-avoidant patterns (e.g., PPPD risk).If this episode helped you, subscribe, like, and share. Comment with your biggest ED dizziness challenge—and we may just cover it in a future episode! For more FREE resources, click ⁠⁠⁠here⁠.⁠⁠ Hosted by: 🎤 Dr. Abbie Ross, PT, NCS 🎤 Dr. Danielle Tolman, PT For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠ Connect with Us: → ⁠⁠⁠Book a free call with us⁠⁠⁠ → ⁠⁠⁠Get free resources straight to your inbox⁠⁠ → ⁠⁠Join The Dizzy Reset⁠ → ⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠ → ⁠⁠⁠Follow us on Instagram⁠⁠⁠ → ⁠⁠⁠Follow us on TikTok⁠⁠⁠ → ⁠⁠⁠Follow us on Facebook⁠⁠⁠ → ⁠⁠⁠Disclaimer⁠⁠⁠ → ⁠⁠⁠Enjoying the podcast? Leave us a review!⁠ Time Stamps: 01:11 Dr. Johns: path to ED & vertigo education 02:41 Dr. Griffith: why PT belongs in the ED 04:01 What PTs actually do in the ED 06:52 Living with diagnostic ambiguity in the ED 07:21 How common is dizziness; risk of dangerous causes 08:17 PT share of dizzy patients in the ED 10:43 Why every ED should have PT (throughput, safety, cost) 13:27 ED goals for dizzy patients & discharge planning 14:52 Gait assessment as a safety linchpin15:22 Rapid Access Dizzy (RAD) clinic model 16:21 When PT flags central signs & stroke alerts 18:09 HINTS exam: when to use it in the ED 20:56 Why no HINTS without nystagmus23:23 Central “red flags” to screen before HINTS 25:18 Imaging realities: CT/CTA vs MRI, US vs Canada 27:36 How ED PTs cut holds, imaging, burnout 28:57 Discharging symptomatic but safe patients 30:21 When not to discharge: gait + no nystagmus 33:12 “Vertigo” isn’t a diagnosis—referrals that help 35:59 Most mismanaged: BPPV and posterior strokes 37:26 The sleeper culprit: orthostatic hypotension 39:24 POTS awareness & functional vitals in motion 42:12 Upstream care: keeping dizzy patients out of the ED 43:45 Training ED clinicians to manage dizziness46:11 PT/OT courses to build ED programs 47:37 Hands-on feedback for HINTS proficiency #Dizziness #Vertigo #BPPV #HINTSExam #Stroke #EmergencyMedicine #VestibularRehab #PhysicalTherapy #POTS #OrthostaticHypotension #NeuroPT #TalkDizzyToMe

    50 min

  8. 2025-08-06

    Concussion Care 101: Assessment, Treatment & Return to Life

    Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT chat with the Concussion Queen herself, Dr. Becky Bliss, PT, DHSc to discuss all things concussion. About the Guest: Dr. Becky Bliss is a Clinical Associate Professor at the University of Kansas Medical Center and Program Coordinator for the University of Missouri’s Neurological Physical Therapy Residency. Board-certified in neurological PT with advanced certification in vestibular rehab, she has over 20 years of clinical experience specializing in concussion management since 2006. Becky is active within APTA’s Concussion Committees, provides national telementorship through the Missouri Telehealth Concussion ECHO program, and pursues research in best practices for concussion care, neuromotor control, and education. WebsiteEmail: rbliss@kumc.edu Like our shirts? Get your Vestibular First "Semicircular Interpreter" shirt here! For more FREE resources, click ⁠⁠⁠here⁠.⁠⁠ Hosted by: 🎤 Dr. Abbie Ross, PT, NCS 🎤 Dr. Danielle Tolman, PT For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠ Connect with Us: → ⁠⁠⁠Book a free call with us⁠⁠⁠ → ⁠⁠⁠Get free resources straight to your inbox⁠⁠ → ⁠⁠Join The Dizzy Reset⁠ → ⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠ → ⁠⁠⁠Follow us on Instagram⁠⁠⁠ → ⁠⁠⁠Follow us on TikTok⁠⁠⁠ → ⁠⁠⁠Follow us on Facebook⁠⁠⁠ → ⁠⁠⁠Disclaimer⁠⁠⁠ → ⁠⁠⁠Enjoying the podcast? Leave us a review!

    1 hr
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5
out of 5
5 Ratings

About

We’re just two vestibuloholics excitedly bringing you a comprehensive view into the complex field of dizziness. Made for both clinicians and patients, we’re aiming to provide you with endless resources, tips & tricks, interviews with experts, and so. much. more. Hosted by Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT

Information

  • Creator
    Balancing Act Rehab
  • Years Active
    2020 - 2026
  • Episodes
    90
  • Rating
    Clean
  • Copyright
    © Balancing Act Rehab
  • Show Website
    Talk Dizzy To Me

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