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Talk Dizzy To Me

Balancing Act Rehab
Talk Dizzy To Me
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  • 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.Connect with MikeEmail: [email protected]: mikestuder.comInstagram: @MikeStuderDPTBook: The Brain That Chooses ItselfTime Stamps03:29 Neuroplasticity defined 05:21 Core principles: intensity, repetitions, salience, task specificity, sleep consolidation09:35 Zooming into vestibular rehab10:06 VR as proof of neuroplasticity; predictive processing 11:32 Habituation/adaptation as exposure-based therapy; links to pain & psychology13:32 Fear, expectations, and patient education14:28 Therapeutic alliance: precision starts with the person17:42 Treating fear: exposure-response prevention & prediction error (dopamine wins)20:05 Dosage variables + motivational interviewing + OPTIMAL theory21:27 Threat perception, amygdala, and “roadblocking” fear pathways24:13 Fear-avoidant vs. fear-adapted movement (new concept in progress)26:11 Cognitive load, exhaustion, and dual-task intolerance29:32 Building alliance between sessions (check-ins)30:00 What dual tasking is (and isn’t): two separate goals31:32 Clinic examples: cognitive+motor; visual+motor with busy backgrounds34:51 Real life: driving with kids, grocery stores, cooking; task switching vs. dual tasking38:40 Overtraining in clinic to empower life outside39:10 Progression: patient-controlled dosage (autonomy)43:27 Neuroplasticity at any age; caveats for degenerative conditions45:26 “Road crew at night” metaphor; why sleep matters47:13 The “1-year” myth; talking to insurers with objective measures49:27 Mic-drop linesHosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT For more FREE resources, click ⁠here⁠.For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠⁠Connect with Us:→ ⁠⁠Book a free call with us-hope and healing start now⁠⁠→ ⁠⁠Get free resources straight to your inbox⁠→ ⁠Join the waitlist for The Dizzy Reset wellness program⁠→ ⁠⁠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!⁠⁠
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  • 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.About the Guests: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 ChannelRebekah Griffith, PT, DPT — Emergency Department physical therapist and educator advocating for PT/OT presence in EDs nationwide.Dr. Griffith's website InstagramKey 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!Hosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT For more FREE resources, click here.For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠Connect with Us:→ ⁠Book a free call with us-hope and healing start now⁠→ ⁠Get free resources straight to your inbox→ Join the waitlist for The Dizzy Reset wellness program→ ⁠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 education02:41 Dr. Griffith: why PT belongs in the ED04:01 What PTs actually do in the ED06:52 Living with diagnostic ambiguity in the ED07:21 How common is dizziness; risk of dangerous causes08:17 PT share of dizzy patients in the ED10:43 Why every ED should have PT (throughput, safety, cost)13:27 ED goals for dizzy patients & discharge planning14:52 Gait assessment as a safety linchpin15:22 Rapid Access Dizzy (RAD) clinic model16:21 When PT flags central signs & stroke alerts18:09 HINTS exam: when to use it in the ED20:56 Why no HINTS without nystagmus23:23 Central “red flags” to screen before HINTS25:18 Imaging realities: CT/CTA vs MRI, US vs Canada27:36 How ED PTs cut holds, imaging, burnout28:57 Discharging symptomatic but safe patients30:21 When not to discharge: gait + no nystagmus33:12 “Vertigo” isn’t a diagnosis—referrals that help35:59 Most mismanaged: BPPV and posterior strokes37:26 The sleeper culprit: orthostatic hypotension39:24 POTS awareness & functional vitals in motion42:12 Upstream care: keeping dizzy patients out of the ED43:45 Training ED clinicians to manage dizziness46:11 PT/OT courses to build ED programs47:37 Hands-on feedback for HINTS proficiency#Dizziness #Vertigo #BPPV #HINTSExam #Stroke #EmergencyMedicine #VestibularRehab #PhysicalTherapy #POTS #OrthostaticHypotension #NeuroPT #TalkDizzyToMe
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  • 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: [email protected] our shirts? Get your Vestibular First "Semicircular Interpreter" shirt here!Hosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT For more FREE resources, click ⁠here⁠.For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠⁠Connect with Us:→ ⁠⁠Book a free call with us-hope and healing start now⁠⁠→ ⁠⁠Get free resources straight to your inbox⁠→ ⁠Join the waitlist for The Dizzy Reset wellness program⁠→ ⁠⁠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!⁠⁠
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  • Advocating for the Invisible: A Candid Talk on Chronic Illness
    Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT chat with Shruti Shivaramakrishnan. Shruti lives in Ontario, Canada and her career background is in patient engagement through strategic content and fostering validating communities. Her Instagram community, Chronically Meh, aims to support people who live with chronic illness, and my work with GetCopayHelp assists patients with affordable prescriptions. Shruti has had migraines since she was a child, with occasional vestibular symptoms. After contracting COVID, the vestibular aspect became more pronounced and has caused ongoing health issues. The unpredictability of her symptoms is frustrating and makes them challenging to manage. While she is frustrated by the lack of effective treatments and general lack of understanding, she tries to focus on the hope advocacy brings, everyday glimmers, and live life fully -  one breath at a time.Where to find Shruti:https://www.instagram.com/chronicallymeh/Hosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT For more FREE resources, click ⁠here⁠.For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠⁠Connect with Us:→ ⁠⁠Book a free call with us-hope and healing start now⁠⁠→ ⁠⁠Get free resources straight to your inbox⁠→ ⁠Join the waitlist for The Dizzy Reset wellness program⁠→ ⁠⁠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!⁠⁠⁠
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  • Sorting Out Dizziness: A Deep Dive into Differential Diagnosis
    Dr. Anand Bery and Dr. David Hale join Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT to discuss the process of differential diagnosis for vestibular dysfunction. Dr. Anand Bery is a neurologist and otoneurologist, with unique subspecialty fellowship training in neuro-vestibular and balance disorders. He specializes in treating patients with dizziness, vertigo, double vision and imbalance. His clinical interests include vestibular neuritis, BPPV, vestibular migraine and nystagmus.Dr. David Hale is a fellowship-trained neurologist specializing in neuro-visual and vestibular disorders. He diagnoses and treats patients with symptoms including dizziness, vertigo, oscillopsia, double vision and imbalance. Dr. Hale’s patient evaluations include vestibular testing. Dr. Hale earned his medical degree at Pennsylvania State University and completed a neurology residency at the Johns Hopkins University School of Medicine. He remained at Johns Hopkins for fellowship training in vestibular and ocular-motor oto-neurology. He serves as the co-director of the Vestibular and Ocular-Motor Oto-Neurology Clinical Fellowship at Johns Hopkins. Neurology Exam Prep Podcast Episodes:Episodic Vertigo (episode 73) https://podcasts.apple.com/us/podcast/episode-73-episodic-vertigo/id1493745353?i=1000678790997 Acute Vestibulopathy (episode 68)https://podcasts.apple.com/us/podcast/episode-68-acute-vestibulopathy/id1493745353?i=1000658289413 Hosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT For more FREE resources, click ⁠here⁠.For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠⁠Connect with Us:→ ⁠⁠Book a free call with us-hope and healing start now⁠⁠→ ⁠⁠Get free resources straight to your inbox⁠→ ⁠Join the waitlist for The Dizzy Reset wellness program⁠→ ⁠⁠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!⁠⁠
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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
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