Talk Dizzy To Me

• 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 fieldAlexander’s law, Brun’s nystagmus, and the origin of the word nystagmusA precise definition of vertigoAdvanced use of the bow and lean test for horizontal canal BPPVWhat happens when BPPV maneuvers go “wrong” (short arm, conversion, retesting)Practical use of the Rinne test, recruitment, and tuning forks in vestibular practiceHow 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 okayWhether 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 ResourcesJeff Walter, PT, DPT, NCShttps://www.vestibular.todayMedBridge Courses: https://www.medbridge.com/educate/instructors/jeff-walter-dpt-ncsHelena Esmonde, PT, DPT, NCShttps://vestibularfirst.comJournal 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_pEDagHqHosted 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!Timestamps00:00 – Intro00:15 – Meet the Hosts & Guests02:09 – Education Resources & Journal Club03:08 – History Lesson: Dr. John Epley06:21 – Alexander’s Law Explained09:39 – Gustav Alexander’s Shocking Death11:10 – Origin of the Term “Nystagmus”13:31 – Brun’s Nystagmus & CPA Tumors15:10 – Defining Vertigo (ICVD-Based)18:22 – Bow & Lean Test: Angles, Mechanics & Clinical Pearls23:24 – Short Arm / Anterior Arm BPPV & Tricks to Get Crystals Moving27:34 – Retesting Posterior Canal BPPV: When You Re-Create the Problem32:23 – Short Arm Debris & “Wimpy” Persistent Torsion35:08 – Maneuver Names, Variations & Confusion in the Literature38:53 – Tuning Forks in Vestibular & ENT Practice45:19 – CT & Superior Canal Dehiscence: Might vs Definitely49:22 – Cough-Induced Nystagmus51:39 – Pattern Recognition, Edge Cases & Not Knowing Everything56:15 – Reassuring Patients & “Doing the Next Right Thing”

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• 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).Guest: Dr. Rob Landel Website: skillworks.bizEmail: [email protected] 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!Chapters (Timestamps)00:00 – Welcome & show open00:45 – Dr. Lindell’s background & early vestibular days03:01 – How far vestibular rehab has come03:58 – Defining CGD clinically05:26 – 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 neck14:10 – Migraine, vestibular migraine, cervicogenic headache—untangling overlap16:26 – How neck input feeds spatial orientation19:43 – Mismatch analogy: why CGD feels like seasickness21:10 – History taking: get precise about “dizzy”22:38 – Traumatic vs. atraumatic onset; red flags & neuro screen26:28 – Exam flow once central/peripheral causes are ruled down27:22 – Head–Neck Differentiation Test (separating head vs. neck motion)30:17 – Cervical Relocation / Joint Position Error (JPE) Test with laser33:27 – Testing extension: stabilizing neck vs. moving head in block35:03 – Treatment blueprint: mobility, pain, motor control, strength/endurance37:26 – Laser tracing progressions 38:20 – Timelines: why strength/endurance take the longest46:18 – Why one therapist managing vestibular + MSK is ideal49:18 – Evidence & experience with traction/manipulation for CGD50:43 – “Heavy-headedness”53:22 – Fatigue → increased sway; training normalizes it54:48 – Wrap-up & future part 2 ideas

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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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