Hi Reader,
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We are back! I hope you all had an amazing summer and it was filled with smiles and sunshine! Mine sure was, along with lots of water time (I am a mermaid at heart!). We spent a lot of time on our sailboat, and this year I even returned to racing, joining up with a great new sailing crew. This is my first time back doing a more intense sport since having cancer and suffering a spinal cord injury, and I am really happy and grateful for this progress!

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One thing I have been especially grateful for is the return of my proprioception. Our proprioception is our awareness of where our body is in space, and I lost this when I had my spinal cord injury. With training I was able to regain it back, but did you know your proprioception is something you can also train to help with your dizziness?

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How Does my Proprioception affect my Dizziness?

We have three systems that make up our overall sense of balance and orientation:

• Vision (eyes)
• Vestibular (inner ear)
• Proprioception (receptors in your neck, feet and throughout your body)

Dizziness can arise when these three systems aren't in agreement or there is dysfunction in one system.

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What is my Proprioception?

Throughout our body we have receptors in our joints that tell our brain about where our body is in space. These sensory receptors exist in our neck and provide input to our brain letting us know where our head is in space. For example, are we looking forwards, to the side, tilting our head, etc.? They also exist in our lower legs and feet, letting us know the position of our feet. For example, are we on an incline, putting more weight on one foot, or on an uneven surface?

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Give this exercise a try to sense your proprioception:

Hold up your pointer finger in front of you and bend and straighten it. With your eyes open you can see that you re doing that motion, so your vision can tell your brain what is happening.

Now close your eyes and bend and straighten your finger. Can you still sense when it is bent or stright even without vision?

I bet you can!

This is our proprioception system at work, telling us all the time what our body is doing!

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What Happens when our Proprioception is Poor?

For some people, these sensory receptors lose sensitivity and our brain no longer receives adequate input as to where our head or limbs are orientated. Since we still receive input from our vision and our vestibular system, there is now a mismatch between our 3 balance systems, and dizziness and imbalance can result.

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How can we Rehabilitate this?

Well this is what we specialize in! In the neck, we can improve the sensory receptors through manual therapy, head position training, posture correction and address muscle imbalances.

Through the rest of our body, we can use weights to help increase the gravitational input, train on varied angles and surfaces, and remove vision to enhance focus on your proprioception system.

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My Favourite Tool

My favourite tool to try with patients to improve proprioception and their gravitational sensors is a weighted vest. You can start by wearing this while sitting in a supportive chair with your eyes closed to help calm the nervous system. If that helps, you can progress to standing, then standing with your feet together.

There are lots of options out there, but I find the ones that sit centrally give people the best response. Below are two examples that I like - I have the first one in the clinic, but also love the weight options of the second one. I use a weighted vest pretty much daily myself, as it has improved my proprioception as well as my bone density post-cancer (a tip for anyone with osteopenia or osteoporosis!).

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What's Coming Up?

September is a HUGE month for vestibular and concussion awareness! Here are some days/weeks to mark in your calendar:

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​VeDA's Balance Awareness Week​

• September 15-22, 2024
• This is a global event to raise awareness of balance loss, vertigo, dizziness, and other vestibular conditions.
• You can show your support through donations, or by sharing your story and raising awareness and support in your community!

​Concussion Awareness Week​

• September 24-30, 2024
• This was established in 2021 to increase concussion awareness by providing information and encouraging action across Canada.

​Rowan's Law Day​

• September 25, 2024
• Rowan's Law was names for Rowan Stringer, a high school rubgy player from Ottawa, who died in the spring of 2013 from a condition known as second impact syndrome (swelling of the brain caused by a subsequent injury that occured before a previous injury healed). Rowan is believed to have experienced three concussions over six days while playing rugby. She had a concussion but didn't know her brain needed time to heal. Neither did her parents, teachers or coaches.
• Rowan's Law was established to honour her memory and bring awareness to concussion and concussion safety.

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Sale Alert! 50% Off!

September is also the month that the Healing Vertigo App goes on SALE! The App will be 50% off from September 15-22 in support of Balance Awareness Week, so if you don't yet have this tool to help treat Benign Paroxysmal Positional Vertigo (BPPV), now is the time to grab it!

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As always, if you have any questions about anything you read in this newsletter, hit respond and send me an email, I would love to chat!

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Thank you for being part of this amazing vestibular community!

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Your vestibular physio,
~ Cheryl