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Off-Topic Dizziness related to movement, especially upright.

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Varjag31

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After more than a year of looking for answers and not getting anything definitive, I’m looking for any advice or pointer in the right direction from the good old internet hive-mind :p

If someone can share some similar experience or someone in the field here point something out, I would be very grateful. I’m aware of the traps of internet diagnosis, and of the rightful reluctance of people to do this stuff over the net, but I’ve been there, done that, went to all the specialists and got nothing substantial out of it, so I’m looking for any possible venue that I didn’t explore.

Before the issues started, I was regularly doing S&S, slowly, with focus on technique, felt very good on it. That is also the reason I’m posting in this forum - S&S was my main exercise program and I really want to get back into it and continue. Wall of text incoming:

A year and a half ago, I started suffering with mild dizziness under certain conditions, which I still don’t exactly know, but I pin pointed some circumstances in which it is most likely to trigger. The feeling I get is as if my head would be a little detached from my body, like one of those old school toys people used to put in a car that would nod their head. The feeling is not overwhelming, like I would fall, more like when you had a drink to much, and you have to go to the toilet and concentrate to walk straight. No one around you will notice that you are tipsy, but you need to work for it. A couple of months later I had an onset of anxiety, which culminated in two panic attacks, one while driving, another one in a crowd in a tourist place.

I’m an office worker, spending way too much time in front of the computer, but that is my profession, and something I have to deal with. I have been physically active most of my life and I do get up from the desk, stretch and walk a bit on regular intervals. I also walk to work (45 min. one way) unless the weather is really bad, at least in one way if I’m tight with time. My summer holidays used to be long backpacking trips for weeks at a time in mountains. I always came in better shape from holidays than when I left. Not for last two years. I’m having issues walking for a long time, because the dizziness starts and it triggers anxiety after a while. I know that I will not collapse, but the hikes are reduced to me just waiting for it to end instead of enjoying it. Backpack makes things worse.

I’m translating a bunch of medical terms on my own here because I’m not from an English speaking country, so I might miss some of the terminology.

I looked for professional help, both physical and mental. Had X-rays of my neck and MR of the head and neck done.

Also, went to the clinic which specialises in dizziness and vertigo, where I had a complete set of vision, nose and ear and vestibular tests done. It didn’t show anything.

I was examined by an orthopedic specialist, which based on x-rays noted “straightened cervical lordosis with signs of angulation, with pronounced osteochondrosis and uncarthrosis in both sides. Osteochondrosis is most pronounced in median distal segment mostly in C5/C6. Neck musculature painful in the attachment area, limited mobility in end degrees of flexion, mostly in right rotation by ¼. Shoulder mobility is good and free of pain, somewhat sensitive left tubercular attachment. Grip strength symmetrical.”

He sent me to do an MR, which showed degenerative changes and narrowing, mostly on C4-C5.

Based on all that the orthopaedic specialist prescribed me a therapy which I had daily for two weeks. It involved manual therapy, chiropractic, magneto-therapy, electrotherapy and postural exercises. He also sent me to the neurologist (who was also specialised in vertigo and dizziness), which after examination concluded that none of the present issues are causing the dizziness.

Had some manual work done on my neck and jaw and skull musculature, and I felt good after, but I really can’t tell if it solved anything.

Psychologist who I worked with for the onset of anxiety, said that it can be a chicken and the egg situation, where the structural issues are triggering dizziness, which leaves me in a constant state of insecurity, driving the anxiety, or it can be come underlying issues causing the psychosomatic reaction – or by now, bit of both combined.

I started getting sick of all and decided to slowly, on my own, very carefully start moving again, and explore the limits. During a month of holidays, I did daily a combination of squats, push-ups and rows with a rubber and I felt good on it. Focus was on technique, and the rep where I started thinking about finishing the set and not about the movement itself was always the last one. I was periodically dizzy during the day, but never during or immediately after exercise.

Came back home and decided to start S&S again, very VERY slowly and with a very light bell, focused on technique, following Kalos Sthenos principles. After a week, I started feeling more tension in my neck and back of the skull. I’m not sure, but I think that carrying things overhead might trigger something.

I decided to back off, let it rest, and downscale. I started the Original Strength program from Tim Anderson, planning to focus on that for some indefinite time. I noticed almost immediate better feeling in my neck and a decrease in sensation of head being detached. I noticed another interesting thing, which is with standing diaphragmatic breathing exercises I start getting the exactly same feeling of instability and dizziness. I plan to continue doing them, to see whether it gets better over time with exposure.

So, my own conclusion, based on exploration, exercises and some anatomy knowledge (which I have to go verify, but frustratingly so, cause no one so far gave me any answers) is that I’m either jamming something in my neck which gets pronounced whenever I lift something overhead, but since it happens with walking it could be in the shoulder/upper chest region, or maybe, since it manifests during standing deep breathing, it is something connected to the firs rib, chest or diaphragm that does not get poked when I’m lying down and very rarely when sitting (it has to already be present, to get amplified when sitting).

I was thinking also, maybe it is some breathing pattern issue, that does not rear it’s head out when in a rested state, but starts showing when moving. I was a mouth breather until my late teens, when through sport I taught myself to breathe through my nose.

So … any ideas, advice, frankly, I’ll go for anything that might be worth exploring.

Thanks,

Mihael

edit for some basic info:

41 years old, 176 cm, 75-80 kg. Sleep ok, +/- 7-8 h/day. Paleo, but not religious diet. Focus on eating things that were alive at some point. Not eating grains cause of mild gluten sensitivity. It will not kill me if I eat a pizza a few times a year, but it will pile up over time if I do it regularily.
 
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Yeah they did that, as a part of that checkup. I went to a hospital that specializes in vertigo and they checked all that ear and nose stuff. Poured water into my ear, spun around on the chair. Stood in a dark room on a moving floor with lights moving and spinning around me, all that stuff. I felt like I'm applying for an astronaut.

Jokes aside, didn't find anything.

The closest to a real diagnosis was the one from the orthopedic doctor.

Neurologist said that that may influence it, but he doesn't believe it, cause usually people with symptoms have much worse deformations and that it's visible on the MR the structure is not touching anything that would be the cause.
 
With all the docs investigating to no avail and without any clear reason why this is happening, you can 'try' things out.
You mention your neck and how movement(s) bring on symptoms then perhaps - perhaps - perhaps - the way you move is worth considering.
Look into the Feldenkrais Method.
It's difficult to describe in a brief overview. If you follow the method then you will never, ever, ever be anywhere near a pain response or being uncomfortable, being totally safe lying down on the floor.
The movements and awareness that it brings may perhaps help trigger new movement patterns in your neck and spine to override the current ones. Maybe.
Plenty info and resources available in books and via Feldenkrais method - awareness through movement online.
I had a focused attempt to rid myself of knee pains and enjoy at least one Feldenkrais session a week for its meditative and general movement quality it brings.
I first learned of it here on this forum too.
 
ali-

I just finished a Feldenkrais session for the knee and it was fascinating. It's certainly too soon to make a judgement, but I will pursue this method. Thank you so much.
 
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I noticed another interesting thing, which is with standing diaphragmatic breathing exercises I start getting the exactly same feeling of instability and dizziness.

Dizziness can result from over-breathing. Looking into methods of learning to breath less. That doesn't mean you shouldn't breath well, just that you may need less air than you think.

I plan to continue doing them, to see whether it gets better over time with exposure.
I wouldn't recommend this.

Our Second Wind seminar might help you. Instruction in Buteyko breathing might as well. NB: I and @Al Ciampa teach Buteyko breathing privately, through this school: Advanced Buteyko Institute | Buteyko Breathing Courses & Instruction

-S-
 
With all the docs investigating to no avail and without any clear reason why this is happening, you can 'try' things out.
You mention your neck and how movement(s) bring on symptoms then perhaps - perhaps - perhaps - the way you move is worth considering.
Look into the Feldenkrais Method.
It's difficult to describe in a brief overview. If you follow the method then you will never, ever, ever be anywhere near a pain response or being uncomfortable, being totally safe lying down on the floor.
The movements and awareness that it brings may perhaps help trigger new movement patterns in your neck and spine to override the current ones. Maybe.
Plenty info and resources available in books and via Feldenkrais method - awareness through movement online.
I had a focused attempt to rid myself of knee pains and enjoy at least one Feldenkrais session a week for its meditative and general movement quality it brings.
I first learned of it here on this forum too.

Thanks I'll look into that ... doubt that I can find a practitioner close to where I live, but I'll check for some resources.
 
Dizziness can result from over-breathing. Looking into methods of learning to breath less. That doesn't mean you shouldn't breath well, just that you may need less air than you think.


I wouldn't recommend this.

Our Second Wind seminar might help you. Instruction in Buteyko breathing might as well. NB: I and @Al Ciampa teach Buteyko breathing privately, through this school: Advanced Buteyko Institute | Buteyko Breathing Courses & Instruction

-S-

Thanks, I'll look into that. ... I've read "Oxygen advantage", but never employed it in practice. I have been aware about the importance of breathing, but I got confused with all the different approaches, from breathing less, breathing more, or even "don't touch what is supposed to be a reflex".

Regardless of the method, what is your experience with transferring breathing exercises while sitting, which is most of the times not that hard, to positions and movements where you begin to be stressed, like vigorous activity. Does it become subconscious over time?
 
Thanks. ...

Regardless of the method, what is your experience with transferring breathing exercises while sitting, which is most of the times not that hard, to positions and movements where you begin to be stressed, like vigorous activity. Does it become subconscious over time?

You’re welcome.

Absolutely it does. That’s the point, and that’s focus of the practice.

-S-
 
It's certainly too soon to make a judgement, but I will pursue this method.

That's the thing with the method, it is non-judgemental. Your experience, unique to you and your movement capacity. Hope you gain some insights.

I found it interesting that Moshe Feldenkrais derived the method from his own knee pain!
I've experienced knee pain relief directly with lessons related to hip, knee and ankle. And also indirectly, with more classic lessons. The body is a whole, so it follows that, and as many others experience too, moving more freely in one area affects others. Movement then becomes more integrated.
A particular lesson focused on tiny movements of the index finger and it unexpectedly improved shoulder function, range and ease of movement.
As idiosyncratic we all are, lessons and the outcomes too are also idiosyncratic.
There are breathing lessons too and although with a different focus than buteyko, or some yoga practices, or other breath holding techniques with a focus to improve a certain function, there is an overlap, given that breathing is in itself a movement. So, yeah, as @Steve Freides says, exploring your breathing patterns, through whatever lens you observe them, could be very useful.
It's worth investing some time in non-invasive, pain-free modalities for general health that may have some impact on specific health concerns, emphasis on may. If you start from the view that it will do no harm then there is no, virtually zero, risk to worsen any symptoms - so, if at a loss, worth a punt. Stay well away from pain or discomfort.
 
Who deals with it will vary a bit from country to country- whoever it is in your locale who deals with cerebrovascular accident / stroke is where I’d start. MR angiography and echocardiography are part of the usual work up.
 
Your experience, unique to you and your movement capacity. Hope you gain some insights.

I don't wish to hijack the thread, but...

At the end of May I noticed that my left foot was striking the floor differently than my right upon entering a building after a rain shower. A few days later things became symptomatic on the outside of the left knee, achy and normal flexion had a twinge of discomfort. I suspected IT band, something that I have experienced before, and approached treating it as I had in the past. No dice. At the end of June I finally relented and saw my doctor. Yep, IT band he said and sent me to physical therapy. They discovered that I was 10 degrees short of full extension. After a month I was released, no limitations, and my leg was "only" three degrees short of full extension. There was appreciable improvement, but the pain behind my knee was still present. A local orthopedist was a former football player of mine as an undergrad so I went to see him. After X-rays he said little to no arthritis and suggested an injection of depo medrol which I accepted. A couple days later there was no pain yet I knew that the injection was likely only masking things. Armed with relief I decided to take matters into my own hands, I know, perhaps not a great idea.

I'm not convinced that the IT band is the culprit but a secondary result of something else. I do not recall an event that would have caused this but I am suspicious that I did something to the knee that I was not aware of at the time which led to the symptoms. I suppose that I should have a MRI.

That's where your reference to the Feldenkrais method comes into play. The only area that seems to get grumpy is the popliteus, although there has been some "snapping" on the lateral aspect of the knee that is gradually diminishing. The precepts of Feldenkrais make a lot of sense to me. I do not believe that I am causing any additional insult to the knee at present so I plan on using the method since it was so revealing even after two sessions. I would prefer to use the energy that made the body aid in healing it if possible.
 
Thanks for all the comments so far,

I'm going to have another neurologist appointment, figure it can not hurt to get a second opinion.

While waiting, I've been reading/looking for a practitioner in my vicinity for both Feldenkrais and Buteyko method.

If one of you can give me some additional info:

About Feldenkrais method: I understand it is not a quick fix, like an adjustment and then things start working, but rather an exploration of your own body. Is it something I would have to take as another training venue and devote time for the long term in order to see results (like taking up BJJ practice for example), or is it something that you do for a limited time (like a few months), until you figure things out?

About Buteyko method: Sheer variety of the breathing approaches available is so confusing to me. Just a single search gives you so many different schools different exercises, that as a layman it is hard to separate chaff from wheat (Buteyko, box, 4-7-8, multitude of pranayama exercises from yoga). In most of them, some kind of controlled breathing exercise is done while sitting/laying down.

I am confused in how to translate that to movement, cause I have a feeling the moment you start doing something dynamic, the breathing changes. How do I, or should I at all transfer the breathing into running or doing swings for example. How do you consolidate the natural breathing rhythm with the rhythm of the movement, for example, when running, I tend to breathe in/out based on number of steps, but that is not breathing in the way you feel like, it is rather subverting the breath to the movement.

In swings for example, I use more a type of a breath like you would do with punching, or Kime from karate. How does Buteyko's slow, calm and steady correlate to swing for example.

I feel that it is like if you are working on static stability, but the moment you start moving, everything goes to hell.
 
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