Posted by: seattledizzygroup | April 30, 2018

Posture and Balance

The Key To Life Is Balance

Postural Control & Balance

by Morgan Kriz, DPT

Vestibular Physical Therapist

 (Presented to Seattle Dizzy Group on 4/14/18)

This presentation gives an overview of how postural control helps maintain balance including the role of the cervical spine and the somatosensory system (musculoskeletal and joint systems).  It also offers a few strengthening and stretching exercises to practice for maintaining better posture and improving balance.

Balance is the ability to maintain the body’s center of mass over its base of support

Balance/stability is achieved and maintained by a complex set of sensorimotor control systems that include sensory input from 3 main systems:

  1. Vestibular System/Inner Ear (motion, equilibrium, spatial orientation)
  2. Vision (eyes)
  3. Somatosensory/Proprioception (sense of body’s position)

These systems are connected to each other and to the brain to help maintain good balance.

Balance System

Vestibular System

  • Size of a coin

Vestibular System size of coin

  • 5 end organs
    • 3 semicircular canals
      • Angular accelerations of the head
    • 2 otolith organs
      • Linear accelerations
      • Utricle
      • Saccule

The Internal Ear

Semicircular canals — Full of fluid that moves when you move your head around (little “fish bowls”)

Otolith Organs — Where otoliths live on a bed of jello


Vision System

Vision is human’s strongest sense

80% of what we learn is through our eyes

40% of our brain is mapped to connect to vision

Vision System

  • Make sure you have vision exam annually
    • Ensure proper prescription for glasses
  • Bifocal and progressive lenses considerations
  • Eyes and inner ears communicate
    • Via Vestibulo-Ocular Reflex (VOR)
    • Practice gaze stabilization
  • Eyes and the body connect
    • Via Cervico-Ocular Reflex (COR)

Gaze stabilization

Vestibular Dysfunction

People with vestibular disorders often experience problems with vertigo, dizziness, visual disturbances and/or balance.

Other problems also arise that are secondary to vestibular disorders, such as nausea and/or vomiting, headaches, “foggy headedness,” heavy headedness, reduction in one’s ability to focus or concentrate and increase fatigue.  (Cervical spine issues can also cause or exacerbate foggy or heavy headedness).

These impairments can be life-altering.

The Brain Controls It All

The midbrain is like a busy mail room.  Incoming messages need to be sorted and sent on.  Error signals cause system alarms (resulting in symptoms such as nausea, headache, etc.).

Brainstem = Body’s Highway

  • The brainstem controls the flow of messages between the brain and the rest of the body.  Sensory and motor neurons connect through here to the brain.
  • It also controls basic body functions such as:
    • Breathing
    • Swallowing
    • Heart Rate
    • Digestion
    • Blood Pressure
    • Consciousness (whether one is awake or sleepy)
    • Vestibular System
    • Motor Movement (particularly movements of the eye)
    • Auditory and Visual Processing


Posture:  The position in which someone holds their body when standing or sitting.  Other:  An approach or attitude.  (Attitude plays a role in brain function.  It is important to give the brain positive encouragement.  For example, congratulate the brain for milestones achieved in the healing process).  Posture and attitude are interconnected.  (For example, good posture brings confidence).

Somatosensory:  Relating to or denoting a sensation (such as pressure, pain, or warmth) that can occur anywhere in the body, in contrast to one localized sense organ (such as sight, balance, or taste).

Proprioception:  The unconscious perception of movement and spatial orientation arising from stimuli within the body itself.  (Humans use nerves, joints, and semicircular canals of the inner ear).

Human Body Anatomy

  • Muscles = 640
    • Eye muscles = 6
  • Joints = 360
  • Circulation System = 60,000 miles
  • Nerves = 95-100 billion
    • Nerves in Brain = 85 billion (of the 100 billion total nerves in the body)

Nerve function

Nerves are like “cords” of the body’s “entertainment system.”  After an injury or onset of an inner ear or balance disorder, Vestibular Rehabilitation Therapy (VRT) helps to organize the “cords” so that the brain and body can relearn to function properly together.

Body Reflexes for Posture

Maintaining balance is complex.  It is dependent on maturity of the nervous system, mobility of the joints in the spine and limbs and muscle power. 

We have involuntary and voluntary reflexes:
  • Involuntary:  Goosebumps when cold, eyes water when cutting an onion
  • Voluntary:  Walking, slapping someone when someone slaps you

Occur through habit.

We get these in the developmental stages of life (start after being born = gravity must be involved).

Vestibulospinal Reflex (VSR):  Motor output to skeletal muscle below the neck

Neck Reflexes

The neck is the bridge between the brain and the body.

  • Vestibulocollic Reflex (VCR)
    • Reflex for the neck musculature in order to stabilize the head
    • Neck movement counters the movement sensed by the otoliths or semicircular canals
  • Cervicospinal Reflex (SSR), also known as Tonic Neck Reflex (TNR)
    • When neck moves, body stabilizes/changes position
  • Cervicocollic Reflex
    • Stabilizes head on the body (like toothpick with a bowling ball on it)
  • Cervico-ocular Reflex (COR)
    • Eye movements driven by neck proprioceptors

Cervical Spine Anatomy

Atlanto-occipital (AO):  flexion/extension “yes joint”

Atlanto-axial (C1-2):  rotational/lateral “no joint”

Lower cervical spine (C3-C7):  rotation

Cervical Spine Anatomy

Position of the Spine Matters!

Spine positionMuscle tightness can change the position of bones and spine.  This can impact blood flow and bring on symptoms such as headache/migraine.  Try not to associate muscle tightness with pain, but instead use muscle tightness as a signal to change/improve posture.  Practice exercises regularly to relieve muscle tightness, change bad habits and improve posture, and increase efficiency of muscles (move easier).

Muscle Tightness Exercises

Muscle Tightness Exercises 2

Exercise Tips

  • It is important to be proactive to exercise to calm your brain prior to it becoming overwhelmed and triggering symptoms.
  • While exercising, use diaphragmatic (deep) breathing to oxygenate the body.
  • Try using phone apps for postural check reminders and breathing pace/biofeedback exercises (for example, the Calm app).
  • A foam roller or lacrosse/tennis ball or trigger point roller ball (pictured below) may be used to help relieve muscle tightness.

Morgan Kriz Posture and Balance

Base of Support

Foot Ankle

Balance Stance

Try Exercises With Your Eyes Closed

  • If we are 80% visually dominant, consider connecting your brain better with other systems (for example, the somatosensory system)
  • Continue exercises/movement but try to also do so with your eyes closed (be safe!)
  • You may have to make balance stance easier to be successful (try not to grab for walls, instead make balance control internal)
  • Purpose:  To know your boundaries in space and catch yourself (increases confidence and reduces fear of falling)


  • Sitting
    • Move every 15 minutes
    • Neck range of motion
    • Stand up every hour
    • Knees hip width apart
    • Ankle rolls/toe tapping
    • Shoulders down and back
    • Screen/book directly in front
    • Breath from belly
  • Standing/Walking
    • Stand tall
    • Keep big toes down
    • Shoulders down and back
    • Engage core
    • Look at stable object in the distance
    • Swing arms

Walking correct posture

Recommended Books

Migraine Brains and Bodies by C.M. Shifflett

The Brain Always Wins by John Sullivan


Morgan Kriz DPT Puget Sound ENT

Morgan Kriz, DPT

Vestibular Physical Therapist

Morgan has a Doctorate of Physical Therapy that specializes in Balance and Vestibular Rehabilitation. Morgan does have a strong background in Orthopedic Physical Therapy and this provides a foundation for general musculoskeletal conditions that may contribute to balance limitations.

Her focus as a provider is for patients to feel empowered with management of their condition and learn strategies to live a functional life so they can participate in the things they love. The human body is a magnificent. Each body system has a distinguished function however all systems are interdependent with one another. Morgan tries her best to educate patients so they may be proactive in their healthcare and strives to communicate well with other providers to give efficient and quality care through a multidisciplinary approach.

Vestibular Rehabilitation is an exercise based therapy program used to treat balance and dizziness disorders. It is based on the body’s natural ability to compensate for balance problems through optimizing the brain’s connection from your inner ear; eyes and body. Morgan uses evidence based guidelines when creating a patient’s individualized plan of care for Vestibular Rehabilitation. Morgan believes getting the most out of life is to make it fun/play games and tries to incorporate this into her rehabilitation programs so the brain retains the information for long-term management.

More information:


Presentation information is not meant to be taken as medical advice.

Presentations posted online may include discussion notes, links, images, and other information added by Seattle Dizzy Group.


© Copyright 2018, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | March 31, 2018

Finding the Balance Within the Mind Body Connection

Mind Over What Matters

Change Your Mind to Change Your Body

Finding the Balance Within the Mind-Body Connection

by LeLa Becker

of Passionate Path Coaching

 (Presented to Seattle Dizzy Group on 3/10/18)

This presentation discusses the mind-body connection and how The Mind Over What Matters System can help restore a healthy mind-body balance with techniques to release negative emotions, alleviate stress and anxiety, and reframe outlook to invite healing.

Controlling our thoughts for the sake of our physical health is a foreign concept, but I will explain. FEAR is False Evidence Appearing Real. If our mind starts to gather false evidence about a situation, and if we start to think of that false evidence appearing real, then our body starts to flush with hormones. If our bodies do not react, and utilize these hormones, then they get stored in our bodies, this in turn will start to have negative effects on our physical bodies.

For example let’s link fear, anxiety, the gallbladder and shoulder pain. If we start to worry about our performance at work, panic sets in and our hormonal glands start to secret. Chemical signals are sent into the body, but the body does not react (we do not run from the tiger), thus the unused hormones get stored in our bodies. The gallbladder, often is over worked as it is with unhealthy eating habits and more and it is then unable to rid the unused chemicals fast enough. The gallbladder will start to clench in tight, trying to squeeze out unwanted entities, as this is its natural function. The meridian that follows the gallbladder then starts to constrict up directly pulling onto our shoulders. The tightness in our shoulders then sends a signal to our brain. The neck may become stiff, the jaw may hurt and all this extra stress on the body creates worry and anxiety and the vicious cycle starts all over again.

So what does this all mean? If we can learn to control the way we think about fear, then we can help to relax the central nervous system and the hormonal flush that happens when we are stressed, thus reducing the stress that is created in our body.

I would like to invite you to change thoughts around FEAR from False Evidence Appearing Real to Feel Everything And Relax.

Our minds have the ability to control us. Tricking our bodies to react in a certain way. It is our path to learn the tools to not allow that to happen.

Find Your Grounding Mudra

Close your eyes.
Drop your shoulders away from your ears.
Inhale and exhale through your nose. (Repeat three times).
Your thumb is your grounding point.
Touch the tip of your index finger to the tip of your thumb.
Notice how that makes you feel.
Touch the tip of your middle finger to your thumb.
Touch the tip of your ring finger to your thumb.
Touch the tip of your pinky finger to your thumb.
Stay with each one for a moment and realize how each one makes you feel.
Go back and piano key your fingers, one by one, noticing each one and how it makes you feel in your body.
Notice if it helps you relax your mind.
Use this mudra throughout your day to bring balance to the moment.

*Breathing in and out through your nose activates the central nervous system and triggers the pituitary gland to secrete hormones that help relax the body and decrease anxiety. With shoulders back to open the lungs, try to take deep breaths all the way down through the belly.

Find Your Feet

Stand on your feet.
Close your eyes and stand up tall.
Draw all of your energy and attention to your feet.
Feel all parts of them.
Feel the outsides, the broad middle, the heel, and the toes.
Feel the way they connect with the earth.

Notice how drawing your attention to your feet can train your mind and relax your central nervous system to feel more balanced.

*This exercise can also be done seated for those with imbalance. If seated, then try to sit up straight with feet flat on the ground. If you are unable to close your eyes due to dizziness, then try to focus your eyes on something stable. You can also try closing your eyes only halfway. As you are comfortable, try to work up to closing your eyes.

Feeling your feet combined with your mudra will bring attention to the body, resulting in a relaxed central nervous system.

The River

A few years ago a group of friends, including my younger sister and I, went white water rafting down the Deschutes River in Oregon. It was a beautiful day. The west coast sun danced on the river. I had not rafted since a few years earlier when I spent the summer on the Colorado River in a tent.   At the mouth of the canyon, we strapped on our life vest and loaded into our boat. The first 30 minutes was supposed to be leisurely float. An easy way to prepare for the upcoming rapids.  We all took a seat on the edge of the 8-man raft.  It had only been 5 minutes before the boat took a sharp left turn into what is called ‘a washing machine’. Its a swirling vortex of strong water, usually created around a large rock. The boat started bucking as it skipped along the violent waves. Our guide seemed to have everything under control.  I looked at him with a sigh of relief, I exhaled, and with that sigh, I was no longer in the boat. Thrown out, on my back, and swiftly pulled into the vortex by a wave that the other passengers say was like a hand that shot out of the water.

The icy water punctured my skin and the vortex took me in. My initial reaction was to kick, struggle, fight my way to the top. The sounds of the waves flooded my ear drums and my survival instincts were racing. My empty lungs became expired and I needed to inhale. I popped to the surface for a quick second, barely able to take in a soggy breath; half air, half water. Actually not quiet a breath at all, more a glimpse into my short future. I panicked. I was sure my future would fade quickly, if I couldn’t recover another breath. I was fighting, and struggling, and working hard, and kicking my way to the surface, but the river apologetically, continued to swallow me. Then, I heard my sisters muffled scream from the boat, and through the water. She yelled “Stop Fighting!” “Let Go!”

And so I did……

Pure exhaustion of futile attempts, I resigned myself to my watery grave. What did I have to loose? I stopped fighting. I closed my eyes and I let go! At that moment my life vest sucked me right to the surface, belly up. I pushed away from the rock and floated on my back. The sun was shinning, the surface of the water had a much appreciated layer of warmth and a red band trout jumped right over my torso.  I laid there for a while, before my boat could come pick me up. It was in those few moments of solitude, that I realized my path.

It occurred to me, as that fish jumped over my body, that my life is the river. “Rivers will flow, no matter what. I could struggle and get sucked down or I could let go and float. Rivers (lives) will keep moving. Yes, often there will be a rock or a scary, confusing vortex, but rivers and life will continue to flow.  We can try to fight, kick, and push against it but more often than not the river will win; taking us with it. I learned, that day in the vortex, the importance of letting go and allowing the river of life to take us where we need to be.”

This material is the intellectual property of Passionate Path Coaching and LeLa Becker. Created in Seattle, Wa 2015

Learn More About The Mind Over What Matters System (To Help You Identify, Break Through and Live Free): 


LeLa Becker

of Passionate Path Coaching

LeLa Becker is the Founder of Passionate Path Coaching and the Creator of The Mind Over What Matters System. She is a Psychonueroimmunologist and intuitive and integrative coach. She specializes in relaxation, stress reduction, and clearing out the clutter to see what paths your lives can lead you to.  She is a certified Homeopath, Ayurveda Therapist, Tantra Philosopher, 500 ERYT Yoga Certified, Zen Meditation Teacher, Aromatherapist and Alchemist, Neurologist and Quantum healing enthusiast.  Her path in life is to help as many people experience bliss as possible. She believes that by doing introspective work and taking control of our minds, we can set our bodies free.

More information:



Presentation information is not meant to be taken as medical advice.

Presentations posted online may include discussion notes, links, images, and other information added by Seattle Dizzy Group.


© Copyright 2018, Seattle Dizzy Group. All rights reserved.


Posted by: seattledizzygroup | February 28, 2018

Getting Through Difficult Days With Chronic Illness


Ways To Make It Through Tough Times With Chronic Illness

Living with chronic illness is challenging especially on days when symptoms and circumstances are at their worst.

These articles offer strategies to get through difficult days while living with chronic illness:

The First Step to Take When You’re Having a Rough Day

A Secret to Surviving a Rough Day

Finding the Strength to Get Through Bad Days

  How to Have a Bad Day Gracefully and Avoid Guilt with Chronic Illness

Balancing Good and Bad Days with Chronic Illness

Pushing Through Brain Fog on Difficult Days

10 Strategies to Try When You’re Sick of Being Sick

101 Self-Care Suggestions for When It All Feels Like Too Much

Practicing Self Care for Coping with Chronic Illness

Turning Negatives Into Positives When You’re Chronically Ill

Things to Do When You’re Mostly Housebound

Coping with the Isolation and Loneliness of Chronic Illness


© Copyright 2018, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | January 31, 2018

Help Make a Difference in 2018

We Grew Stronger Together in 2017! Help Us Continue to Make a Difference in 2018!

Seattle Dizzy Group is a respected leader in the vestibular and balance disorders patient support community with increasing national and global reach. (Read about our 2017 Highlights below). We hope you will join us in 2018 and help us continue to grow, provide community, and offer support to people living with chronic dizziness and imbalance–in Seattle and beyond.  With your help, we can continue to make a difference by expanding community outreach and involvement (including hosting professional speakers on various vestibular/balance topics and connecting with local health providers/resources) and also increasing our advocacy efforts to raise awareness about vestibular and balance disorders (including participating in Balance Awareness Week with our annual Walk for Balance Event, see Making a Difference for Balance Awareness).

Get Involved!

Seattle Dizzy Group is organized entirely by volunteers (the majority who are personally impacted by chronic dizziness and imbalance). With your help, we can continue to make a difference in 2018! We invite you to contribute to our group however you are able. Spread the word about Seattle Dizzy Group and invite others to join us. Share Seattle Dizzy Group information and resources with others. Participate in online discussions. Help with hosting in-person meetings and activities (be a greeter, assist with room set-up and take-down, bring snacks, provide transportation, etc.). For more info, email:

We are an independent, not-for-profit group funded through donations. As we continue to grow and expand our outreach efforts, we are naturally incurring more expenses. Our goal is to continue to offer no-cost support and resources to those in need in the vestibular community–in Seattle and beyond. Please consider supporting Seattle Dizzy Group with a financial gift to help us keep growing and thriving in 2018!  (Any donation amount is greatly appreciated!).

Ways your financial gift helps support Seattle Dizzy Group:

  • Providing materials, supplies, and hosting for monthly support group meetings.  (Each meeting costs about $25, or about $300 annually).
  • Providing thank you gifts for guest speakers. (As funds allow, we strive to honor speakers with about $25 value gift, or about $100 annually).
  • Providing administrative support, online services/resources, and website hosting, etc.  (Administrative costs are about $500 annually).
  • Providing funding for Balance Awareness Week event(s) and other group activities.  (Costs may be about $50-$100 or more per activity).
To give Seattle Dizzy Group a donation of any amount by credit card or PayPal, click the “Donate” button below.

PayPal Donate

(Gifts to Seattle Dizzy Group are not tax deductible at this time)

THANK YOU for your support!

2017 Highlights

  • In September, we hosted our Seventh Annual Walk for Balance Event in celebration of Balance Awareness Week and Falls Prevention Awareness Day/Week with a goal of raising awareness for vestibular and balance disorders and showing our support for people living with chronic dizziness and imbalance. We started the event with a Tai Chi warm-up activity led by Cascade Dizziness & Balance PT and then invited others to “Walk a Mile in Dizzy Shoes” with us at Green Lake.  We increased our impact during our walk by wearing blue, Seattle Dizzy Group gear, and Walk for Balance badge stickers as well as carrying balloons and balance awareness signs. After walking together, we honored event participants with our third annual Dizzy Spirit Awards. As a part of the celebration, we enjoyed food and giveaways (including free visit coupons from Move Beyond Limits Feldenkrais, North Seattle Community Acupuncture, and Bastyr Center for Natural Health). We also had a balance awareness Information Fair  throughout the event. It was a fun day that hopefully helped lift spirits and build momentum for the cause. We received wonderfully positive feedback from participants, and we are excited to continue to grow the event in 2018!
  • In October, we celebrated 11 years together as a support group!

  • In 2017, we continued to expand the Seattle Dizzy Group website/blog and online services/resources and reached thousands of people around the globe. (For example, our website/blog was viewed over 10,000 times in 2017 by visitors from about 100 different countries worldwide!). Additionally, we gained followers on Facebook and  Twitter, and increased membership of our MeetUp Group.  We appreciate everyone who connected online with Seattle Dizzy Group in 2017 and are especially grateful for all those who helped get the word out about our group and shared our posts/resources with others.

See also: Past Annual Highlights

© Copyright 2018, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | December 24, 2017

Surviving the Holidays with Chronic Illness

Ways to Survive the Holidays with a Chronic Illness

Living with a vestibular or balance disorder can be especially challenging during the holidays.  These articles offer ways to survive and enjoy the holiday season with a chronic illness:

Everything You Ever Wanted to Know about Surviving the Holidays with Chronic Illness

Surviving the Holidays When You’re Chronically Ill

Tips for Getting Through the Holidays with Chronic Illness

Finding Joy During the Holidays with a Chronic Illness

6 Things You Don’t Have to Do During the “Most Wonderful Time of the Year”

Holiday Tips for Vestibular Patients

   How to Survive the Holidays with Meniere’s Disease

How to Handle the Holidays with Hearing Loss

Holiday Migraine Avoidance Tips

Tips for Loved Ones:

A Holiday Letter to Loved Ones from the Chronically Ill

5 Holiday Wishes from Someone with an “Unseen” Illness

6 Things I Wish People Knew about Being Chronically Ill During the Holidays

8 Ways to Support the Chronically Ill During the Holidays

See also:

Holiday Tips

Tips for Surviving the Holidays with Joy and Peace

Living with a “New Normal” in the New Year

Ways to Survive Winter with a Chronic Illness


© Copyright 2017, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | November 30, 2017

Managing Hearing Loss and Tinnitus

Strategies for Improving Communication with Hearing Loss & Tips for Managing Tinnitus

by Mary Henry, AuD

of Swedish Balance Center

 (Presented to Seattle Dizzy Group on 11/4/17)

This presentation discusses hearing loss/impairment and offers strategies for improving communication with others as well as tips for managing tinnitus.

The majority of people with hearing loss have loss in the high pitches of speech (“f, s, th, k”), which tends to cut out the clarity of speech. This is why a common complaint for a person with hearing loss is “I can hear fine – people speak loudly enough, but they mumble!”  However there are many different configurations of hearing loss, particularly for those who experience balance problems.

If you have ever had a hearing test (or plan to have one), feel free to draw your right (O) and left (X) hearing scores on this graph and see which letters you might be missing! The letters you have difficulty hearing are the ones which fall above your scores (as they are softer than the softest sound you can hear). Talk with your audiologist if you have questions about this.

Communication  Strategies for the Individual

Advocate for Your Listening Needs

Hearing loss is “invisible.” This means it is difficult for others to determine when you are having difficulty hearing. Acknowledging your hearing loss and educating others about your listening needs will facilitate successful communication. Many are unaware of strategies that can improve communication. Education and gentle reminders to use strategies are helpful to improve communication.

Strategies to Share for Improving Communication

  • “Please get my attention before speaking to me. It is helpful if you say my name or tap me on the shoulder to ensure you have my attention before beginning to speak.”
  • “Please look at me when speaking. I benefit from seeing your mouth for speechreading cues.”
  • “Please speak slowly and clearly. It is difficult for me to hear some speech sounds when speech is spoken quickly.”
  • “Please reduce the background noise. I will hear you better if the television/radio/dishwasher/fan is turned off.”
  • “Please don’t cover your mouth while speaking to me. I benefit from seeing your mouth for speechreading cues.”
  • If you only hear part of a sentence, repeat the part of speech that you did hear, for the other person to fill it the part you missed. (“You want to go to the movies when?”)
  • “Please let me know if the topic of conversation changes. Please give me a clue such as: Movie. What movie would you like to see?”
  • “May I sit at the center of the table? Sitting in the center allows me to clearly see everyone, which will provide me with visual cues about the conversation.”
  • “May I sit with the noise to my back? It will help my hearing aids reduce those sounds” (if you wear hearing aids with directional microphones).

Communication Strategies for Friends and Family

Hearing loss is “invisible.” The nature of hearing loss makes it difficult for communication partners to realize when a communication breakdown has occurred. People with normal hearing may be unaware of the additional concentration those living with hearing loss exert to communicate. As a communication partner to someone with hearing loss, you can take the following steps to facilitate communication and understanding:

  • Always speak from within the same room.
    • A person with hearing loss will not hear your message when you speak from one room into another.
  • Face the listener when speaking.
    • The listener with hearing loss utilizes visual cues in addition to hearing. Clearly seeing the mouth is essential.
    • Do not cover your mouth with your hand or an object as this muffles your speech and removes visual cues
    • Take advantage of well-lit areas to increase facial visibility.
  • Get the listener’s attention before speaking.
    • Tap the listener on the shoulder before talking, if mutually agreeable by both individuals.
    • Say the listener’s name before talking. This simple step focuses the listener’s attention and a head turn provides acknowledgement to the speaker that the listener is prepared for conversation.
  • Reduce background noise when conversing.
    • Turn off the television, radio or noisy equipment when possible.
    • Select quiet establishments or dine during off-peak hours when visiting restaurants.
    • Conversations in the car may be challenging. Assistive devices may be helpful in reducing these challenges. Talk to your audiologist to determine if these are appropriate.
  • Visit in smaller groups when possible.
    • Many hard of hearing people have difficulty following and participating in rapid conversations between many speakers. Reducing group size to a smaller group of three or four versus a larger group of eight or more speakers can result in easier participation.
    • Cue the listener with hearing loss when the topic of conversation changes.
  • Speak slowly and clearly.
    • Rapid speech is often difficult to understand for those with hearing loss. But don’t slow down too much — that can also reduce understanding!
    • Enunciate clearly.
  • Do not shout.
    • While speaking loudly and clearly are appreciated, shouting is not necessary.
    • Shouting distorts facial features and may hinder lip reading cues.


What is tinnitus?  Tinnitus (pronounced TIN-it-us or tin-NIGHT-us) is the perception of a sound or noise in the ear or head that occurs in the absence of a sound.  Some people perceive tinnitus as a ringing sound while others report it as a clicking, roaring, hissing or static noise.  It is also common for tinnitus to become louder and change in severity from time to time.   The exact cause of tinnitus is unknown, however it is often associated with hearing loss and is sometimes a symptom of it.  It should be noted that tinnitus can occur independently of hearing loss, and sometimes people with normal hearing will also experience it.

What causes tinnitus?  The exact physiological causes of tinnitus are not known.  It may be associated with many factors, including the following:

  • Noise exposure
  • Cerumen (ear wax) impaction
  • Side effects of medications (particularly anti-inflammatory medications and medications in the aspirin family
  • Fatigue
  • Stress
  • Vascular abnormalities
  • Ear conditions, including hearing loss, Meniere’s Disease and ear infections
  • Ear, head and neck traumas and jaw misalignment
  • Other possible factors that are less conclusive include alcohol, caffeine and smoking
  • Other unknown factors

Can it be cured?  Though it is the subject of extensive research, there is currently no known cure for tinnitus.  The nature of tinnitus is unpredictable.  For some it may spontaneously resolve over time.  Others learn to live with tinnitus as a chronic condition.  Coping strategies are recommended to manage tinnitus symptoms.

What can I do to manage my tinnitus?  Different strategies work for different people.  Below are some suggestions:

  • Remain positive. It can be easy to become discouraged by limited tinnitus treatment options.  Tinnitus is an area of extensive research.  We may have insights and answers tomorrow that are not available today.
  • Redirect your attention. Many report that focusing on the tinnitus can exacerbate the symptoms.  Pursuing a hobby or favorite activity can be an effective refocusing tool.  Many report that they are unaware of the tinnitus when reading an interesting story, watching a favorite television program or having a conversation with others.
  • Explore masking noises. Tinnitus is often most noticeable when trying to fall asleep or early in the morning.  Some find that the use of noise machines or a radio playing at a low level mask the noise of tinnitus while falling asleep.
  • Wear hearing aids if appropriate for your hearing. Many report that tinnitus is less noticeable when hearing aids are worn.  Hearing aids do not cure or prevent tinnitus.  The increased volume provided by hearing aids can sometimes mask tinnitus sounds.
  • Avoid loud noises. Always wear hearing protection when operating machinery and lawn equipment and when attending concerts or playing an instrument.
  • Reduce stress. Many report that tinnitus is more prominent during periods of stress.  Consider breathing exercises, yoga or taking a walk to reduce stress.
  • Rest. Get adequate sleep at night.  Fatigue has been associated with increased tinnitus.

Where can I find other tinnitus resources?  Tinnitus information, management strategies and support groups can be found through the following sources:

American Tinnitus Association:

American Academy of Audiology:

American Speech-Language and Hearing Association:

Mayo Clinic:

TM Soft: Downloadable white noise maskers:


Mary Henry, AuD

of Swedish Balance Center





Presentation information is not meant to be taken as medical advice.

Presentations posted online may include discussion notes, links, images, and other information added by Seattle Dizzy Group.


© Copyright 2017, Seattle Dizzy Group. All rights reserved.


Posted by: seattledizzygroup | October 31, 2017

Treating Dizziness and Imbalance with Physical Therapy

October is National Physical Therapy Month!

Every October, the American Physical Therapy Association (APTA) celebrates National Physical Therapy Month (NPTM) which is a great opportunity to learn about the many benefits of physical therapy and recognize the impact of physical therapists.

Maximize your movement. Participate in your recovery. Choose physical therapy!  

Find out more:

How Can Physical Therapy Help with Dizziness and Imbalance?

Dizziness is a common problem, especially among older adults. In fact, for people over the age of 65, dizziness is one of the most common reasons for physician visits and hospitalizations. Regardless of the cause of dizziness, the sooner you get help, the better.

The good news: most dizziness and balance disorders can be successfully treated—and they are not an “inevitable” part of aging.

Your physical therapist can perform tests to determine the causes and also to assess your risk of falling. Often, there is more than one reason for dizziness and falls in the same person. Based on your physical therapist’s evaluation and your goals for recovery, the therapist will customize a treatment plan for you. Your therapist’s main focus is to help you get moving again and manage the dizziness at the same time. Exercise and new ways to perform daily activities are the primary treatments.

During your recovery, your physical therapist will teach you strategies to help you cope with your symptoms:

  • Do certain activities or chores around the house cause you to become dizzy? Your therapist will show you how to do those activities in a different way to help reduce the dizziness.
  • Have simple activities become difficult and cause fatigue and more dizziness? Your therapist will help you work through these symptoms right away so you can get moving again and return to your roles at home and at work more quickly.

Physical therapy treatments for dizziness can take many forms. The type of exercise that your therapist designs for you will depend on your unique problems and might include exercises to improve your balance, to improve your ability to focus your eyes and vision, and to “correct” differences between your brain and your inner ears. The inner ears tell the brain how the body is moving in relation to gravity. They also communicate information about head motion, which is used to coordinate eye motion.

In addition to those exercises, your physical therapist might prescribe exercises to improve your strength, your flexibility, and your heart health—with the goal of improving your overall physical health and well-being.

(Information from Move Forward PT)

Evidence has shown that vestibular rehabilitation (a specific type of physical therapy) can be effective in improving symptoms related to many vestibular (inner ear/balance) disorders. People with vestibular disorders often experience problems with vertigo, dizziness, visual disturbance, and/or imbalance. These are the problems that rehabilitation aims to address. Other problems can also arise that are secondary to vestibular disorders, such as nausea and/or vomiting, reduced ability to focus or concentrate, and fatigue.

Symptoms due to vestibular disorders can diminish quality of life and impact all aspects of daily living. They also contribute to emotional problems such as anxiety and depression. Additionally, one of the consequences of having a vestibular disorder is that symptoms frequently cause people to adopt a sedentary lifestyle in order to avoid bringing on, or worsening, dizziness and imbalance. As a result, decreased muscle strength and flexibility, increased joint stiffness, and reduced stamina can occur.

Treatment strategies used in rehabilitation can also be beneficial for these secondary problems.

(Information from Vestibular Disorders Association)


Vestibular Rehabilitation Therapy Promotes Compensation

Vestibular rehabilitation (VR), or vestibular rehabilitation therapy (VRT) is a specialized form of therapy intended to alleviate both the primary and secondary problems caused by vestibular disorders. It is an exercise-based program primarily designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and falls.

For most people with a vestibular disorder the deficit is permanent because the amount of restoration of vestibular function is very small. However, after vestibular system damage, people can feel better and function can return through compensation. This occurs because the brain learns to use other senses (vision and somatosensory, i.e. body sense) to substitute for the deficient vestibular system. The health of particular parts of the nervous system (brainstem and cerebellum, visual, and somatosensory sensations) is important in determining the extent of recovery that can be gained through compensation.

For many, compensation occurs naturally over time, but for people whose symptoms do not reduce and who continue to have difficulty returning to daily activities, VRT can help with recovery by promoting compensation.

The goal of VRT is to use a problem-oriented approach to promote compensation. This is achieved by customizing exercises to address each person’s specific problem(s). Therefore, before an exercise program can be designed, a comprehensive clinical examination is needed to identify problems related to the vestibular disorder.

Depending on the vestibular-related problem(s) identified, three principal methods of exercise can be prescribed: 1) Habituation, 2) Gaze Stabilization, and/or 3) Balance Training.

For patients with Benign Paroxysmal Positional Vertigo (BPPV) the exercise methods described above are not appropriate. First a clinician needs to identify the type of BPPV the patient is suffering from, and then different repositioning exercises can be performed. After BPPV has been successfully treated and spinning symptoms resolved, some patients will continue to report non-specific dizziness (symptoms other than spinning) and/or imbalance. In these cases, treatment using habituation exercise and/or balance training may be indicated.

(Information from Vestibular Disorders Association)


More Information about Vestibular Rehabilitation:

VEDA Article “Vestibular Rehabilitation Therapy (VRT)”

Overview of Vestibular Rehabilitation

Vestibular Testing

Treating and Managing Vestibular Disorders

Calm, Cool, and Compensated

Vestibular Rehabilitation from a Pilates Point of View


© Copyright 2017, Seattle Dizzy Group. All rights reserved.


Posted by: seattledizzygroup | September 22, 2017

Balance and Falls Prevention Awareness

September 18-24, 2017 is Balance Awareness Week!

The goal of Balance Awareness Week is to “Defeat Dizziness” by reducing the time it takes to diagnose a vestibular disorder.

Through Balance Awareness Week, the Vestibular Disorders Association (VEDA) hopes to raise public awareness about vestibular disorders and encourage people who have experienced symptoms like dizziness or vertigo to become informed about their condition and seek help from a vestibular specialist.  Increased awareness can reduce the time it takes patients to receive a diagnosis and put them on the road to recovery.

Find out how you can get involved at

The human balance system is complex, involving the inner ear, eyes, joints & muscles, and brain. When one part of the system is damaged by disease or injury debilitating dizziness and imbalance can result.

To learn more about vestibular and balance disorders, visit:

Balance Awareness Articles:

Raise Balance Awareness

Balance Awareness Facts, Figures & Trivia

A Balancing Act: Improving Balance and Preventing Falls

Exercise & Tai Chi Moving for Better Balance 


September 22-28, 2017 is Falls Prevention Awareness Week!

Among older adults, falls are the leading cause of injury deaths, unintentional injuries, and hospital admissions for trauma. Falls can take a serious toll on older adults’ quality of life and independence. The first week of Fall each year is Falls Prevention Awareness Week with the goal of spreading the message that falls are preventable.

More information about Falls Prevention Awareness Week:

September 22, 2017 is Falls Prevention Awareness Day!

This year is the tenth annual Falls Prevention Awareness Day which is celebrated on the first day of fall.  In honor of this notable milestone, the National Council on Aging (NCOA) has chosen the theme 10 Years Standing Together to Prevent Falls. This event raises awareness about how to prevent fall-related injuries among older adults.

More information about Falls Prevention Awareness Day:

Falls Prevention Resources:

Falls Prevention Fact Sheet

NCOA List of Falls Prevention Articles

Help Raise Awareness with Seattle Dizzy Group!


In celebration of Balance Awareness Week and Falls Prevention Awareness Day/Week, Seattle Dizzy Group will host our Seventh Annual Walk for Balance Event on Saturday, September 23, 2017 (12-2:30 pm at Green Lake).  Join us for this fun community event where we will “Walk a Mile in Dizzy Shoes” together to help create greater awareness for vestibular and balance disorders and show our support for people living with chronic dizziness and imbalance–in Seattle and beyond.

Event details:

(Also, find out how Seattle Dizzy Group is Making a Difference for Balance Awareness) 


Walk for Balance TM

© Copyright 2017, Seattle Dizzy Group. All rights reserved.


Posted by: seattledizzygroup | August 31, 2017

Coping with the Isolation and Loneliness of Chronic Illness


Strategies to Overcome Feeling Alone with Chronic Illness

Chronic illness may cause or increase isolation and feelings of loneliness. Adjusting to a “new normal” includes finding ways to cope with feeling alone and maintain social connections while living with chronic illness.

These articles discuss the isolation of chronic illness and offer strategies to overcome feelings of loneliness:

The Isolating Loneliness of Chronic Pain & Invisible Illness

Isolation Risk of Chronic Illness

Handling Isolation that Comes from Chronic Illness

Curing the Loneliness of Illness

6 Ways to Cope with Loneliness

8 Ways to Cope with Loneliness and Isolation When You Have a Chronic Illness

10 Things to Try When You’re Feeling Lonely

Things to Do When You’re Mostly Housebound

Ways to Maintain Healthy Relationships & Social Activity Despite the Challenges of Living with Chronic Illness


Post Updated February 2018

© Copyright 2017, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | July 31, 2017

Caregiver Tips

Helpful Suggestions for Caregivers & Supporters of the Chronically Ill

Adjusting to a “new normal” can be as challenging for those in a caregiving or support role as it is for a chronically ill loved one. It is important to find ways to maintain healthy relationships in spite of chronic illness.

These articles offer advice for caregivers and supporters as well as loved ones with chronic illness:

A Not-To-Do List for Caregivers of the Chronically Ill

How to Help Your Caregiver

The 5 Caregiver Commandments: How to Support a Loved One with Invisible Illness

7 Ways to Keep Your Relationship Strong Despite a Chronic Illness

Supporting Relationships Through Chronic Illness



© Copyright 2017, Seattle Dizzy Group. All rights reserved.

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