Dry Needling Explained: How It Can Support Vestibular Dysfunction Treatment

Dizziness in the emergency department is common—and complicated. Today, hosts Dr. Abbie Ross, PT, NCS and Dr. Dani Tolman, PT 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 stroke, 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 GuestsPeter Johns, MD — Emergency physician and vertigo educator (creator of “Spin Class” vertigo course and a popular YouTube channel).Dr. John's "Spine Class" Course: https://emneuro.com/spinclass/Dr. John's YouTube Channel: https://www.youtube.com/@PeterJohnsRebekah Griffith, PT, DPT — Emergency Department physical therapist and educator advocating for PT/OT presence in EDs nationwide.Dr. Griffith's Website: https://theeddpt.com/Instagram: https://www.instagram.com/theeddpt/https://www.instagram.com/theeddpt/Key TakeawaysUse 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!#Dizziness #Vertigo #BPPV #HINTSExam #Stroke #EmergencyMedicine #VestibularRehab #PhysicalTherapy #POTS #OrthostaticHypotension #NeuroPT #TalkDizzyToMeHosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT 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→ ⁠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

Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT chat with the Concussion Queen herself, Becky Bliss, PT, DPT, DHSc to discuss all things concussion. About Becky Bliss:Rebecca Bliss is a clinical associate professor in the University of Kansas Medical Center Physical Therapy, Rehabilitation Science, and Athletic Training Department. She is board-certified in neurological physical therapy and serves in the role of program coordinator for the University of Missouri’s Neurological Physical Therapy Residency. She holds her certificate in vestibular rehabilitation from the APTA, as well as an advanced vestibular certificate. Becky has been actively practicing in the field of physical therapy for 23 years, with specialization in concussion management since 2006. Becky is active within the Academy of Neurological Physical Therapy and American Physical Therapy Association’s Concussion Committees and also provides telementorship nationally through Missouri Tele network Concussion ECHO program. Her clinical research interests include translating best practice in concussion care into clinical practice and higher-level neuromotor control deficits that are not detected by routine clinical examinations. Becky is also active in educational research and is a member of the Leveraging Education And Research Now (LEARN) LabWhere to find Becky:- website: https://www.blissfully-in-balance.com- email: [email protected] our shirts? Get your Vestibular First "Semicircular Interpreter" shirt here!: https://vestibularfirst-swag.printify.me/Hosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT 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→ 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!

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 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→ ⁠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!⁠

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 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→ ⁠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!⁠

Enjoy this fun bonus episode with Karen Tartt, who shares her expertise with a phenomenal and tasty migraine friendly cocktail she created. Dr. Abbie Ross, PT, NCS, Dr. Danielle Tolman, PT and Karen are also joined by Christine Moyer from the podcast Unsteady and Unfiltered. First, prepare the "shrub"Woody Pear Shrub -1 ⅓ cup Pear Juice* -⅔ cup Cane Sugar -1 cup White Distilled Vinegar -2 large sprigs of Rosemary -4 bunches of Thyme -3 Bay Leaves Measure and add all ingredients into a pot on your stove. Cover and turn heat to high. Bring liquid to a boil. Turn down the heat, take off the lid and stir until the sugar is completely dissolved. Turn off the heat and let cool to room temperature. Pour the contents of the pot into a sealable container and store in the fridge for several hours or overnight. In the morning, strain steeped herbs out of the liquid using a wire mesh strainer or a nut milk bag. Store finished shrub in a sealable container in the fridge until use for up to a month. *Be mindful of the ingredient label when selecting a pear juice. You’ll want to find one that uses ascorbic acid (powdered Vitamin C) as the color protectant instead of lemon juice. Knudsen Juice is a widely available brand that is safe, although I’m sure there are many that are also okay.Pear Cocktail-1 ¼ oz 40% Clear Spirit (vodka, gin, blanco tequila, etc.) -2 oz Woody Pear Shrub -Soda Water -Ice *Measure ingredients into a Collins glass over ice. Using a spoon, gently stir to incorporate all ingredients. Garnish with additional herbs (rosemary, thyme & bay). About KarenIn March of 2019, after 18 months of searching for answersto the seemingly mysterious symptoms Karen had been experiencing, she was diagnosed with Chronic Vestibular Migraine. Post diagnosis, she learned about the ⁠Johns Hopkins Migraine Diet⁠ through Dr. David Buchholz’s book, ⁠“Heal Your Headache”⁠, and started to undergo the tedious elimination process to figure out her personal migraine triggers. In May of 2020, during the Covid pandemic quarantine, Karen launched a blog focused on migraine-friendly cocktails for the at-home bartender, Tartt Drinks. This creative outlet, along with an online audience of fellow migraineurs, provided a space for her to explore the cocktails, flavorsand spirits that were missing from the lives of those affected by migraine. Her migraine-friendly cocktails have since been featured in the Bombay Sapphire Artist Showcase, ⁠Speed Rack⁠ Trading Cards, ⁠Dizzy Cook⁠’s first book release party, ⁠Miles for Migraine⁠ ⁠Social Events⁠ and an upcoming cocktail book. She currently resides in San Francisco, CA and works at ⁠Wildhawk⁠ in the Mission District. She’s currently researching gas chromatography analysis in spirits to more clearly define what makes a spirit migraine-friendly. She’s also studying different ways to create more complete citrus alternatives.Karen can be reached for consultations and inquiries at ⁠[email protected]⁠.Hosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT 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→ ⁠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!⁠

In this episode, Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman talk with Karen Tartt about managing life with vestibular migraine symptoms in various settings. Her expertise in developing migraine-friendly cocktails will blow your mind! About KarenIn March of 2019, after 18 months of searching for answersto the seemingly mysterious symptoms Karen had been experiencing, she was diagnosed with Chronic Vestibular Migraine. Post diagnosis, she learned about the Johns Hopkins Migraine Diet through Dr. David Buchholz’s book, “Heal Your Headache”, and started to undergo the tedious elimination process to figure out her personal migraine triggers. In May of 2020, during the Covid pandemic quarantine, Karen launched a blog focused on migraine-friendly cocktails for the at-home bartender, Tartt Drinks. This creative outlet, along with an online audience of fellow migraineurs, provided a space for her to explore the cocktails, flavorsand spirits that were missing from the lives of those affected by migraine. Her migraine-friendly cocktails have since been featured in the Bombay Sapphire Artist Showcase, Speed Rack Trading Cards, Dizzy Cook’s first book release party, Miles for Migraine Social Events and an upcoming cocktail book. She currently resides in San Francisco, CA and works at Wildhawk in the Mission District. She’s currently researching gas chromatography analysis in spirits to more clearly define what makes a spirit migraine-friendly. She’s also studying different ways to create more complete citrus alternatives.Karen can be reached for consultations and inquiries at [email protected] by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT 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→ ⁠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!⁠

Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT are joined by Edo Zylstra, PT, DPT, OCS to discuss the the potential of Dry Needling in the treatment approach of patients with Vestibular Dysfunction and Migraine.About Edo Zylstra, PT, DPT, OCSDr. Zylstra has over 20 years of experience in orthopedics, pre-/post- surgical care, sports performance, wellness training, chronic pain treatment, and injury prevention. He works with patients of all ages and across all activity levels. He evaluates and treats from a whole-body approach. His treatment combines knowledge and understanding of anatomy and function within the context of full body structure, function, and movement patterns. He works to restore compromised mobility, strength, stability, and movement patterning. This is achieved through various manual techniques, active modalities, progressive exercise, and education. Outside of the clinic, Dr. Zylstra brings his knowledge and expertise to continuing education course, and educates clinicians on dry needling techniques.Where to find Edo:https://www.kcarephysio.com/Hosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT 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→ ⁠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!⁠

Welcome! Christine Moyer is the new host of a supplemental podcast to Talk Dizzy To Me. These easily digestible episodes will share a lighthearted, but informative, approach to various topics as they relate to living life with vestibular dysfunction. Having experienced it herself, Unsteady & Unfiltered episodes may include TDTM recaps, “hot takes” on trending issues, relatable stories, tips/tricks, and even the occasional special guest. Living with vestibular dysfunction is not easy, but Christine’s uplifting and grounding personality will surely bring listeners a moment of levity to a challenging situation.Episode Resources:Christine’s 2023 TDTM Episode: https://youtu.be/YisqP_Iop-0?si=Wg3zw_y3bkV-F5ZK Hosted by:🎤 Christine MoyerWhere to find Christine:→ Email: [email protected] → Facebook:⁠⁠ That Dizzzy Girl → Instagram:⁠⁠ @thatdizzzygirl → TikTok: @thatdizzzygirlFor 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→ ⁠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!⁠

Can you believe it’s been 3 YEARS since we first had a conversation with Dr. Shin Beh about vestibular migraine? Dr. Abbie Ross, PT, NCS, and Dr. Danielle Tolman, PT catch up and discuss some new updates in vestibular migraine treatment approaches. About Dr. BehDr. Beh completed his neurology residency training at the University of Texas Southwestern Medical Center. His fellowship training consisted of: Neuroimmunology & Multiple Sclerosis, Neuro-otology, and Neuro-ophthalmology. His fellowship training was completed at three centers – the University of Texas Southwestern Medical Center, Johns Hopkins University Hospital, and New York University Medical Center. After completion of his fellowship training, he returned to the University of Texas Southwestern Medical Center to to set up its very first Vestibular & Neuro-Visual Disorders Clinic. This Clinic was built to help care for the many people suffering from neurological disorders that caused vertigo, dizziness, and imbalance. Initially, he divided his time between multiple sclerosis and vestibular disorders. After realizing there was a far greater need among people with vestibular disorders, he focused solely on this area, and joined the Headache & Facial Pain Program. Where to find Dr. Beh: https://www.vestibularmd.com/ Hosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT 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→ ⁠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!⁠

Dr. Dara Meldrum, founder and CEO of Vertigenius, joins Dr. Abbie Ross, PT, DPT, and Dr. Danielle Tolman, PT, to discuss the role of technology in improving the effectiveness of at-home vestibular rehabilitation for patients.About Dr. Dara MeldrumDr. Dara Meldrum is a physiotherapist and an Associate Professor at the Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland. With over 25 years of experience in clinical practice, research, and teaching, she specializes in vestibular and neurological rehabilitation. Clinically, she works at the Balance Centre in Dublin.Dr. Meldrum's research focuses on applying technology in physical measurement and neuro-rehabilitation. She is the inventor and founder of Vertigenius™, a medical device incorporating a wearable head sensor, clinician platform, and patient app to aid in the treatment of dizziness, vertigo, and imbalance.🔗 Learn more about Vertigenius:https://vertigenius.com/Featured Research Articles📄 Wearable Sensor and Smartphone-Assisted Vestibular Physical Therapy for Multiple Sclerosis: Usability and Outcomes (Frontiers in Rehabilitation Sciences, 2024)🔗 Read the full article https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2024.1406926/full📄 Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline (American Physical Therapy Association, 2024)🔗 Read the full article https://academic.oup.com/ptj/article/104/5/pzae045/7633220 📄 Toward a Digital Health Intervention for Vestibular Rehabilitation: Usability and Subjective Outcomes of a Novel Platform (Frontiers in Neurology, 2022)🔗 Read the full article https://www.frontiersin.org/articles/10.3389/fneur.2022.836796/fullHosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT 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→ ⁠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!⁠