Episode #38: Balance & The Vestibular System with Dr. Charles Riddle

November 29, 2019

Show Notes:

Speaker 1: (00:00)
Hey everybody, what's going on? Dr. Chad Woolner here. I'm Dr. Buddy Allen and this is episode 38 of the health fundamentals podcast. And on today's episode, we are here with our good friend and special guests, Dr. Chuck riddle. And he's going to be talking with us about balance and the vestibular system. So let's get started.

Speaker 2: (00:15)
You're listening to the health fundamentals podcast. I'm Dr. Chad Woolner and I'm Dr. Buddy Allen. And this show was about giving you the simple but powerful and cutting edge tools you need to change your health and your life. So sit back and enjoy the show as we show you the path to your best life down to a science.

Speaker 1: (00:35)
So, Hey everybody, uh, we want to welcome our good friend, dr Chuck riddle here with us. Thanks for being here with us, Dr. Riddle. Thanks. Thanks for having me. Appreciate it. Yeah. Um, so we go back quite a ways. In fact, it's been a while since we last chatted. Uh, a lot has changed over the years. Um, but, uh, Dr. Riddle and I, um, Kelly hasn't been nearly 10 years ago, almost 10 years, almost a decade. Um, we started working together, uh, collaborating with patients. Uh, it was a lot of fun to be able to, uh, to refer patients over to him and get referrals back. And, um, there was definitely some overlap in terms of what he did and what we did, but obviously his expertise and experience in physical therapy, uh, came in handy for a lot of the more challenging cases in those realms where we just needed some, uh, some help and maybe even another set of eyes to look at those things. But, uh, so we kind of go way, way, way back. But, um, obviously your story starts even further back from there. So for those watching, uh, I guess the first question maybe tell us a little bit about your story in terms of what got you into physical therapy in the first place. Obviously your physical therapist, um, over at I can, uh, I can be is that I can physical therapy. Um, so kind of give us a synopsis of, of where your story begins.

Speaker 3: (01:49)
Um, it goes way back to when I was in high school and junior high. I was very active. Um, I had some health issues at the time, specifically with running and, uh, saw a few physicians that really made, made my life kind of difficult. Um, I was hoping to go to med school and that was my plan. And, uh, in the end, um, had a couple of bad experiences that drove me towards physical therapy instead. And, uh, so went to high school, college under that same guys and ended up going all the way through and finishing a doctoral degree in physical therapy.

Speaker 1: (02:19)
You know, it's funny because it, it, uh, sounds very reminiscent of so many chiropractic stories that we, you know, uh, some pivotal experience or a set of experiences that people have either in high school or in college that really shape, uh, you know, in a very powerful way that future for them. And so you could literally insert, had an experience with a chiropractor and you, you know, it sounds so similar to so many other stories that we hear. So, uh, you know, one of the reasons why we've always loved working with Chuck over the years is that, um, and, and I know, uh, people paint chiropractors with broad brushes as well, but, but sometimes we paint physical with the broad brush of, you know, so often one of the primary complaints that we hear, uh, about physical therapists is, is that it's nothing more than like a glorified gym experience where you've got a babysitter who hands you a sheet of exercises, they go off in the corner. They do that. I'm sure you hear this too from people who didn't like their previous physical therapist. Um, Chuck obviously takes a far more hands on approach with his patients and does things maybe for those watching. Uh, what would you say are some of the key differences between your approach, uh, versus that kind of unfortunately stereotypical approach?

Speaker 3: (03:36)
Yeah, I, yeah. Unfortunately, a lot of physical therapists do have a bad name because they set people up on timers. Do this thing for a couple minutes and I'll come back to you. People get lost in the mix. And even people that I know, here's your sheet, go to it and get it done and, and we'll see you in 30 minutes. That's not our approach. It never has been my personal approach. Want to be there every minute with every patient talking with them through the process. Uh, it's very important when you're doing the things the way we do it. Um, and making sure that every posture, every exercise, every repetition is completed properly so that it's not just another exercise at the gym.

Speaker 1: (04:09)
Yeah, it's funny you say that cause I've had a patients that they'll say, I can do that at home. You know, someone you can hand me something, I can do that at home. I can go and do that to the gym. Uh, but to have someone sitting there saying, well, maybe you could, but I'm going to make sure you're doing it correctly or make sure you're activating the right muscles. Stretching the right area, whatever it might be. So that's a, that's kind of a, a major part of why you would need to see a professional is, am I doing it correctly in the first place? Right. And, and that's the key, right? What you said there is, it's not just the what of what's being done, it's the how. And that's why you're paying a professional, like a doctor of physical therapy is not for the what necessarily, but more so for the how important.

Speaker 1: (04:53)
We've all seen the funny videos on YouTube of people doing crazy exercises using equipment completely wrong. Right? So, uh, yeah, so people say, I know what I'm doing. And then you watch them at the gym and you're like, mm, maybe not. Exactly. Maybe not. Yeah. So one kind of key area, uh, that you really specialize in or focus on, uh, is balance and stability or the vestibular system. So, uh, let's first kind of maybe for those watching put in plain English, what we mean by the vestibular system and then talk kind of the importance of balance and how you focus on that.

Speaker 3: (05:28)
So the vestibular system is made up of a couple of different parts in your brain, obviously eyes, ears, and then your body and all of these parts communicate together. And if you imagine that there's kind of a traffic cop in your head telling you what is and isn't appropriate, um, it has to bring in your eyes and say, okay, what do I see? What do I, what, what's on the horizon for me? The ears tell me about movement. And then your body tells you about whether or not you're positioned or planted in space. And when those three parts correctly, you get upright balance. You get the ability to stand, walk, sit, comfortably tolerate movement patterns. If not, then you're tipping over and people wake up. You know, occasionally with that, that old spinning thing going on. If there's something that confuses your brain, like alcohol for example, you get the spins, you've heard of that before. And that's because there's some kind of confusion in that system. So your vestibular system gives you all of that information together and organizes it, analyzes it, and allows you to progress and function.

Speaker 1: (06:29)
What are some of the most common, uh, vestibular disturbance issues that you see in your practice? We see a lot of [inaudible]

Speaker 3: (06:37)
of, um, BPPV which has benign paroxysmal positional vertigo. Um, we're pretty close to a couple of primary care clinics I should say. And um, so people come in, they wake up with the spins. Like I said, they wake up just completely dizzy for a variety of reasons. And with a few simple maneuvers, we're able to get them back on track. Um, also as people age, they tend to lose balance. They tend to lose the ability to be active for whatever reason, health function or physical maladies. And so we help those individuals also restore normal balance, uh, to be more active.

Speaker 1: (07:11)
Yeah. But, you know, balance is such a, I think unsung or underlooked or over under overlooked. I'm not sure which, uh, uh, keys to overall health and function. You know, I, I don't know if you had heard of that, uh, Brazilian study that was published, uh, Kelly five, 10 years ago, something like that. The sitting, rising test, um, where basically what this test predicted was your mortality in the next five years. Basically what they did, the abbreviated version of the test, it's far more sophisticated than that what I'm saying here. But they basically assessed, could you stand and then go from a standing position to a sitting position and then a sitting position to a standing position without significant assistance or help, significant shaking, faltering, uh, balance problems or whatever. And what he found was those who scored in the lowest tier, it was a score out of 10 basically is how they scored it.

Speaker 1: (08:02)
And you're familiar with what I'm talking about, obviously. Um, and what they found was those who scored in lowest, the likelihood of them dying within the next five years was like way high. It was frightening. I mean it was scary. And, and, and the point was, without getting into the minutia or the specifics of it is the point is balance is such a huge part of our overall health and function. And, uh, and, and what we've, what we've said in our practice, cause we look at balance in a pretty simple way, um, is, is balanced, is one of the most simple windows into looking at how the brain is communicating with the body and the body with the brain. And so assessing balance and helping people restore balance to you know, full function or as close to full function as possible, um, is such a, again, I think overlooked thing that that sometimes happens, you know, with health and with well, and moreover when you look at a lot of people will look at their balance.

Speaker 1: (09:00)
Um, as they get older they're like, Oh, I've always had bad balance or my balance is getting worse or I've never been able to touch my toes. And, and it's kind of funny to be able to show people and you very much like us, we get to say, just because you haven't been able to do it doesn't mean you can't do it. They act like it's like this one, a road they've or a door they've gone through that they can't turn around and walk back through. Right. Life is just this inevitable decline, you know, cause so often we get sold that, right? Yeah. Bye bye. Bye. [inaudible] doctors, they tell us, you know, like you're just getting old either. Exactly. It's just, it's just part of aging and it just kind of like, that's like the catchall excuse for things that we don't, we're too late on the stand or lazy or too lazy to take the time to dig in further and figure those things out, you know, sink into the recliner. Right, right. Exactly. So, so what are some things, I mean in general, obviously we could talk for hours and hours, but what are some things that you do specifically to help people address balance issues? Obviously you talked a little bit about BPPV, you talked about some maneuvers and things like that, but other areas for balance. What are some, some general or specific things that you guys do to help?

Speaker 3: (10:06)
Uh, we do, we do a whole series of exercises including gait analysis to make sure that the, the patients we see are functioning as high as they can. Um, the research you're alluding to research, a lot of the research suggests that as our current baby boomers age, um, the number one predictor of, of mortality as you described is going to be a fall. And so we, we assess falls. There's about a dozen different tools that we use. Um, the timed up and go, um, turnaround tests, uh, standing tests as you said, the sit to stand test, um, that give us an idea about how your balance is. And then with eye exercises, standing exercises, even some sitting exercises, we can help them restore balance. Um, there's, there's some great stuff out there that we use. So we took a class, like I said a little bit ago and, um, we, we've been really successful with a lot of the aging population that we see. Um, we, we hope to make a change for them because that's going to be kind of the wave of the future is making sure everybody has decent balance.

Speaker 1: (11:01)
Yeah. And, and, and, and you think about such a fundamental component of function that would allow people to enjoy those years. You know, that's the irony that I see so often is that people delay and put off and make so many sacrifices for this period of time in life, you know, retirement, you know, the golden years or whatever. And we wind up seeing far too often that those are anything but golden for people that unfortunately, uh, those years are, are again, that slow and steady decline for people. And so that's got to feel or be extremely rewarding for you to see, uh, the impact that you're making in terms of helping people enjoy that time in their life. You know, at least for that population. I haven't seen, no, that's not the only population that you see with, with balance issues too. I'm, I'm assuming you probably see athletes as well and things like that

Speaker 3: (11:51)
as though young people that when they can't jump, all of a sudden they can, they're like, yeah, I can jump again. The, you know, the aging population, when they can do something they haven't done for five years, it makes a huge difference to them. They're very thankful for that.

Speaker 1: (12:02)
Yeah. Yeah, absolutely. So, yeah, that's important. So anyways, uh, what, let's kind of wrap up with, with one last question for you. What's one thing about what you do that's maybe a huge misnomer that would surprise people about physical therapy or at least your approach with physical therapy?

Speaker 3: (12:21)
I think the biggest, the biggest thing I see is that people come into physical therapy with the concept of I'm going to hurt. And I'm literally the biggest side effect that we can report as a physical therapist. A profession is pain, however, it's intentional pain and it's like peeling off a bandaid. You know, you've got an injury, it's got to heal, we have to cover it and keep it clean. But at some point you got to peel that bandaid off and essentially we're peeling the bandaid off to let you heal and go and do. So it may hurt a little bit, but we're going to make it fun. We're gonna make it enjoyable. We're going to probably feed you while you're at, uh, at our office. Um, and, uh, we're gonna, we're going to keep this thing really lively for you so you're not going to notice it. Like go into the gym and sweating it out at 5:00 AM this is a, this is a different experience,

Speaker 1: (13:04)
right? No, and that's good. And we've seen, we've seen what Chuck does. He makes sure that the environment there is a really inviting and friendly environment. So it's a lot of fun. And it's interesting on that note, you know, talking about pain, uh, we have such a different concept when it comes to pain. A very, I would say very unhealthy relationship obviously with pain here, uh, in, in the Western hemisphere and the Western hemisphere. You know, obviously as evidenced by the opioid epidemic that we see. Um, I, I had a friend of mine who lived quite some time in Taiwan and he said over in Taiwan, there was like this philosophy that they had where a small amount of pain on a daily basis, they equated to good health is what they, you know, if you didn't feel some sort of pain in, and especially with like therapeutic interventions, like the more painful the process was, the better it was for you is what they truly, I mean that's, they equate that like that's a sign that you're alive.

Speaker 1: (13:59)
You know what I mean? And that's something that that Dr. Allen has said a lot, you know, with, with patients that he sees too, is it's like, look, if you're not feeling some sort of pain, your dad, you know, T T to live life is to feel a, a, a wide palette of sensations, pain being one of them, you know? And so I think that's a misnomer. I think that we see too sometimes that I go and I see the chiropractor or the physical therapist for that matter. Therefore I should never feel any pain the rest of my life. Oh, what Dr. Riddle did, didn't work. I'm feeling pain again. It's like that's part of life to a certain extent, you know,

Speaker 3: (14:35)
but some point I can get a whole bunch of rash on the front of me from laying on the beach cause that would be

Speaker 1: (14:40)
yeah, that's right. I know, right. Ain't no brain. I like that. Yeah, yeah, yeah, yeah, exactly. So anyhow, well, uh, dr [inaudible], we know you're a busy guy and we appreciate you taking time out of your schedule to be here with us. Um, uh, for those who want to be able to get ahold of you, maybe they've got further questions about balance or vestibular system or anything else for that matter of physical therapy related, what would be the best way for people to reach out to you?

Speaker 3: (15:02)
Yup. I can t.com I can check us out on Facebook and um, and go check out our website. We do offer free consultations. Uh, they're quick, but we'll make sure you get at least some information. So

Speaker 1: (15:12)
cool. Awesome. And we'll make sure in the show notes that we get, uh, everybody your contact information there. So just a quick link that they can click on if they have any questions for you or anything. And he's not too far from us for those who are watching. We're a local, um, he's just down the road, uh, Eagle and Overland and, uh, so yeah, so again, thanks a ton for being here with us. Has been a ton of fun kind of reconnecting. We haven't chatted in quite some time, so it's been good. Good getting to see you again and uh, anyways, uh, yeah, we're looking forward to sharing more with you guys. Hopefully this has been valuable. Share this with others who you think could benefit. If you know, friends who maybe have some balance issues that they may be, are looking for answers towards or uh, or maybe they're just looking for a really awesome physical therapist. Uh, dr Chuck has our endorsement, uh, hands-down. So, uh, thanks again guys, uh, for watching or listening and we'll talk to you on the next episode.

Speaker 2: (16:01)
Thanks for listening to the health fundamentals podcast. Be sure to subscribe so that you stay in the loop and in the note with all of the cutting edge health information that we share, if you know other people that could benefit from this information, please share it with them as well. Also, be sure to give us a review. These really help us to ultimately help more people. Last but not least, if you have questions that you want answered live on the show, or if you have ideas for topics that you would like us to cover, please shoot us an email and let us know at info@thehealthfundamentals.com.

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