Personal Training a Client With Meniere’s Disease

What does your diet have to do with balance? Quite a bit! Especially for people who have Meniere’s disease. For these clients, spatial experience is significantly different than the average person working toward balance goals, warranting extra attention from their personal trainer.

You can learn a lot about the factors that affect spatial awareness from studying this condition.

A Dizzying Experience

The manifestations of Meniere’s disease include experiencing a violent sense of vertigo; anything within the line of sight is perceived to be spinning, rendering the individual off-balance and often finding himself on the ground. Tinnitus, or a buzzing/ringing sensation in one ear, frequently accompanies such episodes.

Temporary hearing loss which may

or may not be assuaged by hearing aids, particularly of sounds in the lower ranges, is also reported, and these attacks may last up to several hours. Loud noises become disconcerting and distorted. After living with Meniere’s for some time, hearing loss typically becomes permanent, at which point many sufferers opt for a cochlear implant.

Meniere’s disease is most likely caused by an abnormality in the volume of fluid within the inner ear. This chronic condition typically strikes between the ages of 20 and 50, with no apparent gender specificity. Currently, the scientific research community is without a cure, but there are exercises and training guidance that can help those living with this illness achieve a greater sense of balance and control in their lives.

Coping Strategies for Meniere’s Disease

Dietary changes are usually the first line of defense recommended following a diagnosis of Meniere’s. Decreasing or eliminating the intake of caffeine, salt and MSG are suggested. Interestingly enough, stress management is among the top suggestions along with a nutritional strategy.

This is one aspect where a personal trainer can be of great help. At the conclusion of a workout, a few moments for engaging in relaxing meditation will go a long way towards reducing anxiety and stress. Yoga classes and body movements that facilitate positive blood flow and passive stretching also are great resources.

Sensory Input: The Brain Game

Our bodies achieve stability as a variety of systems coordinate their input to the brain. Meniere’s disease causes a disruption in the vestibular system, which is comprised of 3 tiny organs nestled within the inner ear: the utricle, saccule and three semicircular canals. The first 2 are responsible for the sensation of gravity and linear movement. Rotational motions are detected by the 3 semicircular canals, which are filled with endolymph fluid.

As the head rotates, this fluid exerts pressure upon the sensory receptors within the inner ear, which in turn send specific impulses to the brain regarding movement. A healthy set of vestibular organs sends identical impulses from the right ear and the left ear. However, in the case of Meniere’s disease, this process is not symmetrical, leading to severe balance problems.

The brain is the Command Center for the complex integration of every system in the human body. Any information obtained through the vestibular system must coordinate with the data being put forth from both the proprioceptive and the visual systems.

A misfire in any of these 3 will disrupt and alter an individual’s sense of balance. If you have ever tried balancing on one foot while closing your eyes, you have experienced an example of this situation. Since Meniere’s disease is considered a problem within the vestibular system, it can lead to challenges with cognitive functioning, vision, and posture.

The Importance Of Exercise

Physical therapists often recommend a patient undergo vestibular rehabilitation therapy. While this must be engaged in under professional therapeutic conditions, patients often wonder what they can do in between PT visits to help mitigate their episodes and reduce stress. Since overall fitness is always going to be beneficial, most ENT’s will encourage exercise. Walking is always a great place to begin, followed by easing into low-impact aerobics. The one caveat that is incumbent upon the individual is to identify and avoid any specific movements that induce dizziness or vertigo sensations.

Balance-retraining exercises are ones with which a personal trainer can assist during a workout session. Tai Chi movements are particularly good for restoring and strengthening one’s sense of balance. Slow foam rolling will help increase and improve circulation, another factor that also accompanies the list of Meniere’s disease attributes.

To further reduce stress to the body while increasing circulation, shoulder work is very helpful. With the client seated in a chair or on a bench, have him shrug his shoulders all the way up to the ears, then release purposefully. Every client is unique, so it is best to try this first without any weights and add dumbbells as the individual progresses. Rolling the shoulders forward and backward with a momentary hold in between each movement has also proven to be beneficial.

Some clients manifest symptoms to a lesser degree and may wish to safely engage in more aggressive movements. In order to facilitate such a request, a little more science and anatomy will be helpful. An individual’s innate ability to control his body as it moves through space is thought to switch on a connection between the brain and the body that to date has not been witnessed while engaging in weight bearing exercise.

A client with Meniere’s disease essentially suffers from a misfire in his vestibular system, as mentioned above; as such, these connections need to be “reprogrammed” and then strengthened. Exercises using only one’s body weight are the key to developing and strengthening these interactions. Since basic resistance-training exercises have their roots in what many professionals refer to as “the classic exercises”, movements such as a push-up, pull-up, sit-up, and bodyweight squat become the platform from which a trainer can facilitate progress for his client.

A client who suffers from exaggerated symptoms must be handled with caution. Often the best place to begin is by establishing surface stability. Have a client stand on a flat, stable surface with his feet apart. Encourage him to distribute his weight equally over both feet. As comfort level increases, have the client slowly move his feet closer and closer together, pausing to establish weight distribution each time. Continue until he feels stable with his feet almost touching each other. After this has been accomplished, assist the client as he moves to his tiptoes, returns to flat feet, and then rocks back on his heels. Remember that what seems rudimentary to some can be an overwhelming challenge to others.

Other Considerations

As we can imagine, living with an illness such as Meniere’s disease often leads to anxiety and depression. By teaching basic exercise strategies to help alleviate some of the symptoms, we can enable clients to go a long way toward confidence building and returning a sense of mastery and control to their lives.

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References

1. http://www.entnet.org/content/menieres-disease
2. http://www.healthyhearing.com/help/tinnitus/menieres-disease
3. http://vestibular.org/understanding-vestibular-disorders/treatment/vestibular-diet
4. http://vestibular.org/understanding-vestibular-disorders/treatment/vestibular-home-therapy
5. https://www.cancertutor.com/menieres_disease/
6. https://www.drweil.com/health-wellness/body-mind-spirit/ears-nose-throat/mnires-disease/
7. http://www.livestrong.com/article/197434-exercises-for-menieres-disease/
8. http://crossingopenground.blogspot.com/2011/04/menieres-disease-and-excercise.html
9. https://en.wikibooks.org/wiki/Exercise_as_it_relates_to_Disease/The_effect_of_exercise_on_the_management_of_Meniere%27s_disease

10. http://www.nchpad.org/505/2398/Moving~with~Meniere~s
11. http://www.nchpad.org/505/2400/Moving~with~Meniere~s
12. http://www.nchpad.org/505/2401/Moving~with~Meniere~s
13. http://www.beginnertriathlete.com/cms/article-detail.asp?articleid=2287