The Top 3 Mistakes You’re Making with the Epley Maneuver!
So what are the three mistakes you might be making when performing the Epley maneuver? Before getting into these common errors, if you're unsure what's causing your vertigo, consider downloading my free ebook on the five most common causes of vertigo and how to recover from them. You can get it by signing up for my email list, and it will be sent directly to your inbox. Follow the link below!
Mistake 1: Inadequate Neck Extension
When performing the Epley maneuver to address BPPV, the first mistake people often make is not achieving sufficient neck extension. Proper neck extension is crucial to facilitate the movement of the displaced crystals. Here's how to ensure you're doing it correctly:
Positioning: Place a pillow right up against your hips and lie down so your head hangs off the pillow, achieving at least a 20-degree extension.
Focus on Head Angle: It's not just about your neck extending 20 degrees backward; your head should be at a 20-degree angle compared to the horizontal plane.
If you have a stiff neck or difficulty extending it due to thoracic kyphosis or a rounded back, you can still achieve the necessary head angle. Work with your therapist to position your body correctly without needing to extend your neck excessively.
Mistake 2: Lifting the Head During Rotation
The second common mistake is lifting the head while rotating it from one side to the other. This error can lead to the conversion of the crystals from the posterior canal to the horizontal canal, complicating the situation. Here's the proper technique:
Initial Position: If treating the left side, start with your head turned 45 degrees to the left and 20 degrees extended back. Stay in this position for 30 seconds or the duration of your symptoms plus an additional 30 seconds.
Rotation: Without lifting your head, rotate it to 45 degrees to the right, keeping it in contact with the bed. Ensure you maintain the head extension throughout the maneuver.
When rolling from your back to your side, keep your chin tucked to your shoulder to avoid lifting your head. This helps maintain the correct positioning and prevents the crystals from moving into the horizontal canal.
Mistake 3: Not Testing the Correct Canal
The third mistake is not testing to identify which canal is involved. The first position of the Epley maneuver is essentially the Dix-Hallpike test, which helps determine the affected side. Key points to remember:
Symptom Duration: If symptoms last less than a minute, the Epley maneuver is likely the right approach. If the symptoms persist longer, it could indicate different conditions like cupulolithiasis, requiring different maneuvers.
Testing: Make sure to test properly to identify whether the horizontal or posterior canal is involved. Different maneuvers are required for different canals, and what works for one person might not work for another.
Testing ensures you're addressing the correct canal. If you find more of a woozy or heavy-headed feeling lasting longer than a minute, it might not be BPPV, and other maneuvers might be necessary.
Conclusion
I hope this guide helps you avoid these common mistakes when performing the Epley maneuver. Remember, achieving the correct neck extension, keeping your head in contact with the bed during rotation, and testing for the correct canal are crucial steps for effective treatment. If you have any questions or have found a maneuver that works well for you, feel free to reach out!
