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11 The initial phases of PT

WARNING: In case you have had any trouble with your neck (e.g. injury or stiffness) consult your doctor before you start positional treatment. You have to be especially careful with the maneuvers for the posterior and superior canals.

At the initial phases you may need personal guidance with these maneuvers by an experienced person if you are aged or there is stiffness, vertigo, or multiple symptoms in your body. That's why avoid e.g. climbing, quick turns, swimming, cycling or driving a car and move carefully in the stairways.

In addition to the treatment of the sense of balance, it's important to have your health checked regularly: e.g. blood pressure and blood sugar and salt so that the amount of medication can be reassessed and decreased if possible. Because PT launches a lot of waste products it is especially important for the liver and kidneys to reduce the side effects of medication so that they can excrete more waste products. If it's possible to decrease gradually or stop e.g. the use of diuretic medicines, sleeping pills, painkillers or antidepressants the prognosis of the treatment of the sense of balance can improve.

The time needed and the result of the recovery depend on the condition of the body.     

Unlike the older PT techniques  (e.g. Lempert, Epley, Rahko), I emphasize the fact that all the three semi-circular canals have to be treated, unless there are some restricting factors such as a person's high age or weak health.

To avoid too many withdrawal effects, you mustn't start all the three maneuvers at the same time. The first stage includes only the maneuver of the horizontal canals. After a few (3 – 6) days you start the second stage, which adds the treatment of the posterior canals. Again, after a few days (3 - 6) you start the third stage by treating the superior canals, too. The younger and / or better-fit you are the faster you can proceed from one stage to another. The initial stages of the treatment have to be the longer the weaker or older a person is. Avoid tight clothes, belts, etc. during the maneuvers.

The following letters refer to the different sequences (order) of maneuvers of positional treatment as follows:

L = left

R = right

LR= first the left side, then the right side

RL = first the right side, then the left side

The first initial phase

During the first treatment session you do the maneuver for the left horizontal canal and after that the same maneuver for the right one, rotating in the opposite direction. The next day you do the same pair of maneuvers, but in different order: first right and then left one. Repeat this pair of maneuvers once a day for 2 – 6 days. Change the left – right order every time.

The second initial phase

After the first phase you start the maneuvers for the posterior canals by doing the maneuver for the left posterior canal and then the same maneuver (rotating in the opposite direction) for the right one. Next, the maneuver for the right horizontal canal and then the maneuver for the left one.

Repeat this series of maneuvers for 3 - 6 days, changing the left – right order every time as follows:         

DAY 1: posterior canal LR, horizontal canal RL

DAY 2: horizontal canal LR, posterior RL

DAY 3: posterior canal LR, horizontal canal RL, etc.

The third initial phase

Now you start doing all the maneuvers repeating the three following sequences

1. superior canal LR, posterior canal RL, horizontal canal LR

2. posterior canal LR, horizontal canal RL, superior canal LR

3. horizontal canal LR, superior canal RL, posterior canal LR

The following chapter 12 The rhythm of PT