Vestibular Rehabilitation Therapy (VRT) for Vestibular Disorders

Dizzy woman overwhelmed

VRT and Physical Therapy For Dizzy and Balance Problems

VRT is designed to help patients compensate for, adapt to, and reduce the symptoms of vestibular dysfunction. It involves a series of exercises and activities that target the vestibular system and its connections with other sensory systems, such as vision and proprioception (sensations from muscles and joints).

The goals of VRT include:

  1. Decreasing dizziness and vertigo symptoms.
  2. Improving balance and stability.
  3. Enhancing gaze stability and reducing eye movement abnormalities (nystagmus).
  4. Increasing confidence and reducing fear of falling.
  5. Improving overall functional activities.

VRT is typically prescribed and supervised by a physical therapist who has experience in vestibular rehabilitation. The therapy is tailored to the specific needs of each patient based on their condition and symptoms. The exercises may include various head movements, eye exercises, balance exercises, and habituation exercises.

Saunders Therapy Centers physical therapists are skilled at many VRT techniques and can help by performing many techniques and exercises or referring you to a specialist as necessary.

Dizzy woman overwhelmed


Physical Therapy For TMJ Disorders

Saunders physical therapists manage head and neck problems with a team approach that includes the dental professional, physical therapist and other medical professionals as needed. Working with other care providers may be essential for successful treatment of TMJ dysfunction. Temporomandibular joint disorders and facial pain can affect people of all ages, and are particularly problematic because they affect so many aspects of daily life such as eating, talking, and laughing! Don’t suffer in silence – our therapists can provide quick relief.

Years of Experience Successfully Treating…


  • Temporomandibular Disorders
  • Arthrogenous (joint) disorders
  • Myogeneous (muscle) disorders
  • Developmental Disorders
  • TMJ Dislocation
  • Osteoarthritis
  • Neck Pain
  • Headaches
  • Post-surgical rehabilitation

Frequently Asked Questions about TMJ Treatment

TMJ disorder treatment

If you suspect you have a TMJ disorder, we can help.

TMJ Treatment

The TMJ is the hinge joint that opens and closes your jaw. Sometimes, you can feel pain directly in the area around the joint, but there are other symptoms you should be aware of:

TMJ Symptoms

The TMJ is the hinge joint that opens and closes your jaw. Sometimes, you can feel pain directly in the area around the joint, but there are other symptoms you should be aware of:

TMJ Headache

Physical therapists can immediately decrease TMJ headache pain with manual therapy, myofascial techniques, postural training, and restoring normal jaw mechanics through specific exercise.


Dry Needling

physical therapist performing dry needling technique on leg

Dry Needling is a technique that is similar to acupuncture. Acupuncture is said to manipulate the flow of energy to promote healing. In contrast, dry needling works directly on painful trigger points in muscles. The technique involves using very thin needles – the width of a human hair – inserted in muscle trigger points to break the pain/spasm/dysfunction cycle. Dry needling can cause minor soreness for a day or so, but is usually not painful. Many patients feel immediate relief with treatment. At Saunders Therapy Centers, dry needling treatment is incorporated into a comprehensive physical therapy evaluation and treatment plan. Expect to receive a thorough musculoskeletal evaluation, and, depending upon what your therapist recommends, manual therapy, exercise, and other interventions to complement dry needling. 

Dry Needling Can Be Effective For:

  • Low back pain
  • Neck pain/headache
  • Post-surgical pain
  • Rotator cuff injury
  • Jaw (TMJ) pain
  • Hip pain
  • Heel pain

Please read our Dry Needling Billing Policy prior to scheduling your appointment.

dry needling physical therapy minneapolis st paul maple grove


Several research studies have shown promising results with dry needling. An example is this study on Disc-related Low Back Pain in the Journal of Research in Medical Sciences:

Fifty-eight patients were randomized into control and experimental groups. The control group received typical, good-quality physical therapy interventions. The experimental group received the same treatment, with the addition of dry needling techniques to myofascial trigger points found in affected low back and hip muscles. Both groups benefited, but the study found a much greater benefit to pain intensity and disability in the group that also received dry needling.

Our treatment philosophy includes:

  • Musculoskeletal Evaluation: A thorough evaluation will be performed to assess for muscle imbalances, myofascial restrictions, joint dysfunction, and nerve involvement. A specific plan of care will then be developed. If you are seeing us after a surgery, we work closely with your physician to restore range of motion, strength and function safely.
  • Manual Therapy: Our therapists have advanced training in manual therapy which is a hands-on approach that addresses restrictions in the soft tissue, myofascial system, and/or joints to facilitate a healing environment.
  • Physical Modalities: Modalities, such as heat, cold, ultrasound, and electrical stimulation are used to help with pain control as needed, but are soon replaced by a focus on progressive exercise and functional activities.
  • Exercise and Return to Function: At the appropriate point in your treatment, exercises and functional activities will be progressed as tolerated. You will do many of these activities at home or at a health club with rechecks as necessary to progress you safely back to full function. Each patient’s plan of care is individualized to what is needed for the best outcome possible.


Physical Therapy for Headache Treatment

Craniosacral technique performed by skilled PT

The key to successful management of headaches is identifying the type of headache you have. There are several types of headaches, and it is common to suffer from more than one type. A thorough evaluation and treatment by a physical therapist can help you find relief. 

Our Process

Musculoskeletal Evaluation: A thorough evaluation will be performed on your initial visit to assess for possible postural contributions, muscle imbalances, myofascial restrictions, and joint dysfunction that may be contributing to your pain.

Manual Therapy: Manual therapy is a hands-on approach that addresses restrictions in the soft tissue, the myofascial system, and/or the spinal joints.

Therapeutic Modalities: Modalities, such as heat, cold, ultrasound, and cervical traction can be used to help with pain control in the initial or acute phase of your headache.

Therapeutic Exercise: Exercise to address muscle imbalances, correct spinal motion, spinal stabilization, and posture are an important part of your treatment.

Education on posture and body mechanics:  We will help you with body awareness and to understand the role posture and the way you move can affect your headaches.

Relaxation techniques: Your autonomic nervous system can play a role in maintaining muscle tension. When you are stressed, the sympathetic part of this nervous system is overactive and can contribute to your pain experience. Headache treatment involving relaxation techniques will help calm this system and help you with pain management.

Craniosacral technique

Since each type of headache responds best to a particular treatment, it’s important for your physical therapist to determine the type of headache you have. Saunders physical therapists are particularly good at this.


Tension Headaches

With tension headaches, pain is usually experienced on both sides of the head, but can occur on only one side. Symptoms are often constant and do not change with activity or rest.

Cluster Headaches

With a cluster headache, pain is very severe and always on one side of the head. Generally pain is experienced behind the eye and is described as pulsing.

Migraine Headaches

With a migraine headache, pain is experienced throughout the entire head, deep within, and is described as pulsing pain of moderate to severe intensity.

Chronic Pain Alternatives

man with chronic knee pain

When it comes to treating chronic pain, physicians have often turned to medication as a first resort for conditions such as headache, neck pain, low back pain, and pelvic pain. In recent years, it is becoming increasingly obvious that this has been a bad approach. The “opioid epidemic”, as it’s now called in local and national news, has claimed the lives and livelihoods of millions of Americans, and shows no signs of slowing down. Why do physicians so quickly turn to medication for treatment of chronic pain conditions? Is strong medication the only thing that can provide relief for headaches? Is there no other approach for treating neck and back pain?

An article in the New York Times discusses alternative therapies, including physical therapy, exercise, acupuncture, tai chi, yoga, progressive relaxation, cognitive behavioral therapy, and mindfulness-based stress reduction. It also discusses a frustration we physical therapists often express: Drugs are often prescribed as a first resort because American health insurance systems have been slow to pay for other forms of care. Physical therapy visits can be limited or associated with very high co-pays, making drugs a more affordable (but more dangerous) option. Other alternative therapies aren’t covered, so back, neck, and headache pain sufferers are forced to pay out of pocket…

Still, one should consider the pros and cons of medication vs. alternative therapies. Most people recover from severe pain without the need for surgery or long-term, potentially addictive medications. If you do not have a serious diagnosis requiring surgery, consider a visit or two to the physical therapists at Saunders Therapy Centers. We can consult with you and tell you if we can help. We are well-attuned to financial considerations and will make sure to not waste your money or time when determining what we have to offer for your particular case.

Arthritis Isn’t Just Wear and Tear!

Arthritis Treatment

Conventional wisdom is that osteoarthritis of the knee results mostly from wear and tear, which is why, these days, it’s more common among older people and those whose excess body weight puts extra stress on those joints. BUT THAT’S NOT WHAT LATEST EVIDENCE SHOWS! 

Dr. Richard Loeser, a rheumatologist who directs the Thurston Arthritis Research Center at the University of North Carolina, Chapel Hill, was quoted in this article published by NPR,  “Your joints aren’t just like your automobile tires that wear out as you use them,” he says. In fact, exercise helps nutrients diffuse into cartilage in the knee and keep it strong and healthy.

If cartilage “is formed and more healthy when you’re younger, then your joints are more likely to be functioning better and have less osteoarthritis when you get older,” Loeser says. And exercise also helps fully grown people.

“By strengthening your muscles and by stimulating your cartilage you can still improve the health of your joint,” Loeser says. Read more in the original article HERE.



Positive Attitude

Let’s talk more about the power of positivity… Trying to be positive when you’re experiencing stress or pain is difficult, and do-gooders who spout trite advice can come off as annoying, at best!

nesting birds

New research by Dr. Barbara Fredrickson, a psychologist at the University of North Carolina, takes the pressure off of trying to be positive all the time. Her theory promotes “micro-moments” of positivity as a key to improving long-term well being. The concept is that repeated brief moments of positive feelings can provide a buffer against stress and depression and improve both physical and mental health.

After reading about this theory in Jane Brody’s April 3rd New York Times article (Turning Negative Thinkers into Positive Ones), I spent a day trying to be hyper-aware of tiny moments that made me happy. Here are a few things I remember:

  1. Discovering that birds moved into the new birdhouse I bought at the Uptown Art Fair.
  2. Noticing the bright, lime-green color of fresh buds on these really cool trees in my neighborhood. 
  3. Being charmed by the baby in the Target checkout line –she flashed me the BIGGEST toothless smile!

Try it out! Dr. Fredrickson’s research has shown that micro-moments of positivity are cumulative, and that we can train the circuitry in the brain to promote more positive responses with repeated practice.

By Robin Saunders Ryan, PT MS

The Power of “Mini-Moments” for Neck and Jaw Pain!

Woman sitting with furrowed brow due to headache

Many patients worry that the changes needed to make  lasting improvements in their symptoms might just be too much to ask of them. A lot of people have the misconception that Physical Therapy will undoubtably require hours of exercise and a complete overhaul of their daily lives. I’m here to tell you that this simply isn’t the case!

I would be a liar if I didn’t tell you that you have to put some skin in the game. There is no free lunch. However, this can mean a lot of things, depending on what your individual issues are. I don’t think it would surprise you to hear that poor posture is often a contributing factor in neck and facial pain. We all know it would be better to sit a little taller, and let go of the muscle tension we are holding, but how exactly do we do this enough to really make a difference? One of the most powerful, yet simple, things you can do is what I call a mini mindful moment.

To me, a mini mindful moment, is where you spend a very brief time (think 30 seconds!) becoming aware of where you are in space and identifying if anything could be improved. This isn’t a time to be critical of yourself, simply a time to take notice. For example, could you be sitting any taller with your ears over your shoulders? Could your shoulder blades gently come a little closer together? Can you soften the muscles in your face and neck and make sure your teeth are apart? Maybe the answer is yes! If so, then I would encourage you to make some adjustments.

Doing that infrequently though, won’t bring you the changes you are looking for. Luckily, this isn’t designed to take you a long time, and it shouldn’t get in the way of your other daily tasks. Perhaps setting a reminder on your phone or computer every 30 minutes might help you develop this check in then adjust habit.

Some people find it helpful to associate the mindful moments with a task they frequently complete during the day. The goal is that this becomes so habitual, you won’t have to think about it, and you won’t feel like it is work!

Please visit your Saunders Physical Therapist for more tips and hands on treatment to help you feel your best!

By Shannon Burrows, PT MSc

Woman with Cervical Headache



Is Your Headache a Pain in the Neck?

Woman working at computer rubbing her neck

Did you know? Many headaches are caused by neck problems. The term for these types of headaches is “cervicogenic.” The joints, discs, ligaments, and muscles contain nerve endings that can refer pain to the head. Although neck related headaches are most common at the base of the skull, your pain can also be felt in the face, forehead, eyes, temples, and even the upper back and shoulders.

If your headache is accompanied by a feeling of stiffness, tenseness, or decreased motion in your neck, upper back, or shoulders, there is probably a neck-related component to your headaches. You should see a physical therapist for an evaluation.

Here’s what we will do:

  • Assess the motion of each of your neck (cervical) joints – Your cervical spine has seven vertebrae – each “segment” has a disc and facet joints, along with the ligaments that hold it all together. We can often find a problem at one or two of these segments. The treatment for this type of problem involves mobilization of the stiff segment.
  • Assess the muscles of your head, neck, and upper back. The muscles that control rotation, side bending, head tilting, looking up and down, etc… can get out of balance – especially when repetitive motion, static postures, or abnormal posture is involved. The treatment for muscle imbalance involves myofascial release, manual stretching, and very specific muscle exercises.
  • Assess your posture and lifestyle – Good alignment of the head and neck will minimize the forces on your neck structures. Poor posture, especially when sitting for prolonged periods, is one of the most common causes of neck related headaches and The treatment for poor posture is exercise and education and, sometimes, assistive devices, or a change in your chair or work station.
Neck Pain Treatment

Medication can help headache pain temporarily, but unless you get to the root cause of neck related headaches, you are only treating the symptoms. Our physical therapists are skilled at headache evaluation and treatment. We can help your physician assess whether neck treatment would be of benefit.

Herniated Disc – Should I be afraid?

Herniated Disc Treatment

A common cause of back pain and sciatica is herniated disc. When our patients first hear that diagnosis, many of them are afraid, because they may know someone who had surgery or might have had a poor outcome. MRIs, CTs, and even drawings of herniated discs can be really frightening!

herniated disc


In fact, most people with a diagnosis of herniated disc do very well with conservative care. We use manual therapy, and teach you proper positioning and exercise to counteract the stressful forces that your work, hobbies and habits place on your back.

A 2016 study in the New England Journal of Medicine* followed a 29-year-old female with herniated disc and nerve compression causing right leg pain and numbness. Five months after epidural injection and physical therapy, an MRI showed that the herniation had disappeared.

Here’s another fun fact: Depending on age, up to 80% of people with NO SYMPTOMS have evidence of disc problems on MRI or CT scan**. This means that, even if you have a herniated disc, it might not be related to your pain. You might just need good, old-fashioned, back rehabilitation. It’s amazing what a handful of targeted exercises can do! Our therapists perform a very specific evaluation to determine which exercises you need to counteract any stability, weakness or range-of-motion problems.

Fear can be debilitating. Don’t let a diagnosis of herniated disc scare you away from doing the things you love. Try physical therapy!

*NEJM. 2016; 374:1564

**Am J Neuroradiol. 2015; 36(4):811-816