You need to work your knee in extension, but very importantly just in the last

15 degrees i.e. only bend your leg slightly not to a right angle. This can be done using the leg extension machine at a gym, by sitting against a wall with your legs slightly bent or by simply hyper-extending your legs alternately.

Support your leg on a chair making sure it’s low enough not to cause pain in your knee. Then tense all your leg muscles as hard as is comfortable for 5 seconds (initially) then relax your leg completely, gently swinging it if possible. Repeat this another 4 times. As your leg strengthens you can increase the length of the contraction, but do this gradually. If you experience pain at any time, stop the exercise.

The Epley manoeuvre is designed to help with a condition called BPPV (benign paroxysmal positional vertigo) that causes dizziness when you move. Small particles called otoliths become detached in the inner ear and the movements that you perform have the effect of re-attaching them, thereby resolving the dizziness.

One treatment may be sufficient- the manoeuvre has a very good success rate however, it may require a number of treatments and self-treatment at home before an improvement occurs.

Self-treatment

Your practitioner will ascertain which side is affected and it is important to remember this fact. There are considerable differences in opinion on how long you should wait in between positions ranging from 30 seconds to 5 minutes. So, if you wait 30 seconds the whole process takes 6 minutes; 5 minute breaks will take 1 hour! I would tailor the timing to how long you have available, and indeed, it is better to do the 30 second version once than not at all.

• Begin in a seated position and then lie backwards, turning your head to the effected side so your nose is 45 degrees from the horizontal and wait for 30 seconds.

• Turn your head through 90 degrees and wait 30 seconds.

• Then turn onto the side your head is facing with your nose pointing downwards and wait 30 seconds.

• Finally, sit up sideways, again waiting for 30 seconds.

• Repeat this procedure a further 2 times.

• You can watch a video of this procedure at  http://www.youtube.com/watch?v=pa6t-Bpg494

Tips & Warnings

• The Epley manoeuvre should initially be performed by a trained therapist or medical physician; after that, it can be modified and performed at home.

• Avoid rapid changes in head position that might provoke benign paroxysmal positional vertigo.

• It's best to perform the Epley manoeuvre before going to bed at night.

• Prop your head up with a couple of pillows when sleeping until your symptoms have resolved.

• Avoid extending your head back on a repeated basis until your symptoms have resolved.

• If you experience weakness, headache, numbness or changes in vision immediately discontinue the Epley manoeuvere and seek medical attention.

• The Epley manoeuvre works for benign paroxysmal positional vertigo only. Therefore the Epley maneuver should be performed at home only after BPPV has been confirmed.

• The Epley manoeuvre is safe and very effective when properly performed. Benign paroxysmal positional vertigo can nevertheless recur.

General Advice

It is very important to identify the cause of your problem rather than just treating the symptoms. Try to turn your attention to your entire head, neck and upper back shoulder area and identify whether or not you are unnecessarily clenching your jaws, this very often being accompanied with tension in the shoulders and upper back. Other habits such as pencil chewing, ice crunching, supporting your head on your hand, grinding (stress) and habitually chewing food on one side can also lead to problems.

Alignment

Look at yourself in a mirror and slowly open your mouth as far as you can without pain. Note carefully its movement and whether or not its finish position is symmetrical, then close your mouth. It may be useful to use a pencil held vertically under your nose to help identify these movements. Then practice opening your mouth completely straight up and down, again slowly and within painless range. It may be useful to actually exaggerate the movement in the opposite direction a few times before trying to move straight. If you experience pain at any time, stop the exercise.

Stretches

Place your hand beneath your jaw and gently push down with your jaw for approximately 5 seconds, then grasp your chin and gently stretch your jaw downwards for about 10 seconds. If your restriction is more on the right it may be useful to stretch slightly to the left as well (and vice versa). Repeat this 3-5 times. To avoid injury, keep the stretch at a mild to moderate level of intensity. If you experience pain at any time, stop the exercise.

Place the palm of your hand against the right side of your jaw with your mouth slightly open. Gently push against your hand for 5 seconds and then relax and stretch your jaw across to the left for approximately 10 seconds. Repeat this 3-5 times (vice versa for the other side). To avoid injury, keep the stretch at a mild to moderate level of intensity. If you experience pain at any time, stop the exercise.

Self-massage

Massaging your masseter muscles (near the jaw joint) and temporalis muscles (at your temples) and your jaw joint gently with your fingertips can also help to loosen your jaw. Perform self-massage before you do the stretches above.