BPPV treatment: Turning 45 degrees?

A positional vertigo patient struggles to understand how to do the maneuver for the right ear:

TURN HEAD TOWARDS ELBOW? Which part of head, the chin or the back of the head? Picture shows back of head towards rt elbow. I don’t see any 45 degree angle; the head looks almost in same plane as back in the picture. R U saying 45 degrees relative to the plane of the back so the chin points slanted down towards the floor?

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The handouts are in our book and at the bottom of the blog webpage, and our videos can help too, but it’s always disorienting to figure out what that means when your head is upside down!  The best way to understand how to correctly move your head is to first practice the head turn when you are upright.

If the right ear is the problem ear, sit in a chair and turn your chin toward your right shoulder, stopping when you are halfway there.  A 45 degree angle is the halfway point to looking fully over your right shoulder.  If you turned all the way, your chin would be almost touching your right shoulder, so you don’t want to go that far.  You will do this same halfway-to-the-shoulder move when you are upside down. 

An easy way to know you are doing this properly when upside down on your hands and knees is to turn until you are looking straight at your right elbow .  This places your head near the correct 45 degree angle.  Your head should be completely upside down, so the chin is not tilted much up or down, although tucking your chin under slightly can help move some deeper particles.    

If your problem is in the left ear, you will want to turn your chin toward your left shoulder and to look at your left elbow when upside down.