TOTAL REHAB of the High Desert

Total Rehab (Visit us here: is our sister company located in the High Desert Region of Victorville, Apple Valley and Hesperia.  Located off of Bear Valley Blvd, we offer physical therapy programs for: Parkinson’s, Stroke, Neurological Disorders, Balance and Movement Disorders, Vestibular Testing (VAT/ENG), Vestibular Rehab, Concussion Rehab, as well as other orthopedic conditions such as: Back and Neck Pain, Headaches, Sprains & Strains, Pre- & Post- Operative Care, Generalized Weakness and Loss of Motion and Soft Tissue Injuries, just to name a few.

Our team of Licensed Physical Therapist’s and Physical Therapist Assistant’s are excited to bring you the latest in treatment technologies and techniques, as well as providing you with the best physical therapy care possible (one on one for a full hour!).

We are Medicare Certified, and accept most PPO’s and have a select few HMO contracts and limited Workers Comp.  Please call us at 800-489-6905 X 101 for more details and we will be happy to discuss your needs and assist in  verifying your benefits to see if we can meet your needs.

And you can always email us: for more info too!


Arroyo PT and Total Rehab Update

We are proud to announce our new Office Location in the High Desert in Victorville: 12241 Industrial Blvd, Suite #210, Victorville, CA 92395.  It is 2400 sq ft of space that fits our practice and patients needs for vestibular/balance issues and our Group Classes.  The Victorville Office operates under Total Rehab, which is a DBA of Arroyo Physical Therapy.

The Pasadena office moved last year and is located at: 1720 E Washington Blvd, #208 Pasadena, CA 91104.

The Palm Desert Office is still at: 36867 Cook Street,  Suite #103, Palm Desert, California 92211. Offering the BEST care and services in the Coachella Valley.

We are still the experts in all things balance, movement disorders such as parkinson’s, vestibular, dizziness, concussion and general mobility problems.  We also treat orthopedic conditions – backs, THR, TKR, general conditioning, cardiac rehab, etc.

Our Staff of Licensed Physical Therapists (PT, DPT’s) and Licensed Physical Therapists Assistants (PTA’s) are the BEST in the industry and continually take advanced education in Parkinson’s, LSVT®Big, Vestibular and more to bring you the BEST care possible.  We only offer 1:1 care for your treatment time as well.

We offer VAT/ENG testing at our facilities and now offer Group Classes in Pasadena and Victorville!

Call 800-489-6905 X 101 for more information and we will be happy to assist in making your life more fun and functional again!

Vestibular Rehabilitation

There are many causes of central dizziness: head injury, anxiety, migraine, medications, cervical issues, concussions, BPPV just to name a few. It is important to have a thorough evaluation by your physician to accurately diagnose and by an expertly trained physical therapist to evaluate and treat your condition. Dizziness can impact your ability to function on a daily basis, such as rolling over in bed, going from sit to stand, driving your car, playing sports or other activities you may enjoy.

Seeing an expert can not only aide in decreasing your signs and symptoms, there are time when your dizziness can completely go away. Other times, we teach you how to manage your dizziness so you can function as normally as possible. Everyone is different, and no one person experiences dizziness and functional loss the same. That is why is it imperative to seek experts that are knowledgeable and resourceful so you get the best treatment available.

For more information, please visit our website at: or give us a call: 626-593-2283, or drop us an email:

Head Concussions and Vestibular Rehab!

Youth Sports and Concussions are getting a lot of attention these days. Read more by CLICKING HERE!

Arroyo Physical Therapy staff are trained in concussion rehab and can assist in restoring as much function as possible. Visit us at: for more information.

Vestibular Concussion Rehab

Here is a recent Article written by Kathleen McGuire, PT, DPT on Vestibular Concussion Rehab.

APT Vestibular Concussion Rehab

If the link doesn’t work, here is the full article:

Vestibular Rehabilitation: The Missing Piece in the Treatment of Concussions
Written by Kathleen McGuire, PT, DPT

Concussion is a prevalent health issue facing athletes, especially those involved in impact sports. Arroyo Physical Therapy of Pasadena, CA., believes there is a vital component of concussion rehabilitation that is commonly overlooked. This missing piece in concussion treatment is addressing dizziness and vestibular function.

According to the Center for Disease Control and Prevention, concussion is synonymous with the term “mild TBI (traumatic brain injury).” Concussion is a complex patho-physiologic process induced by traumatic forces secondary to direct or indirect forces to the head that disrupts the function of the brain.1 Head trauma can cause central nervous system trauma (eg, a post-concussion syndrome), peripheral vestibular system trauma (eg, labyrinthine concussion, BPPV, perilymphatic fistula), neck injury (eg, whiplash), or some combination of these injuries.3

As concussions have been shown to potentially damage the central, peripheral and cervicogenic parts of the vestibular system, a full comprehensive evaluation of the aforementioned systems is indicated post-head injury. The neurological location of the insult plays an important role in concussion prognosis. Outcomes of rehabilitation in patients with central vestibular disorders are not as good as outcomes following peripheral vestibular disorders. Patients with only central vestibular disorders, however, have better outcomes than do patients with combined peripheral and central dysfunction.3

Central vestibular function controls eye movements, postural movements and spatial orientation3 as needed for high level sports activities. The central vestibular system is also important for modulating vestibular responses and allowing the vestibular system to adapt to injury, disease and changes in sensorimotor demands as well as affects the person’s ability to recover from a peripheral vestibular ailment. This has implications in recovery from multiple concussions and plays a role if the head injury has resulted in both a central and peripheral vestibular injury.3

The primary symptom indicating vestibular damage is dizziness. Dizziness as a symptom of concussion has been reported to occur in 23% to 81% of cases in the first days after injury. The report of the presence of persistent dizziness highly varies from 1.2% at 6 months to 32.5% at 5 years.1 In a study by Meehan et al. 2010, they found the symptom of dizziness/unsteadiness to be the second most commonly reported symptom with concussion, only second to headache. Dizziness was reported in 74.6 of all concussions they studied.

In a study by Lau et al. 2011, they looked at which on-field symptoms at the time of injury were predictive of a protracted recovery (>20 days). The symptoms they assessed included confusion, loss of consciousness, posttraumatic amnesia, retrograde amnesia, imbalance, dizziness, visual problems, personality changes, fatigue, sensitivity to light/noise, numbness, and vomiting. Dizziness at the time of injury was associated with a 6.34 odds ratio of a protracted recovery. To their surprise no other on-field symptoms were associated with a longer recovery period. Therefore they concluded that the assessment of on-field dizziness might help identify those athletes who are at risk for a protracted recovery.

A longer recovery period post-concussion puts the athlete at risk of developing Post-Concussion Syndrome (PCS). PCS refers to a large number of symptoms and signs resulting from a concussion that do not resolve independently with time. The most common complaints are headaches, dizziness, fatigue, irritability, anxiety, insomnia, loss of consciousness and memory, and noise sensitivity.

Despite the high incidence of dizziness and balance dysfunction status-post concussion, reports of vestibular and balance rehabilitation in the management of concussion are sparse.1 Research is limited, but it has been documented that vestibular rehabilitation in the treatment of concussion related dizziness and balance dysfunction has been promising.1 A chart review of patients treated with vestibular rehab post-concussion conducted by Alsalaheen et el. 2010, showed a significant treatment effect in self-reported outcome measures and performance measures. Vestibular rehabilitation showed to reduce dizziness and improve overall balance for individuals with concussion.

The current standard in baseline testing for at-risk athletes is to perform cognitive screens and balance evaluations to compare to post-concussion results. The pre-post tests currently used in concussion management include a thorough cognitive assessment looking at orientation, memory and concentration, and a balance and coordination evaluation assessing static stability and upper limb tasks controlled by the cerebellum. While these tests have been found to be reliable and valid for cognitive and balance function, they have not been shown to be useful in predicting the need for more comprehensive therapy, including vestibular rehabilitation. We propose that baseline and post-injury vestibular function testing should be performed in addition to the cognitive and balance screens for a more comprehensive and efficient post-concussion evaluation.

Based on their research, Alsalaheen et al. recommend having a profile for the patient with concussion in which all the tests for the different domains (symptoms, neurocognitive, and balance) at all evaluation points (baseline, immediately after concussion, and throughout recovery) are documented in a systematic manner and kept accessible to every member of the treatment team. They propose that a proper concussion rehabilitation team consist of a multidisciplinary group of physicians, neuropsychologists, physical therapists and athletic trainers.

Arroyo Physical Therapy proposes that vestibular rehabilitation is the missing component for comprehensive concussion recovery. Based on our research review and professional experience, athletes who report a symptom of dizziness post head injury are at risk for delayed returned to play and increased risk of repeated injury. We believe that supplementing the athlete’s current rehabilitation program with vestibular exercises will enhance and quicken their concussion recovery.

1. Alsalaheen BA, Mucha A, Morris LO, et al. Vestibular rehabilitation for dizziness and balance disorders after concussion. JNPT. 2010;34: 87-93.
2. Broglio SP, Ferrara MS, Sopiarz K, Kelly MS. Reliable change of the sensory organization test. Clin J Sport Med. 2008 Mar;18(2): 148-54.
3. Furman JM, Whitney SL. Central causes of dizziness. Phys Ther. 2000;80: 179-187.
4. Lau BC, Kontos AP, Collins MW, Mucha A, Lovell MR. Which on-field signs/symptoms predict protracted recovery from sport-related concussion among high school football players?. Am J Sports Med. 2011 Jun 28.
5. Meehan III WP, d’Hemecourt P, Comstock RD. High school concussion I the 2008-2009 academic year: Mechanism, symptoms and management. Am J Sports Med. 2010 Dec;38(12): 2405-2409.
6. Register-Mihalik JK, Mihalik JP, Guskiewicz KM. Balance deficits after sports-related concussion in individuals reporting posttraumatic headache. Neurosurgery. 2008 Jul; 63(1): 76-80; discussion 80-2.