The pounding pain was relentless and almost nauseating. What had begun as mild pain behind her left eye was now making driving seem like a bad idea. What to do? Did this call for a trip to the ER, or could she just go home and try to sleep it off? When do you call a PT? 

Sorting out when a headache is just a headache can be daunting, especially when you are in the middle of it. But ruling out bigger problems is important. Here are some symptoms that, if accompanying your headache, require further investigation:

• Dizziness

• Double vision
• Difficulty swallowing
• Nausea
• Numbness
• Anxiety
• Difficulty walking a straight line

If any of these symptoms accompany your headache, call your doctor right away. 

If, however, the headache is something you've experienced before, and you've ruled out bigger problems, you may well have a headache that comes from musculoskeletal tightness. The top three vertebrae in the neck might be the first place your therapist investigates. Any well-trained PT will check the ligaments at the base of the skull to make sure instability is not the culprit. But problems in the bones and joints that create headaches can come from farther away as well.

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Walking on icy streets and sidewalks during the winter is treacherous.  Wrist fractures, hip fractures, and strains and sprains are more common than ever during the winter. If you want some good strategies for preventing falls on the ice, walk like a penguin. 

Keep your arms apart, your feet spread slightly, and take short, even shuffling steps. Place your foot flat, rather than hitting with the heel. Keep your center of gravity directly over your feet. You may look like a penguin, but how many penguins fall on the ice? 

You are more likely to fall while getting in or out of your car, or coming inside and stepping on tile with wet shoes. Any outdoor slopes, however slight, increase fall risks. 

Once you've got the penguin shuffle down, here are some important facts about when falls occur and how to prevent them.