Balance! Use It or Lose It!


September is Balance Awareness Month! Balance is one of the most important aspects of life that most of us take for granted until we begin to lose it. Take a few moments this month to get familiar with balance!

Remember when you were a youngster and fell all the time, and bounced up like nothing happened except for maybe a scrape or small bruise? Well as adults, we tend to fall much less until we reach a certain age. As many as 1 in 4 adults over the age of 65 experience a fall every year.  That’s 25% of human beings!  The risks of falls become greater as we age as well – torn muscles, broken bones, and even head trauma. Balance and steadiness on our feet are concepts we often take for granted when we are younger. However, as we age we can become less stable and with that can come the fear of falling. With aging, muscles begin to atrophy, bones become weaker, and our sense of balance diminishes. But it is possible to train our bodies to become more resilient and prevent falls. 

Balance is the process by which we keep our center of mass over our base of support, whether it is stationary or moving (static vs dynamic), and the ability to make adjustments to stay upright in a given environment. This involves an inherent problem-solving process where our brain and our body interact to provide equilibrium between gravity and ourselves. This process is multidimensional based on the interaction of specifics of the task at hand, constraints imposed by the environment, and individual capabilities. Therefore balance strategies are highly variable between individuals. 

A variety of systems work together to maintain an upright posture: 

  • Musculoskeletal: muscle strength, endurance of muscles, range of motion of specific joints
  • Neuromuscular: the coordination of strength, timing and sequencing of muscular contraction
  • Somatosensory: nerve receptors and the ability to feel and detect changes in surface
  • Visual: provides info about body position and environment
  • Vestibular: our equilibrium system! This serves to stabilize our gaze during head movement and provide info about our head position relative to gravity
  • Cognition: individual awareness, attention, memory, emotion, and judgement all have an effect on postural control and balance

It is the sum of these systems that provides our balance within our environment! Balance impairments begin to occur when pathology or dysfunction is present in one or more of the above systems that alters the relationship between them. Common causes of balance dysfunction include weakness in trunk and legs, tightness in hips and ankles, loss of visual acuity, decreased sensation (especially in the feet and ankles), vestibular disturbances such as vertigo or dizziness, and any change to the nervous system that involves control of our muscles. Many of these balance impairments can be addressed by physical therapy or regular exercise/practice. 

Balance can be broken down into static and dynamic balance. Static is when the body is not moving and dynamic is when the body is in motion. It is important to address both of these in order to keep balance sharp and prevent falls. Here are a few strategies to help keep those systems up to par!

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Static Balance Practice: 

  • Standing Feet Together
  • Standing Feet Staggered
  • Standing Feet one in front of the other (tandem stance)
  • Standing on One Leg

* These can all be made harder or easier with closing the eyes, moving the head back and forth, or changing the surface you’re standing on!

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Dynamic Balance Practice:

  • Walking
  • Marching in Place
  • Marching while walking forward
  • Walking heel to toe (one foot in front of the other)
  • Turning around in space
  • Walking sideways
  • Walking backwards

Keep in mind everyone will be at different levels of where their balance capacity is. Some things may be easy, some things may be difficult. It really depends on what systems are dominant versus underutilized. Just remember balance is something that CAN BE IMPROVED if practiced. It truly is a USE IT OR LOSE IT kind of deal! 

If balance is a concern for you, come see one of our Physical Therapists at Innovative Physical Therapy. They can help decipher which systems are working well, and which systems may need some work to help improve balance. Life is all about balance, so let us help you stay upright and healthy!

Blog researched and written by Dr. Justin LaLonde PT, DPT