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  • Dori Nissenson

Are You Balanced?

I am going to open with something all my readers already know, and that is: WE ARE ALL GETTING OLDER…

That said, we are not too old to start thinking about our balance and ways to sharpen our balance abilities.

Ever so gradually, after we hit 30, the muscles that we use to stand tall weaken, the length of our stride when we walk shortens, our walking pace slows and our vision becomes fuzzier. Even menopause can make our walking a little more wobbly.

BUT, aging isn't the only reason why our balance abilities can become adversely affected. Balance is really “use it or lose it”, so the way to maintain balance is to stay active. How well we keep our balance now, in midlife, can protect us from what lies ahead later in life and better balance now will help us all age safely!

Keep in mind, though, an enhanced sense of stability doesn't just help protect you from future falls. There are immediate health benefits that result from balance training. Those are: better mobility, fewer injuries, and a greater capacity to push yourself harder during workouts, which directly relates to an overall increase in your level of physical fitness. Even naturally agile people and those in excellent physical shape need to work to boost balance with age.

“Balance is a separate system, just like strength and flexibility. You can improve it, if you challenge it." - Dr. Edward Laskowski, MD, co-director of the Mayo Clinic Sports Medicine Center

What Are The Causes Of Bad Balance?

The following three systems work together to give you your balance abilities:

The Somatosensory System: Your muscles and your joints have receptors that give signals to the central nervous system, which in turn, gives you your sense of body posture and spatial awareness.

The Vestibular System: Your inner ear that acts like a carpenter’s leveler to keep you level on the ground.

The Visual System: This system sends signals from the eyes to the brain about your body’s position in relation to its surroundings.

An issue in any of the three systems can cause impaired balance and lead to injuries and falls IN ALL AGE GROUPS.

In this newsletter, I am going to focus on how your muscles and joints (the somatosensory or musculoskeletal system) contribute to balance, how this system affects your balance abilities, as well as ways to improve your balance through training this system.

Balance issues in this system primarily result from:

  • weakness in your muscles, particularly the muscles of the core and those around the hip, knee and ankle.

  • decreased mobility of the joints of the spine, pelvis and leg

  • decreased flexibility of the muscles of the core, pelvis, hip and knee

  • poor sense of proprioception (body posture or spatial awareness) in the hip, knee and ankle joints

  • Injury or trauma to the bones or muscles of the spine, pelvis, and lower extremities

How Can You Make Your Balance Better In The Musculoskeletal System?

Improving your balance abilities will help you across the board...from your daily activities, to work related tasks, to getting more out of your workouts. Seek the help of a physical therapist who can evaluate your balance and design a balance training program to address your specific needs. Your PT program should consist of: 1. Strengthening and lengthening: Your physical therapist will want to start with a clean slate...and by that I mean strengthening any weak muscles and stretching any tight ones so that higher level balance training can be successful. 2. Joint mobilization: Your PT will want to restore joint mobility throughout the core and legs so that you can maximize the results of your balance training. 3. Core strengthening: Physical therapists have been using core training techniques for years to increase balance... and now if you walk into any fitness arena, everyone is doing core exercises! Core training is essential to improving your balance because your center of gravity lives in your core and in order to maintain upright posture, your center of gravity needs to be stable. Your core is involved in everything you do from your household and professional activities, to your athletic pursuits. It does not matter how strong your legs and arms are if what they are attached to is weak. Additionally, without strong trunk muscles, you are more likely to suffer from chronic back pain, and more prone to injury when doing other workout routines. Your physical therapist can instruct you in easy core strengthening exercises that can be incorporated into your workouts. 4. Compound movements: Your PT will instruct you in exercises that incorporate using both your arms and legs in multiple positions. These exercises will create and enhance strength and stability. 5. Unilateral exercises: Your PT will instruct you in exercises and activities to perform on one leg to strengthen your balance abilities and stabilize your core. 6. Training on uneven surfaces: Your PT will have you perform strengthening exercises while standing on uneven surfaces such as foam pads, air filled discs or the BOSU. This will challenge the nerve receptors in the hips, knees and ankles that help you with body posture and spatial awareness and will also strengthen the muscles in your legs more intensely than performing exercises standing on level ground. 7. Performing exercises that require coordination: Coordination and balance are closely related. Your PT will give you activities that challenge your coordination in the lower extremities to sharpen your balance abilities.

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