Balance is crucial for everyone, of all ages. You are never too young for balance training. Surely, balance can mean different things to different people. To a 6 year old, balance is learning to roller skate. To a 35 year old, balance can mean catching yourself while tripping over kids toys, while carrying a load of laundry. To a 70 year old, balance is breaking a fall while stepping up a curb. So whether you are young, middle aged, elderly or fitness enthusiast, sedentary, athlete or just an average person trying to maintain a healthy lifestyle, you can definitely benefit from balance exercises.
What is Balance? The ability to control and maintain your body’s position as it moves through space.
How does the balance system work?
Balance is a coordinated function of mainly 3 systems- Visual system, vestibular system, somatosensory system. It is a constant process of position detection, feedback and adjustment between inner ear, eyes, muscles, joints and brain.
Vision is a source of gathering sensory information around you. It’s hard to maintain balance when you close your eyes.
Deep inside the ear, is the inner ear. One part of inner ear functions for hearing, another part is called vestibular system. It sends information about the position of the head to the brain. Dizziness and Vertigo are symptoms of vestibular balance disorder. (and my favorite conditions to treat 🙂
Proprioceptors are the sensors in the skin, joints, muscles that provide information to the brain on movement, the position of parts of the body in relation to each other and the position of the body in relation to the environment.
Using these visual, vestibular and proprioceptive feedback, the brain sends information to the muscles to move and make adjustments to the body position to maintain body’s equilibrium.
Balance Training can reduce the risk of musculoskeletal injuries in athletes.
The popular belief is that balance training is for elderly. Traditionally, balance training was used as a rehabilitation program for ankle injuries.However, more recently balance training has been adopted to try and prevent injuries to ankle and knee joints during sports in athletes. Balance training when added to agility training significantly reduced the risk of ankle injuries in volleyball and recreational athletes. Balance training on its own has also been shown to significantly reduce anterior cruciate ligament injuries in soccer players.1
When you injure a joint, for example ankle sprain or knee ACL injury, the proprioception of the joint is abnormal. The joints and muscles are unable to give correct input to the brain about its position in space and position related to other joints. This puts the joints at further risk of repeat injuries, due to lack of postural coordination and balance.
Balance exercises can help improve the proprioception whether you have an injury or not.
Balance training can help prevent falls in the elderly.
As we age, we start to lose the balance function. This loss is due to diminished sensory system caused by vision deficits, diminished proprioceptive inputs from loss of musculoskeletal function.2
Body sway increases as we age. The optimal balance is achieved in late adolescence and is maintained until about 60 years of age. The risk of falls increases beyond 60 years of age.3
As a physical therapist, I see atleast 2 patients everyday for either fall prevention program or rehabilitation of injuries sustained from a fall. According to CDC, more than one third of adults 65 and older fall each year in the United States, and 20% to 30% of people who fall suffer moderate to severe injuries. I have personally seen, a rehabilitation plan involving balance training supported by a strong body of research can work wonders in preventing falls and injuries.
TEST YOUR OWN BALANCE:
When you see a physical therapist for balance training, there is a battery of standardized tests that you will be performing that helps to determine various aspects of your balance, which helps in developing an individualized program. But in case, you are eager to check your balance on your own, single leg test is the easiest and quickest to perform at home.
One legged stance test– Standing on one leg requires leg strength and static balance. Stand in front of a sturdy chair or object for safety. Have somebody use a stop watch or clock with a second hand to time. Cross your arms on your chest. Lift one leg off the floor and start timing. Hold (for up to 30 seconds). Then try again with your eyes closed. This is usually quite difficult, and the main reason you will need a chair or another object for safety. As soon as you close your eyes, you will feel the body swaying. Below are the normative values for this test.4
The timer stops as soon as you either 1.use your hands(uncross your arms), 2. Shift the weight bearing leg, 3. Touch the nonweightbearing leg to the leg you are standing on, 4. open your eyes when attempting closed eyes test.
Give it a try and find out what your balance-age is. Decreased time on eyes open single leg test has been associated with increased risks for falls. The test itself can be an exercise to improve your results. Our brain learns fast. You will be surprised to see the results.
Balance trainig exercises: Below are some of the basic, fun exercises to challenge your balance.
- Feet Together progressions– Stand with both feet close together. Cross your hands on your chest. Keep your eyes open and focus on a stationary object and try to maintain your balance for atleast 30seconds. To make it more challenging, rotate your head side to side, move it up and down. Slowly increase the speed of head movements and maintain your balance. To take it up a notch, maintain balance with head steady and eyes closed.
- Tandem stance- Stand with one foot in front of other, with arms crossed on your chest. If this stance is challenging, stagger your feet to have a wider base. Maintain your balance with eyes open for atleast 30seconds. Next, rotate your head side to side, move it up and down. And also maintain your balance with eyes closed.
- Single leg balance– Stand on one foot with hands on hips. Try to maintain your balance safely with eyes open. Progress to single leg deadlifts, Leg raises to the front, side and back, Single leg stance with eyes closed.
- Unstable surface– Stand on a pillow, foam, bosu ball with feet together, tandem, single leg and perform the exercises progressions as described above in 1 and 2. Try eyes closed as well.
- Multidirection Hop drills– With hands on hips, hop from leg to other side to side, front and back, diagonals while balancing on one leg. To make it more challenging, hold a dumbell or kettlebell in your hands.
If you are unstable with any of the exercises, be sure to practice in a safe spot. Have someone spot you to avoid any falls and injuries. If you get dizzy with any exercises, seek out a medical consult. Lets get some balance in our lives!!!
- Hrysomallis C. Relationship between balance ability, training and sports injury risk. Sports Med. 2007;37(6):547-556. doi:10.2165/00007256-200737060-00007
- Konrad HR, Girardi M, Helfert R. Balance and aging. Laryngoscope. 1999;109(9):1454-1460. doi:10.1097/00005537-199909000-00019
- Liaw MY, Chen CL, Pei YC, Leong CP, Lau YC. Comparison of the static and dynamic balance performance in young, middle-aged, and elderly healthy people. Chang Gung Med J. 2009;32(3):297-304.
- Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther. 2007;30(1):8-15. doi:10.1519/00139143-200704000-00003
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