Don’t Fall for Fall - Balance Blog
Balance is something that comes into play throughout your entire life. From your first steps as a toddler learning to walk, to maintaining balance as we age, balance keeps us upright and safe while standing, walking and riding on subways and trains. Let’s break down balance, and then discuss ways to improve our balance.
What is balance? Balance is your ability stay upright and steady against perturbation or movement. Balance is a combination of three systems in our body that all tell us where we are in space and work together to maintain equilibrium. These systems are our vestibular, visual, and proprioceptive. Our vestibular system is part of our inner ear. Our vestibular system can be negatively affected with ear infections or vestibular neuritis. The next system is our visual. Our eyes integrate visual information which helps us put together what our vestibular system is telling us to help us stay upright. Our final system is our proprioceptive system. Our muscles, tendons, and joints have mechanoreceptors that constantly appraise what our body is doing to constantly give feedback to our brain of where we are in space as we move. It is the combination of all three systems that give us our ability to balance. Take out one system and we may still be able to operate but take out two and we have a difficult time balancing or even avoiding nausea, dizziness or other symptoms.
Now that we know where balance comes from, you can see how certain illnesses or issues can really affect us when we are standing or walking. Is balance something we can improve? The answer is yes! When I am working on a plan with a patient to improve their balance, I approach it in two ways.
Strengthen your muscles that keep you upright and balanced
Strengthen your inner system that keeps you upright and balanced
To break down your strength system, we are going to start very simple and look at the foot. The muscles INSIDE your foot (your intrinsics) act like your core muscles do for your low back because they stabilize your foot. To train these, the gold standard is short foot or foot doming.
Next, we get to your ankle. One of your deep stabilizes of your ankle is your tibialis posterior (the muscle attached to the posterior side of your tibia). To target this muscle we are going to do resisted sickling (Take a resistance band and wrap it our the inside (big toe side) of your forefoot, cross this foot over your other knee, and then pin both ends of the band with your foot that is on the ground. From there, slowly point and adduct your foot in a sickle motion against resistance).
Finally, we want to incorporate something with a bit more motion, something more along the lines of what we do when we walk and push through with our feet. For this we do rocker rises (Stand with your feet together, rise up onto your toes, lower, and then flex your foot lifting your forefoot off the ground). This helps you improve your ability to move your weight forward and back while controlling this movement with the muscles surrounding our ankles, located in our calves.
Aside from working on our ankle/foot stability, don’t forget to add some exercise for knees, hips, and core! For core more ideas on these areas of your body, check out our other blogs with lots of information and suggested exercises.
Now that we have the muscles we need to target in our ankles and feet, let’s work on our INNER SYSTEM:
We are going to start with simple working on balance directly. It’s very easy to start simple and build up slowly towards a single foot stance. For example:
You can start with feet very close together, then progress to standing on one foot with your other foot touching just the toes on the ground, then to standing in tandem stance (heel to toe), then to standing on one leg with a hand on a chair, eventually working to even standing on one leg with one hand on a ball then on a chair.
Once you know what your comfortable with and which stance option you want, then you can play around with your visual system:
*You can keep your eyes fixed and rotate your head.
*You can keep your eyes fixed and tilt your head.
*You can close one eye,
*or even eventually close both eyes.
JUST REMEMBER: always make sure you have a chair or something behind you in case you need to sit all of a sudden. Keep a chair or counter in front of you in case you need to grab it for balance assistance. And of course, if you’re concerned about doing this at home alone, go get the green light from your doctor, chiropractor, or physiotherapist before attempting any at-home balance work.
For more information on balance, please email Dr. Stephen Gray at hello@madetomove.ca or book in for an initial consultation plus first treatment. All new patients receive a full rehab plan with all patient goals in mind.
