When was the last time you stopped to consider how impressive it is that you were able to accomplish your day without falling? Every day we stand, walk, get in and out of the car, and walk up and down stairs without incident – probably without giving it a second thought. Balance is one of those things that we typically take for granted until it becomes an issue. Then, all of those once simple tasks begin to become scary, intimidating, or even dangerous. Statistics show that 1 in 4 adults over the age of 65 falls every year. Complications sustained from falls are the leading causes of injury and accidental death among the elderly population. However, falling and poor balance are not limited to the elderly, but can be a common complication from a multitude of sources including disease processes, concussions, medication side effects, or simply poor coordination. Our feeling of balance is the net result of several body systems and processes that give us the ability to control out body and coordinate movement in open space. It is not uncommon to hear people say “I have just always had poor balance”. The good news is that balance can be improved with training and improved utilization of the systems that influence it. So what are those processes that enable us to successfully balance?
Vision- Humans are typically very visually reliant, as the information we gather through our eyes account for one of our most dominant senses. We utilize vision to orient ourselves in relation to our surroundings, as well as identify potential barriers and hazards that we will be required to negotiate when moving about. Maintaining good visual health with regular evaluations by an optometrist and with use of prescriptive lenses when needed is important to be able to address any degenerative conditions or impediments.
Vestibular Sense- Our vestibular sense is the equilibrium created in our inner ear that serves as an internal gyroscope to help us remain aware of our orientation in space. Similar to how a pilot would use an instrument panel to help maintain level flight when other visual information is unavailable, we utilize our vestibular system to remain upright and confident. Our vestibular sense also overlays onto our vision and eye movements in a response called Visual Ocular Reflex (VOR) which helps to coordinate eye movements to maintain steady gaze during movement. People who have a poor VOR are more susceptible to motion sickness and dizziness brought on by their inability to coordinate their vestibular sense of position with their visual input. Most people don’t realize is that this system can be trained and improved with specific exercise in the same way you would train to strengthen a muscle. Have you ever wondered how ballet dancers or figure skaters can spin around and not get dizzy? Talk about a finely tuned VOR!
Proprioception- The brain is responsible for receiving a huge amount of sensory information from the body and processing it into actionable detail. The information from sensors in our muscles and joints results in our proprioceptive sense or “self-awareness” of where we exist in space as well as our ability to quickly adjust to unexpected actions. When you catch your toe on the rise in the floor you didn’t see, it is your proprioceptive sense that allows you to employ a balance strategy to catch yourself before you fall to the floor. Improving our coordination and ability to utilize this information to make fine tuned adjustments to our posture and movement is another example of a system that can be trained with practice and specific awareness. An example would be exercising to improve the ability to balance on one foot.
Strength- A prerequisite to being able to effectively utilize our balance senses is the foundational strength to support the body against gravity. Maintaining an active lifestyle along with specific training to address core and leg strength can provide a more stable foundation from which to build your balance ability.
Here are some quick balance assessment baselines to determine whether or not you may benefit from balance training with a physical therapist.
- Can you stand with your feet together and eyes closed for up to 30 seconds?
- Can you walk heel to toe in a straight line for 10 steps?
- Can you balance on a single leg for 30 seconds?
- Can you sit down and stand up from a standard chair without using your hands?
- Can you turn 360 degrees in place without getting dizzy or losing your balance?
At Symmetry Physical Therapy we consider each of the aforementioned balance systems to ensure the safety and successful independence of our patients. Our therapists are well skilled in evaluating your balance strategies, fall risks and conditioning. We can also work with you to set up an individualized plan to improve your coordination, strength and endurance so that you can continue to live a healthy and active life. If you have had a recent fall, concussion, or simply have less independence due to lost balance and coordination contact us today at 512-339-1500 to set up an evaluation. We can help you to balance better!