Maintaining Balance Throughout Life

Working on balance isn’t just for “old folks”

There is a lot of emphasis these days on cardiovascular fitness and strength training, to help us age well.  However, just as important is our balance.  Just as our strength and endurance decline with age, our balance can as well, especially if we are not challenging it.

Balance involves not only the strength of our leg and trunk muscles and flexibility, but also 3 sensory systems.  Our vision helps us with balance by telling us where we are in relation to other objects.  If I see a door frame is vertical, I know I’m vertical.  The sensation of proprioception in our feet and legs tells us if we’re leaning one way or the other, or what kind of surface we’re on, such as thick carpet for a firm floor, or if we have weight more on one aspect of our foot than the other.  The inner ear system, known as the vestibular system gives us information on where we are in space, and if we are moving, turning, tilting or changing speed.  During every activity we do, our brain takes input from each system, integrates the information and forms the needed response to move in a specific environment.  For example, when we walk in the dark, either outside at night or when turning out a light and walking across a room to go to bed, we can’t use our vision as much to help us balance.  Our brains have to know how to use the vestibular system and the sensation and proprioception in our feet and legs to walk safely.  If we walk on uneven surfaces, the brain has a harder time using the sensation in our feet for information, we have to rely more on our vision and vestibular system.  A more complex task is walking on uneven surfaces at night when both vision and sensation inputs are not 100%.  Our brain then has to rely the most on information from the vestibular system.

If we’re not challenging our balance as we age, it can decline, just like muscle strength and flexibility.  If our brain never has to use the vestibular system, it will in a sense “forget” how to use it when it needs to.  Our proprioception can decline with age so we may rely too heavily on vision for balance and ignore the other systems.  Once people start to feel a little off balance or even fall, they lose confidence in doing the things they enjoy and may limit themselves or stop the activity altogether.  This can lead to further imbalance or debilitation if they end up limiting a lot of activities.  Obviously, that can lead to further medical issues and decreased quality of life.

Just like strengthening our muscles, there are exercises and activities we can do to “strengthen” the balance system.  A lot of fitness centers and social centers are incorporating balance into their exercise classes and/or offering classes specifically to help with balance.  Tai Chi is a popular exercise which has been proven through research to help with balance.  Activities to help improve balance can include standing with your eyes closed,  standing with one foot in front of the other or on one leg, using a chair beside you to hold on to for safety if needed.  These activities can help your balance now, to help keep you active as you age.

Physical Therapists who are trained in Vestibular Rehabilitation are also good resources for improving balance.  If you or a loved one is beginning to feel off balance with their normal activities, or beginning to fall, seek help from a therapist trained in this area.  They can design an exercise program specifically for your needs based on the difficulties you are having with balance.  Often, only a few visits are needed to make some significant progress balance to prevent falls as people age.