Better learn balance. Balance is Key. Here are some physiological reasons!

Let’s talk Balance!

Balance is a component of life that is often overlooked and taken for granted. When we have injuries and as we get older, this component often suffers. When is the last time you stood with your eyes closed and tried to maintain your balance? It’s surprisingly way harder than you would think! Do you have no time to practice balance? Try standing on one foot when brushing your teeth. Left foot in the morning, right foot at night.

Here are some important facts about balance

• You have increased fall risks if you are overconfident or under confident about your ability to balance.
• Your balance gets worse as you get older.
• There is an increased reliance on the visual system as we age.
  • Unfortunately, the visual system also gets worse as we age.
• Repetitive ankle sprains will impact your balance and if not rehabbed can impact you for years.
• There are 3 physiological ways that we are able to maintain our balance: through our somatosensory, vestibular, and visual systems.

Somatosensory

This system requires proprioceptive and cutaneous input to maintain posture and balance. Your central nervous system will process inputs from sensory organs located in your tendons, joint capsules, and muscles and then signal muscles to respond. This is an important component following ankle sprains, surgeries to any joint, or when walking on an unstable surface (rocks, grass, etc). After an injury or surgery, there can be a deficiency in the receptors, requiring you to now rely on the vestibular or visual centers more.

Vestibular

Our inner ear is made up of 3 semi-circular canals along 3 planes that will detect angular acceleration/deceleration forces on our head. Otolith organs in the ear will detect linear acceleration. Reflexes will then process this information to help stabilize our gaze during head movements as well as regulate our posture. Sometimes issues with this system are termed as “vertigo”, other common impairments include benign paroxysmal positional vertigo (BPPV).

Signs that something needs to be checked out with this system include:

• Dizziness, especially when quickly changing positions, rolling over in bed, washing your hair, or standing up from a chair.

• Difficulty walking and moving around

• Lightheadedness

• Motion sickness

• Nausea

• Unsteadiness

Vision

The visual system provides information on orientation of where we are in space and gives us information on the environment. As we get older, we rely more on this system, and unfortunately, it also gets worse as we age, leading to higher risks of falling. The visual system helps us to notice obstacles ahead of us so that we can react before we encounter them, also known as anticipatory posture control.

Since this system is often over relied upon, there is often an increased risk of falling when the eyes are closed or when vision is impaired. Times when this could happen include going to the restroom at night, walking in the dark, or washing your hair and trying to keep soap out of your eyes.

Ways to improve the systems

• Somatosensory:

  • Close your eyes when working on balance

  • Make head turns, left/right or up/down while working on balance

  • Change the surface that you are standing on, add foam, pillow, or a bosu ball

• Vestibular

  • Gaze stability exercises

  • Sometimes you may need to see a physical therapist to see if special techniques need to be performed to make sure the semi-circular canals can perform their job

• Visual
  • Corrective lenses – Go see your local optometrist

As you can see the main one that can easily be worked on at home is the somatosensory system. Usually, when the vestibular and visual system are impaired, a specialist has to be brought in.

In Conclusion

As you can see there is a lot that goes into balance! Honestly, this is only a very small portion of it! Training balance is multifaceted, and it takes looking at all of these systems as well as your own personal anticipatory and reactive strategies. Every program is unique to the individual. If you have been falling more often, feeling dizzy when you stand up, or have been having a hard time walking, give us a call and let us help you feel better! Just make sure that you practice balance in a safe environment and if you have a history of falling, talk to a professional first.

Author

Alana Hamilton Alana Hamilton is a physical therapist at Advantage Physical Therapy in Falls Church, Virginia. She is a proud Hokie from Virginia Tech with a major in Biology and a minor in psychology and sociology. Following graduation, she immediately got her doctorate in Physical Therapy from Radford University. She is an avid fan of Pilates, running, and hiking. On the weekends, she can be found hanging out with her family and babies as well as doing Spartan races with her old physical therapy classmates and friends. She is a big believer that during rehabilitation, "Motion is the Lotion" and that staying active is key to remaining healthy.