Balance - the ability of our body to maintain equilibrium when we stand, walk or perform our daily activities. As ‘toddlers’ we toddled as our growing bodies developed the pathways that today enable us to balance. We unconsciously do it all of the time but at some stages of our lives it is harder to achieve and maintain balance.
Athletes and sports people spend many hours perfecting specific skills for their sports which all involve honing their balance. Imagine Daniel Carter kicking goals, or Irene Van Dyk shooting hoops if unable to balance. Even lesser athletes amongst us can improve our performance with enhanced balance skills.
Certain illnesses or damage to the brain can impair our ability to maintain balance. As we age our balance deteriorates and requires training to maintain the skills we have mostly taken for granted all our lives. To understand our changing ability to balance it helps to understand some of the anatomy or the ‘nuts and bolts’ that make it work. Our balance control centre is in the brain in particular, the cerebellum. This area receives and processes information from three types of sensors in other parts of the body and then co ordinates our muscles to respond to maintain balance. The eyes send visual cues to the brain. An example of how this visual feed-back helps is when we walk straight down a passageway in day light, but at night with the light off it is hard to keep straight and off the walls. The inner ear or labyrinth contains a series of fluid filled canals. As our body and head position changes the fluid moves, generating feedback to the brain rather like a 3D spirit level. The third set of sensors are the proprioceptors; nerve endings found in muscles, tendons, joints and skin. These are sensitive to stretch and pressure. A simple test of their sensitivity is to bend your finger right backwards- it is the proprioreceptors that tell you to stop! And in weight bearing joints that message contributes to your ability to balance .
At different times our ability to balance can be compromised, either by our brain’s inability to receive and process the sensor’s feedback (eg; head injury), the sensors feeding inadequate information to the brain (eg; inner ear infection or reduced proprioception in an ankle joint after an ankle sprain), or by our body’s inability to react to the brain’s instructions (eg; muscles not strong enough or joints too stiff to perform the balance correction)
Test Your Balance - Find a safe space where there is something solid to support yourself if you do lose balance. As you attempt these exercises assume the position and try to hold it for 10 seconds. When you can achieve this, attempt the same position with your eyes closed, again aiming to be able to hold for 10 seconds before progressing to the next level of exercise.
i) Stand with both feet together
ii) Stand with one foot in front of the other-heel to toe
iii)Stand on one leg
iv) Stand on one leg on a soft surface (folded towel)
If you are of advanced years and your balance is not as stable as you would like, discuss your problem with your GP or Physiotherapist who is able to help identify why your balance is impaired and may recommend a balance strengthening exercise programme.
If you are younger, (especially if you are an active sportsperson) and are unable to maintain balance while standing on one foot with your eyes closed for at least 10 seconds you also would benefit from a specific balance exercise programme.
A balance exercise programme will include exercises to sharpen up your balance sensors, strengthening exercises for your trunk (core muscles), hip extensor (butt) muscles, quadriceps (thigh) muscles and calf muscles, as well as stretches.
Balance is an integral part of general fitness and is essential in prevention of falls. Subtle changes in balance are an indication that it may be time to seek some assistance from your Physiotherapist.
Jeannie Brown is a Physiotherapist at the Oamaru Physiotherapy Clinic. She has a wealth of physiotherapy experience in the management of orthopaedic and musculoskeletal conditions.