What’s the Big Deal About Balance?

By Jo Singer, PT, CMC

There have been hundreds of articles written about balance, especially in older adults. You can’t pick up an AARP magazine without seeing one of them, it seems. Many people think that, if they aren’t using a cane or other assistive device, their balance is fine. 

Think for a minute. When you encounter stairs with no handrail, do you have to think twice? Do you find another route? When you come to a curb, do you have to consider how to go up/down? If you are out walking with a grandchild and they race off the pathway, do you have a hard time keeping up on rough ground? And—worst case scenario—what if you have to cross a stream going from rock to rock? Now balance does seem like a big deal. Without it, your quality of life is impaired. And we won’t even talk about not falling. 

Lots of factors come into play with balance. First, your posture. Have you caught sight of yourself unawares and wondered who that stooped over old person is? Yep, that’s you all right. Head pushed forward, shoulders slumped and rounded, upper back bowed forward—all of your upper body forward of your feet. Consider that your center of gravity is squarely between your feet and you see the problem. Try being more mindful of where you are in space. Bring your head back in line with your shoulders and keep your shoulders lined up over your hips. To practice, find a smooth spot of wall or stand against a closed door. Put your heels against the wall, keep your bottom and lower back on the wall and try to bring your upper body back so your head touches the wall. Now try to bring your shoulders back to the wall, too. However much you can do this, try to hold the posture, breathing deeply, for 30 seconds. Relax and then try it again for 30 seconds. Eventually, this will become easy. Translate this posture to your walking posture and it will help your balance.

Second, your balance needs muscle strength. Your back, legs and abdomen are the key muscle groups here. Walking actually strengthens your back, so do a lot of that. (Remember that posture and your abdominals will get a workout, too.) Climbing stairs and walking backward and/or sideways will strengthen your legs. For double the benefit—strength and balance at once–try  getting into and out of a chair without using your arms. To work your abdominal muscles, lie on your back with your knees up and try to touch your kneecaps. 

Third, your vision comes in to play. I have had many patients who pass my balance test right up until I ask them to stand with closed eyes. I have seen some begin to fall like a tree. So keep that in mind and have your eyeglass prescription current and plenty of light where you are going to walk. 

Fourth, footwear. The more supported your foot, the more sure your balance. That is why the therapy gyms are full of people wearing sneakers! You get better results when your foot is confident. 

 

Begin being more active.

Start wherever you are and build from there, a little bit each week. It is never too late to develop more strength and balance. I had a 93 year old woman, living with her daughter, who’d had several falls. She was okay, but her balance was not. I worked on a program of standing balance exercises with her and gave her home exercises to do.  Doing those daily, with the help of her daughter, she was able to raise her balance test score from “high fall risk” to “low fall risk” in about three weeks. You can, too.

 

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