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Writer's pictureWellFit by Jennie

Balance & Fall Prevention


WellFit by Jennie services include Personal Training, Health Coaching and Education, Fitness Assessments. Available in-person in Marquette, Negaunee, Ishpeming, Gwinn, Marquette County, MI or online nationally.


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Did you know that at least one out of four older adults has a fall each year? This startling figure results in countless preventable emergency room visits, hip fractures, concussions, and even deaths.  Furthermore, the rate of falls per year has increased among all age groups since 1999.

As we head into the colder months of the year with the associated cold rain, snow, ice, and shorter daylight hours, it is increasingly important to be shored up on your balance skills and mindful of safety to prevent falls.  This post will discuss why balance is essential, factors that compromise it, and the differences between static & dynamic balance.  Next, tips for improving balance and preventing falls will be identified.  Finally, the post will conclude with a sequence of simple balance exercises to add to your toolbox! 

 


Balance, Defined

 

In general, balance is your ability to stabilize yourself against the risk of falling over. Balance is an aspect of fitness just like cardiovascular fitness, strength, flexibility, mobility, and agility.  Indeed, it is required in order to enjoy good mobility and have sufficient agility in the context of your life. 

 

Interestingly, balance is the only aspect of fitness that improves in the moment as neuromuscular pathways from the muscles to the brain and nervous system are created or reactivated.  Thus, you do not have to wait for days or weeks to see improvement as you would with strength or cardiovascular fitness.  Balance helps you to safely and effectively use the gains you make in other aspects of fitness.

Strength without balance is an accident waiting to happen.

 


Balance across our Lifespan

 

In early childhood as we learn to walk, balance generally comes easily to most of us.  It is intuitive.  The health and vitality of youth are on our side.  A robust and resilient nervous system allows for quick adaptation to our environment.  Furthermore, children seek out active play which tends to further improve balance.

Balance is valuable for people of all ages because it enables us to navigate about our lives safely, function autonomously, and enjoy a good quality of life.  The confidence boost from having a good sense of balance even improves mental health.  Like other aspects of fitness, balance is a use or lose proposition.  It is especially important as we grow older in order to prevent falls and the common post-fall downward spirals.

 


What Leads to Poor Balance?

 

There are several reasons that a person’s balance may be compromised. 

 

Inactivity  Balance must be practiced in order to be maintained.  A sedentary lifestyle can be a strong deterrent to good balance.  This can happen at any age.

 

Injuries  Injuries increase pain and inflammation, interfering with nerve signaling and normal use of the injured part.  

 

Surgeries  Surgery is controlled injury or trauma, which disrupts nerve signaling. The incision itself literally cuts through nerves, thus disrupting the normal process of communication and feedback between the brain and the involved body part.

 

Muscle imbalances  When joints are not in their proper position due to muscles and connective tissue being too tight or weak, this can compromise balance. Joints need to be aligned i.e., where one bone meets another, in order for the brain to receive messages from a given body part, for instance, the legs and feet. Think of the spine with all of its 24 (moving) vertebrae!  This is one reason that good posture and a neutral spine are so important.

 

Poor posture  Poor posture and alignment sacrifices balance in a few ways.  Posture problems both cause and reinforce muscle imbalances, causing joints to be misaligned.  Elements of typical poor posture e.g., head forward throws the body’s entire balance off from a purely physics standpoint as well. 

 Neurological conditions  Certain conditions such as multiple sclerosis, Parkinson’s disease, and dementia greatly interfere with balance due to a compromised nervous system. 

 

Diabetic or other neuropathy  Impairment to the nerves, particularly in the lower legs and feet, causes symptoms like numbness, tingling, and pain.  Again, this interferes with nerve signaling between the brain and the feet, hindering balance.

 

Sensory impairment  Those who have eyesight or hearing loss are affected because they do not experience the expected visual and auditory cues needed to keep oneself from falling.  They must rely on other tools and supports to navigate about safely.

 

Medications  Many medications may include side effects like dizziness or drowsiness, directly detracting from the person’s ability to balance.

Inappropriate footwear  The feet need to be able to sense the ground beneath us in order to feed correct information back to the brain.  Feet may also need appropriately supportive footwear.  Shoes with greater heel cushioning tend to throw the lower body out of whack due to the increased angle between the rear foot and the ground, resulting in an anterior pelvic tilt that causes multiple muscle imbalances in the lower body.  Whether your shoes provide inadequate support or too much cushioning and motion control, both can play a critical role in affecting your balance.

 


Static vs Dynamic balance

 

Static balance simply refers to your ability to keep yourself upright when standing still.  Dynamic balance is the type of balance you need while in motion.  While both are important, dynamic balance is more functional because much of the balance we need involves balance during walking, running, or some other movement.  Static balance must be trained first.  Nevertheless, we must be able to stay upright and in control of the body whether we are standing in line at the bank or out walking the dog!


Improving Balance

 

The following are some ways that you can work on improving your balance:

 

Practice.  Over and over, consistently. Remember the use or lose nature of balance, and be encouraged that balance improves every time you attend to it.


 

Go barefoot. If you can, spend time around your household barefoot.  Weather and surface permitting, perhaps you can even walk around unshod outdoors.  Standing or walking on natural surfaces like grass, dirt, sand also grounds you while you are improving your balance!

 

Use good posture & alignment.  Keeping your joints well-aligned and muscles as close to their optimal length-tension relationships as possible will help immeasurably to keep your body in balance.

 

Improve core strength.  Every movement we make should start with engagement of the core muscles, especially the abdominal muscles of the trunk.  The core provides a significant source of stability for the body to perform various movements.  Without it, we will become more easily injured and are more likely to fall.

 

Progress appropriately.  As your balance improves, upgrade challenges in a safe manner e.g., letting go of support incrementally, adding head turns, crossing arms over the chest, or exercising with a stability ball or balance pad.

Add in more dynamic balance.  As you get stronger, try heel-toe walks, crossover steps, or walking on an uneven surface like grass.

 

Take a class.  Classes like Asahi or Tai Chi contain movements that will help you develop better balance.


Try aquatic exercise. Water provides a safe, gentle medium to practice all kinds of balance moves that may not be possible, at least initially, on land.

 

Talk with your doctor.  At your next appointment, bring a list of items to discuss with your doctor. How might certain medications or health conditions be hindering your ability to balance?  What are appropriate things for you to try in your efforts to improve?

 

Work your way up to barefoot walking or wearing more minimal shoes over time to minimize injury risk.

 

Example balance exercise progression

 

Here is a simple static balance sequence to start with, depending on what would constitute a moderate challenge for you.  These can be done at your kitchen sink!  Hold the position(s) for as long as you safely can, working up to 30 seconds, 45 seconds, or 1 minute.  Feel free to start by holding on lightly or using a “fingertip grip” and work up to not having to hold on.

 

  1. Two-Leg Stand  Simply stand with feet hip-distance apart, using good posture (ears over shoulders over hips, knees, & ankles; chin pulled back and chest open; knees unlocked).


  2. Two-Leg Stand, Narrow Stance  Standing with feet closer together or right next to each other in good posture is more challenging because you have decreased your base of support.

 

  1. Staggered Stance  Place one foot in front of the other, either partially or completely.  Repeat after switching feet.  Notice if one side is harder than the other.  This decreases your base of support yet again.


  2. Single-Leg Stance  Stand on one leg for as long as you can, then switch legs.  As you are ramping up your level of challenge, feel free to use a 'fingertip grip' or hover your hands over a supportive surface, tapping fingers down as needed for support.

     

Add other challenges  Once you are able to hold for 30 seconds on most of these, start adding in challenges like placing your arms across your chest, making other arm movements, turning your head side to side, or passing a medicine ball back and forth with someone else.


Other Fall Prevention Tips

 

These practical changes in your home environment will keep you safer:


-       Ditch thick rugs in favor of a low pile carpet.

-       Add traction to the floor of the shower or bathtub,

-       Add grab bars in the shower or any other potentially slippery places.  

-       Use better lighting around the house. 

-       Clean up any floor spills immediately and completely.

-       Stay off wet floors until completely dry.

-       Keep the floor clear of clutter. 

-       Repair broken floor boards. 

-       Keep outdoor walkways clear and well-lit during the winter. 

-       Use assistive devices such as canes, walking sticks, or walkers as recommended by a qualified health professional..  

-  Arrange furniture in a way that allows easy and safe navigation throughout the household.  



Be Proactive & Mindful

 

The best way to prevent falls is by using a proactive approach.  Don’t wait until a fall happens to decide that it is time to work on your balance.  Do a little bit of balance practice each day in a way that is safe for you.

 

Overall, greater mindfulness and informed actions will reward you with a better quality of life.  I incorporate balance into every client’s exercise program, regardless of age.  I wish for you great balance and no falls or injuries!

 

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