Each year, approximately one in three adults over the age of 65 fall at least once (1). That number is staggering. Good balance is the key to remaining independent and injury free throughout our retirement years. Take a walk into any physical therapy office, and you will see many patients struggling to improve their balance. “I have never had good balance,” or “Wow, when did my balance get so bad?” patients exclaim as they struggle to stand on one foot. With a third of adults affected by falls, don’t you think a “prescription” for improving balance should be part of our health care system?
Our balance system is incredibly complex. Balance uses three main systems: our visual system (eyes), somatosensory system (sensation of what surface we are on or where our joints are in space), and vestibular system (inner ear). We also rely on on musculoskeletal system (muscles, joints, and posture) to maintain optimal balance. All of these systems provide important information to our brain for our ability to stay upright and not unexpectedly end up on the ground. With so many pieces making up our balance, it’s no wonder we get unsteady as we age!
Is Imbalance Inevitable?
Getting older does not have to go hand in hand with declining balance. Practice makes perfect! Or in this case, at least improved. Challenging your balance with specific exercises will make it better. That’s right; exercise is the prescription for declining balance. There are a lot of different ways to test your balance (too many for me to cover in this short article). For today, we will focus on narrowing your base of support.
Where our feet are placed in relation to the rest of our body (base of support) will either make it easier or harder for us to balance. What would be easier to balance: a pencil on its flat eraser side or on the sharpened lead tip side? I’ll give you a minute to think about it or even try it. Both are challenging, but the flat eraser side would be easier because there is a larger surface area for it to balance on. The same goes for us. The smaller the base of support (closer our feet are together), the more challenged our balance system is.
Test Yourself: The Balance Prescription
When testing your balance, stand close to your counter top or other sturdy surface. This will allow you to have support if you begin to lose your balance and need to catch yourself. The counter top is there for safety. When progressing your balance exercise, hold on with as little support as you can do SAFELY. Balance exercises should be challenging, yet attainable, and most importantly SAFE.
Start by standing with a wide base of support (feet shoulder width apart). Can you hold that position without holding on for thirty seconds? If so, try bringing your feet together. You may notice a slight increase in sway, or that you can feel your feet wiggling and adjusting to help you keep your balance in this position. Still easy? Next, try placing one foot in front of the other in a heel to toe position. For those who are master’s at balancing and find this tandem stance easy, balancing on one foot is the final step.
If you are in fear of falling or are unsure where to start, join us at a free seminar on Wednesday, March 29th at 7:15pm in our East Aurora clinic. The class will cover our balance system with more depth, quick tips to avoid falling, and exercises to do to reduce your fall risk!
1. Shumway-Cook A, Baldwin M, Polissar N, Gruber W. Predicting the probability of falls in community dwelling older adults. Physical Therapy. 1997; 77(8): 812-819
2. O’Sullivan S, Schmitz T. Physical Rehabilitation 5th Edition. Philadelphia, PA: F.A. Davis Company; 2007.
3. Rosen T, Mack K, Noonan R. Slipping and tripping: Fall injuries in adults associated with rugs and carpets. J Injury Violence Res. 2013; 5(1): 61-69.