You wobble slightly stepping off a curb, and then down you go. It happens fast, and leaves you to wonder what happened to that great sense of balance you used to have. Balance doesn’t stay steady throughout life. Like muscles and bones, steadiness can deteriorate if not maintained. And balance training just isn’t part of most workouts.
Balance is often something most people don’t think about. That is, until a slip, trip or fall happens. Maintaining balance is easy for most younger people, but as we age our bodies loses muscle mass (about 1% a year starting after middle age) and bone mass. And senses involved with balance start to dull too as we get older: vision as well as senses of touch, pressure and proprioception (the sense of body placement and how it moves through space).
Certain medications can affect balance too. And the end result can be serious: Falls in older people can result in a broken hip, which, in turn, can trigger a downward spiral into dependence and ill health. Even a fear of falling can keep someone housebound for months leading to feelings of loneliness and depression.
Skills such as timing and coordination that are involved in balance are learned and practiced and honed. The more we sit, the more those skills erode. The old adage: “Use it or lose it” certainly applies to our balance.
But balance can be shored up, even in very old age. A 2007 study in the journal Osteoporosis International looked at the effect of a yearlong balance training program on women with osteoporosis. By the end of the study, the women’s functional and static balance improved, as did mobility. Falling frequency also declined.
Another study in the International Journal of Rehabilitation Research in 2010 found that elderly people enrolled in an eight-week balance or weight training program were less likely to slip and were more likely to recover if they did slip.
Balance training starts with stretching and strengthening all the muscles in the body. To do the activities of daily living as they relate to balance — walking down the stairs, getting in and out of the bathtub — is really about maintaining good muscle movement and strength. This can be done with an overall weight training program. For those who haven’t been to the gym in a while — or ever — that training should start with the basics and get progressively more difficult so that the muscles are always challenged.
When it comes to balance-specific training, your ultimate goal is to be able to maintain your balance in tricky situations. In Physical Therapy when we have a patient with poor balance skills, we will start off with safe floor exercises, then progress to standing on two feet, then on one leg. As a patient progresses the exercises also progress thus always providing the challenging effect that must be present for balance to improve. Balance training almost always involves targeting core muscles — the ones surrounding the trunk and the back, as well as our powerful and important leg and hip muscles.
People who want to advance their balance training can invest in equipment such as balance pads, therapy balls and discs. These objects are wobbly when stood on or sat upon — can be used without any other equipment, or with light weights or other gear for even more demanding workouts. Just doing a simple squat or a soft cushion offers great balance training.
Even cardio workouts should involve some instability. Elliptical trainers, stationary bikes and other cardio machines may raise the heart rate sufficiently, but they always offer an even, steady surface — and that does precious little for preserving someone’s balance. Taking a class, playing a sport, or walking, running or cycling outside on a variety of surfaces force the body to travel in more planes of movement and are more challenging to our balance systems and thus much more effective at improving balance.
Pilates and yoga can help develop balance as well. These methods of exercise are particularly good at improving balance because they help improve body awareness, improve flexibility and strength.
For individuals who have had falls, or are at a risk of falling, a supervised balance program designed by a physical therapist trained in balance and vestibular therapy is appropriate.