It has been found that nearly 172 million falls occur worldwide each year and result in long term consequences for the individual. These may occur for any number of reasons ranging from physical weakness, reduced function of the neurological system, poor vision, reduced sensation and more. To reduce the prevalence of falling and maintain physical function, experts recommend regular physical activity which involves balance training, strengthening, and aerobic exercise. As we age, many may feel limited and unable to participate in these types of activities due to increased pain, fear of falling or injury, reduced balance, or lack of knowledge. These causes, explanations, and solutions might be easier than you think.
The Sensory System and How It Affects Balance
Many people may not be aware that there are three components that contribute to balance. These are the visual, proprioceptive or sensory, and vestibular systems. The visual system is powered by the optic nerve and sends visual input from the eye to the occipital lobe of the brain for interpretation. Proprioception refers to the body’s ability to sense movement and information on where it is in space. These proprioceptive cells are located throughout the body to provide our brain with important feedback and contribute to balance. The vestibular system is centered in the inner ear and relies heavily on the vestibulocochlear nerve and sends information to the brain about position and motion. If any one of these systems is impaired, it can play a huge role in limiting the body’s ability to maintain balance, so it is important to keep them functioning at their highest capacity. Just like muscles can be strengthened and trained, so can these various systems.
Common Conditions Affecting Balance and Limiting Activity
As we age, there are certain conditions we become more susceptible to or that may impact our ability to balance or participate in physical activity.
Arthritis – Arthritis refers to inflammation and tenderness of a joint, usually due to cartilage breakdown causing the innervated & vascularized bone to touch. There are many different types and it can affect almost any joint, but the general symptoms of all can include; pain, decreased motion, swelling, and redness. This disease can make any and all movement and weight bearing uncomfortable if not treated and managed appropriately, making physical activity uncomfortable. This pattern of inactivity can lead to weakness and increase fall risk as well.
Diabetes – Diabetes, which is caused from the increased levels of glucose, or sugar, in the blood, can cause a condition called “diabetic neuropathy.” Diabetes can damage the blood vessels that supply nerves which can cause the nerves to become injured. This can cause sensations of burning, tingling or numbness in feet and lower legs. This weakened and usually painful sensation may increase the risk of falling due to the impaired signal transduction to the brain, making it difficult to adapt to unpredictable obstacles or terrain while walking or running.
Weakness – Weakness, or muscle atrophy, can occur during periods of inactivity. This is where “if you don’t use it, you lose it,” usually comes into play. Weak muscles can increase fall risk in many ways but some common examples include; weakness of ankle muscles to lift the foot off the ground which could cause the toe to drag and possible tripping, or weakness of the muscle of the hip and knee could make it difficult to control the descent from a curb or steps causing the leg to give out underneath you.
Back pain – Over 70% of the population suffers from low back pain, and can make us feel debilitated if not treated properly, limiting our function and ability to participate in the activities we love. For types of back pain and how to identify what may be going on with the pain in your back, refer to our article here where we take a deeper dive!
How to Improve or Maintain Balance and Live the Active Lifestyle You Want!
The good news is that there are solutions to many common causes of poor balance and reduced activity levels. A good starting point is to practice balance in a safe environment in your home. Increasing activity levels is best done in a graded manner, adding a little bit more activity to your day each week. For example, if you are used to walking about 3,000 steps/day and about 30 minutes of activity, try increasing this by 1,000 steps and adding 15 minutes of activity. Once you achieve this consistently for a week, increase at the same rate for the following week.
In physical therapy, various exercises for balance & strength are used to help you achieve your goals & keep living a long, active life. Here are a few examples of exercises that will help increase stability and balance. They will help challenge two of the main components of balance, the vestibular and sensory systems (as we talked about before). You should do these in a corner of your home with a chair in front of you for support if you need it. Sometimes, people feel more comfortable with the supervision of a friend or family member as well.
Single leg stance:
Try to stand on one leg at a time. Start with a short time frame anywhere from 5-15 seconds and perform three times on each leg each day. Steadily increase the hold time by 5-10 seconds each week until you can hold the position easily for up to one minute.
Single leg stance with eyes closed:
This exercise is just like the one above, but you should close your eyes when you do it. Challenging, right?! Try to hold for 5-10 seconds and perform 3 times on each leg daily. Continue to extend the time each week as balance improves until position is held up to 30 seconds.
Single leg stance with head turns:
This is another variation of the first exercise, but add head turns side to side. Try to hold 5-10 seconds and perform 3 times on each leg everyday. Increase time by a few seconds each week as balance and stability improves.
Mobility Exercises
The following are activities that will help maintain and improve mobility and flexibility of commonly stiff and restricted muscles. Stretches should be held for at least 60 seconds and performed at least 3 rounds in the morning and evening.
Piriformis stretch:
Hamstring stretch:
Pectoralis stretch:
Calf stretch:
That Was Awesome, but I Need Help
If you or someone you know is struggling to live the life they want doing the active things they want to do, has had falls, or wants to know how to avoid these issues all together, click here to talk with a PT & get a full strength and balance assessment. A physical therapist will be a great solution and resource to help address these problems and keep you safe and mobile. Because our bodies may be getting older, but we’re still kids at heart. 🙂
