Paspa Physical Therapy

What Causes Balance Problems

Are you losing your balance while walking?

 Or you wobble slightly stepping off a curb, then down you go. In the second or two before you hit the pavement, you 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 trained. Most work-outs do not include balance training.

Balance is something that people never 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 lose muscle mass (about 1% a year starting after middle age) and bone mass. 

Gait and balance disorders are among the most common causes of falls in older adults, 1–4, and often lead to injury, disability, loss of independence, and poor quality of life.

What causes balance problems?

The senses involved with balance start to dull as we get older: vision as well as senses of touch, temperature, pressure and proprioception (the sense of body placement and how it moves through space).

Certain medications can affect balance too. Illness such as low blood pressure, arthritis, head injury, inner ear problems, vertigo, neurologic problems and general physical decline with aging.  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 loss of independence and ill health. Even a fear of falling can keep someone housebound.

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.

Can I Improve my Balance?

The answer is a definitive, Yes!  Balance can be sharpened, 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. This all translated into reduced frequency of falls.

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.

That being said, it is always better to start training balance earlier in life. This way it is maintained and the risk of injury from a fall is significantly reduced. 

How do you treat balance problems?

Treatment of balance problems is multifactorial. It involves strength, coordination, and proprioception. 

To do the activities of daily living as they relate to balance — walking down the stairs, stepping off a curb and getting in and out of the bathtub — is really about maintaining muscle 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. 

The muscles that need to be targeted are the core (the ones surrounding the trunk and the back, such as the abdominals, obliques)  , the glutes (the muscles at the buttock) and leg muscles.  

Strength training is just one component of balance training. You also need to work on specific balance exercises. 

When it comes to balance-specific training, Your ultimate goal is to be able to maintain your balance in tricky situations. If we have a patient with poor balance skills, we often start in the sitting position either on a chair (if balance is really poor) or a stability ball. We can challenge them in this position by having them move their arms away from  their center of gravity or away from the midline. We can also challenge them by having them lift one foot at a time off the floor “marching while sitting”. We then progress to standing on two feet, then on one leg. We can add challenges such as standing on a foam mat to mimic a soft surface such as grass or unlevel sidewalk, ½ foam roll (which will challenge coronal plane movements) , one foot on a step stool, and  tandem stance (one foot in front of the other). For higher level patients we can add playing catch while in one of the above positions. 

People who want to advance their balance training can invest in equipment such as Bosu Balance Trainers, stability balls and wobble boards. Bosu balls — half-sphere inflatable balls that are wobbly when stood on or sat upon — can be used without any other equipment, just doing a simple squat or a lunge on a Bosu offers great balance training.

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 little for preserving someone’s balance. Taking a class (yoga), playing a sport (tennis), or walking, running or cycling outside force the body to travel in more than one plane of movement. That being said, never participate in an activity unless you are cleared by your physical therapist to perform it.  Safety is our first concern. 

Pilates and yoga can help develop balance as well. In yoga, you’re doing a lot of standing poses, so you have to learn to gauge your core stabilizing muscles — otherwise, you’ll tip over.  Martial arts training, which often involves standing on one leg, also improves stability. I often recommend Tai Chi for my older patients.  It is great for movement and balance training. Sports such as tennis or golf can challenge and improve your balance and coordination. Its never too late to learn a sport and enjoy not only the benefits of exercise but to be outdoors and in a community of like minded people. 

Bottom Line

It’s never too late to start working on your balance. Improved balance means reduced risk of falls and improved quality of life. 

If you have any questions contact Paspa Physical Therapy www.paspapt.com

 

FAQ’s

How do you treat balance problems?

Treatment of balance problems is multifactorial. It involves strength, coordination, and proprioception. do the activities of daily living as they relate to balance — walking down the stairs, stepping off a curb and getting in and out of the bathtub — is really about maintaining muscle strength.

Can I Improve my Balance?

The answer is a definitive, Yes!  Balance can be sharpened, even in very old age. It is always better to start training balance earlier in life. This way it is maintained and the risk of injury from a fall is significantly reduced. 

What causes balance problems?

The senses involved with balance start to dull as we get older: vision as well as senses of touch, temperature, pressure and proprioception (the sense of body placement and how it moves through space).

 

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