By owner of Treloar Physiotherapy Clinic and physiotherapist, Deb Treloar
When we refer to the term balance you may think of standing on one leg and seeing if you can stay upright but it has a much broader definition than that. Think about everything you do during your day and what positions you get into in order to do them. In nearly every case you are required to keep your body positioned against gravity while you move, eat, reach, carry, tie up your shoelaces, sit, walk, avoid obstacles and more. All of these require balance. Some of these we will do with ease and others we will find more difficult. So how does our body maintain balance?
Balance is the result of many systems in the body working together efficiently. Our ability to balance allows us to keep our center of mass (the point that is the middle of the total mass of the body) positioned over or around our base of support. The base of support can be two feet in standing but it also might be both hands and feet in a push up position or one foot as we kick a ball. If we reach into a cupboard and lean on the counter to do so our base of support might be one foot on the ground and one hand on the counter. Sometimes our center of mass may actually be outside our base of support, which requires a great deal of control from our body to keep from falling.
The systems our bodies use to maintain balance are our eyes or visual system, our vestibular system that is found in our inner ears, and the somatosensory system, which is the name of the system that receives feedback from the joints and the capsule and ligaments attached to them, our muscles, and the skin. These systems receive information about the environment around us, the position of the parts of our body, and weight distribution on a surface of contact. Our brains process this information and send signals back out to our muscles to respond to the information. If the response is appropriate we are able to maintain stability while we move to complete a task.
Check your balance now...
1. Stand on one leg and notice how you use your arms to help you stay upright. Ideally you should be able to stand on one leg and not engage your arms to help with your balance as normal activity requires you to balance and keep your arms free in case you need them to use them.
2. Now see if you can maintain balance while moving one of your arms. Lift the other arm up and down. Try moving the leg that is in the air and as a final test try looking around in different directions.
3. Progress to balance on one leg on a surface that is unstable. If you are at home try using a pillow. Make sure someone is available to spot you in case you can't maintain your balance.
4. Finally try to balance on one leg on an unstable surface and kick a ball. You'll need a partner to help you with this exercise and we only recommend that you try it if you were easily able to complete exercises 1-3 above. You can see that Curtis must go into flexion in order to maintain his balance and kick the ball which means it is a little too hard for him.
Balance Basics continued....
Injury or changes with aging that adversely affect the visual, vestibular or somatosensory systems will decrease our ability to balance. For example with an ankle sprain there is often damage to the ligaments of the joint that alters the feedback from the receptors from the capsule and ligament. The joint itself may not move in the same way and there may be damage to some of the muscles that control joint movement. As a result of the altered input or feedback from the damaged ligaments, capsule and muscle in this area, the brain does not get the same information to process so the response to changes of body position is altered and is not as effective. It is now more difficult for you to control your center of mass over your base of support. This is the case with injuries in any part of your body.
Exercises that retrain the responses of the balance systems to various positions of your body have been shown to be very effective in preventing further injury. Your brain and your body are very adaptable and if left without retraining will figure out a way to accomplish a task whatever it may be but it may be in a way that is stressful to other parts of your body. Over time this will manifest itself in aches and pains to these parts, which will further decrease your ability to balance.
