Having good balance is something taken for granted when we were young and active. Balance and coordination just seemed to happen naturally, without having to think about it. However, over time, there are several factors that can affect our balance. Age and decreased activity are obvious factors. Other things that can affect balance include an injury or surgery involving the spine or legs, and any illness involving the brain or inner ear.
Often, we can lose our sense of balance without even realizing it has happened. This leaves us vulnerable to falls and injuries, and can make us fearful of activities we used to enjoy – which just leads to more inactivity and worse balance!
Fortunately, in most cases, balance can be regained through some simple exercises and strategies.
It’s important to understand where our balance comes from. The body has three main strategies in use at all times to keep our equilibrium and coordination:
1. Vision: Your eyes tell you if you are tilting in relation to the horizon, and the brain automatically tries to keep you level. If you are overly dependent on your vision to maintain your balance, you are at risk of falling in low-light situations such as getting up in the dark to go to the bathroom or crossing a parking lot at night.
2. Inner ear: Called the “vestibular system,” the inner ear has tiny crystals floating in fluid. The brain recognizes when those crystals move, telling you how fast and in what direction you are tilting. Conditions such as Meniere’s disease, chronic ear infections or even minor head injuries, can lead to mixed signals from the inner ear resulting in poor balance.
3. Sense of joint position and joint movement: The medical terms for these are “proprioception” and “kinesthesia.” Without even looking at your left ankle right now, you hopefully can feel exactly what position it is in. If you move it, you can feel how big and how fast the movement was. There are special nerve endings in the joints that sense position and movement, and tell our brain we had better fire the right muscles fast or we’re going to twist the joint and/or fall. Those nerve endings can be damaged with sprains or joint surgery and must be rehabilitated or we remain at risk for injury.
A physical therapist can help determine if you are lacking in one or more of these balance strategies using a simple five-minute test called the Tinetti Balance Test. Simple and effective exercises can help improve balance and coordination.
It’s also important to make safety modifications at home, such as installing nightlights, if you are visually dependent. A walking stick can give you a “third leg” for safer hiking if your inner ear or sense of joint position are lacking. FBN
Suzanne Motsinger, P.T., D.P.T., C.S.C.S., is a physical therapist with Flagstaff Medical Center’s Therapy Services. She has both a master’s and doctorate degree in physical therapy. Suzanne has been a physical therapist for 23 years and is a certified strength and conditioning specialist. Is there a health topic you’d like to know more about? Please write to Mountain Medicine, c/o FMC Public Relations, 1200 N. Beaver St., Flagstaff, AZ 86001, or visit FlagstaffMedicalCenter.com.