Balancing Act

By Gill Scheepers

The term balance is usually associated with a balance between work and family, or between exercise and rest, however balance in the physical sense of the word is an underestimated component of fitness, and one that should not be neglected when it comes to an exercise programme. While we may spend time focusing on improving strength and cardiovascular fitness, perhaps adding in some stretching and flexibility training, balance training is something that is all too often ignored.

What is Balance?

Balance can be divided into two components, namely static balance which is the ability to remain motionless about a fixed position, and dynamic balance which is the ability to remain motionless about a fixed position, whilst simultaneously completing a physical action/movement. Good balance can be defined as the ability to remain upright and steady with an even distribution of weight.

The term proprioception is important when discussing balance. Proprioception is the ability to sense where the body is in space, or in other words, our internal sense of balance and body position. It provides us with a sense of body awareness and can be thought of as almost a ‘sixth sense’. It allows you to recover when you may stumble over an object or to fall with a minimum amount of injury as your body subconsciously makes adjustments to restore its sense of balance. A proper sense of balance is a survival necessity.

The proprioceptive system uses stretch receptors and pressure receptors situated in our muscles, joints and skin to inform our brain about our physical environment and how we are interacting with it, and then to provide subconscious adjustments and corrections to keep our body’s in a safe and stable position.

A large percentage of these receptors are in our feet; which makes sense as they are the parts of our body most in contact with our physical environment. If we reduce the sensory feedback from our feet to our brains by wearing thick, shock-absorbing soles then the brain has less information to work with, thus reducing the quality of the movement pattern produced. Taking this into account, it may be a good idea to perform balance exercises bare-foot, just make sure that you are in a safe environment with no sharp objects around.

Good balance and proprioception is dependant on the body’s vestibular system (located within the inner ear- the reason why you may feel a lack of balance if you have an inner ear infection), the visual system and the musculoskeletal system. These systems all work together to maintain balance.

The vestibular system uses a complex mechanism in the inner ear to help the brain sense position and movement (i.e. up and down, side to side and circular movements). The visual system uses our sight to tell us where we are in relation to our surroundings- you can test this by closing your eyes while standing and feeling how your sense of balance changes. The musculoskeletal system provides the ability to stand, move and sense positions and movements through our muscles and joints, and to adjust the position of the body to maintain balance, this occurs throughout the day without us even realising it. If you stand still, preferably with eyes closed, you will feel how your body shifts and moves around to maintain balance, a mechanism known as postural sway.

Maintaining a good sense of balance is important for your survival. A lack of balance can lead to injury, accidents or an inability to respond to changes in your environment. Poor balance leads to a fear of falling, which results in fear -related avoidance of many day to day activities. This can ultimately lead to a lower quality of life, something which should be avoided. There are many things which can impair your sense of balance. Illness is one the most common causes of a loss of balance and can affect almost anyone (anything from an ear infection to more serious neurological illnesses such as Parkinson’s disease).

Balance training challenges body equilibrium and teaches the sensory receptor and motor systems to rapidly integrate and perform highly skilled movement patterns in a safe and balanced manner.

Consequences of Poor Balance
A lack of balance is often associated with an older population; however it is just as important in the younger, as well as athletic population. Although a lack of balance is one of the key reasons for falls in the older adult population, a lack of balance and proprioception in the younger population can not only cause injuries, but also predispose to re-injury, if not properly addressed and corrected.

Benefits of Balance Training

·        Strengthens muscle stabilizers-postural muscles, if you are prone to ankle sprains - then regular balance training can help to prevent and correct this.

·        Decreased incidence of lower limb (predominantly knee and ankle) injuries in athletes. -football players with inferior balance experienced four times the amount of ankle injuries compared to those athletes with satisfactory balance.

·        Decreased incidence of falls in older populations

·        Decreased chance of injury recurrence, if balance is  restored following a fall or injury

Exercises to Improve Balance and Proprioception
Exercises which are targeted at improving balance and proprioception are simple and time efficient, and can be easily and often rapidly progressed. Effective exercises challenge the vestibular (inner ear), visual and musculoskeletal systems. Try and spend a few minutes at the end of your training session performing some of these exercises.

Single Leg Stand with Eyes Open:

·        Stand on a stable surface.

·        Transfer your weight to one leg and squeeze the standing leg glute.

·        Lift the opposite leg up, so you are balancing on one leg.

·        See if you can hold the one-legged stance position for 30 seconds.

·        Swop sides to balance on the other leg.

·        Repeat a few times.

Progression:

·        Perform the same exercise with the eyes closed.

·        Perform the same exercise standing on an unstable surface, such as a wobble cushion, a BOSU, a thick exercise mat or pillow.

·        Hold the single leg stance position and turn the head to look from side to side and look up and down.

·        Hold the single leg stance position and reach down to touch your toes, while trying to maintain a balanced position.

·        Hold the single leg stance position and bend the standing leg into a squat without losing balance.

Balance is a multi-sensory activity. Our “sense” of balance, is based on the proper functioning of the vestibular system in close conjunction with our visual, motor skills and positioning (proprioceptive) systems. Body position, muscular-skeletal control, tactile feedback, motor coordination and visual processing inputs all combine to form a “multi-sensory network” with many functions. This seamless system of inputs and feedback must work precisely to form what we call our sense of balance.