How To Improve Your Balance So You Can Age Well and Reduce Your Risk for Falls
If you feel your balance is bad and are wondering what you should do, you have found the right physical therapy clinic to help you! At Purple Mountain PT, helping people improve their balance, mobility, strength, and confidence is near and dear to our hearts. Our clinic was founded by Dr. Maureen O’Keefe, DPT and one unique thing about her Temple University School of Physical Therapy education program was that she was required to complete 3 semesters of courses regarding Balance and Falls in the Elderly. This is unusual in PT curriculums and provides our patients a huge advantage compared to traditional PT clinical care. We have a complete balance and bone density improvement program. If you are interested to learn more about this, call us at (616) 516-4334 or submit an online inquiry here.
If you believe you have bad balance and don’t know what you should do to improve it, let’s look at what you can do to gain better balance, based on what research has found.
PRACTICE BALANCE
It makes sense that to improve balance, you must practice balance. If you have bad balance, you should be challenging your balance to improve it.
Did you know that balance precipitously declines through our lifespan? By the 50s, balance experiences a steeper decline. If you don’t keep your mobility and strength, your balance will greatly suffer.
- Research has found that adults in their 30s and 40s demonstrate single leg balance ability for a minute or longer.
- At age 50 the single leg balance ability decreased to 45 seconds and continues to decline with each decade.
- By Age 80 adults are typically able to stand on one leg for less than 12 seconds, and often with impairments in posture and joint mobility noted.
Some of our patients come to us with a history of multiple ankle sprains and weak ankles, predisposing them to balance impairments. These patients have been found to have deficits in proprioception and control of their foot and ankle balance. Fortunately, research supports that training your balance with a physical therapist improves balance:
The subjects from both groups participated in a unilateral, multilevel, static and dynamic balance training program 3 times a week for 4 weeks… Following training, subjects from both groups demonstrated significant improvements in balance ability….Balance training is an effective means of improving joint proprioception and single-leg standing ability in subjects with unstable and nonimpaired ankles
Balance can be impaired at any age. Our PTs see it all the time in adolescent patients, women who have EDS, women who are in their 20s or 30s and expect their balance to be great, yet it measures below average, women in perimenopause or menopause who lack the balance & stability that they used to have and men, of any age, who are tight, stiff and lacking fully mobility from feet to neck and have impaired balance.
If you are worried about your bad balance, bone density, lack of pelvic floor strength, chronic back pain, or your stiffening joints that feel out of shape, give us a call and rest assured that our PTs can help personalize a treatment program that will help you learn what you should do and get you feeling good again.
Whether you have good balance or bad balance, there are a lot of things we all should be doing.
There is strong evidence to suggest that balance training can improve static balance ability on stable and unstable surfaces, as well as dynamic balance ability. Elite athletes have the potential to improve static balance on an unstable surface and dynamic balance ability, but a ceiling effect appears to occur with stable balance ability on a stable surface. Balance training programs performed at least 10 minutes per day, 3 days per week, for 4 weeks that incorporate various methods of balance training appear to improve balance ability. Types of balance training included the use of tilt boards, unstable surfaces, and dynamic body movements while maintaining a static stance.
Balance requires complex neuromotor control and coordination. Often our patients rely too heavily on their vision to maintain balance. Sometimes patients simply think standing on one leg and balancing is good enough. In reality, falls tend to happen during dynamic activities, such as turning around, reaching for something or walking. Because of this, it is important to train both static balance (such as standing on one leg) and also dynamic balance (such as lunging and twisting to reach something). Yet, any balance exercise is a risk for falls, so when you work with our PTs, we remain right by your side, spotting your performance and preventing any falls.
This systematic review article summarizes the specific benefits of balance training as follows:
Exercise as a single intervention can prevent falls (pooled rate ratio 0.84, 95% CI 0.77-0.91). Meta-regression revealed programs that included balance training, contained a higher dose of exercise and did not include walking training to have the greatest effect on reducing falls. We therefore recommend that exercise for falls prevention should provide a moderate or high challenge to balance and be undertaken for at least 2 hours per week on an ongoing basis.
EXERCISE: INCLUDING STRENGTH TRAINING, WALKING AND BALANCE EXERCISES
Declines in Muscle Power, Strength and Mass Cause Balance Deficits.
Additionally, these declines cause worsening physical performance and greater fear of falling while also negatively impacting quality of life. How can we prevent this? Exercise that includes strength training, HIIT training, walking and balance exercises have all been found to help improve balance.
This study looked at the effects of high intensity interval training (HIIT) and moderate intensity interval training (MIIT) on balance and found encouraging results:
Statistical analysis showed improvements after the intervention in the HIIT group compared with the MIIT and control groups regarding the fear of falling (p < .05 and p < .01, respectively), gait (both ps < .05), and dynamic balance (p < .05 and p < .01, respectively), whereas both HIIT and MIIT groups improved balance confidence compared with the control group (p < .01 and p < .05, respectively). We can conclude that HIIT has significant beneficial effects of fall risk in older adults.
Here’s more encouraging news: research supports that it is never too late to improve your balance. Aging well is about building & maintaining strength, balance and mobility.
For women, this becomes especially important during perimenopause and menopause, when estrogen declines and bone density also declines, rendering us at higher risk for fractures. This study looked at the benefits of strength training
Subjects, ranging in age from 65 to 83 years, were randomly assigned to a strength and balance/gait group (SB, n = 21 ) or a control group (S, n = 18) receiving strength and relaxation training. Both groups significantly increased their strength and gait speed over the 12-week training period, but step length remained unchanged. The results suggest that elders can make significant gains in muscular strength and walking speed through resistance training, and that adding balance and gait training to resistance training can significantly improve some balance and gait measures beyond improvements achieved from strength training alone.
This study affirms that people 65 years old and beyond can improve balance. Balance begins to decline as early as your 5os, so let’s be proactive about working on this. Using our progressive balance training exercises, whole body vibration, applied biomechanics, rotational movements, posture correction, myofascial release, joint mobilization and stretching, our PTs customize treatment plans to help improve balance, strength, mobility and confidence. Would you like to learn more? Call 616-516-4334 to speak with one of our knowledgable team members or ask us a question here.
BUILD MUSCLE
If you have bad balance, what is one important thing you should do to improve your balance? Strength Train!
You Must Avoid Sarcopenia!! Sarcopenia is a loss of muscle mass and function. When we see frail, elderly women they have sarcopenia! We must do our best to avoid this by staying active and avoiding disuse and sedentary lifestyles! If you have bad balance, there are so many things you should do to improve it. Building and maintaining strong muscle mass by strength training is one important step to take.
Sedentary lifestyle comes with a progressive loss of muscle mass and function with an increase in fat inside the muscles, as the years advance. Sarcopenia is a progressive loss of muscle mass, strength, power and physical performance. Don’t fool yourself into thinking sarcopenia only happens to women in their 80s. Is your lifestyle sedentary? Then you are at risk, also!
An encouraging study of people aged 40-81 years old who exercise 4-5 times a week looked at their thigh muscle peak strength.
This study found that muscle mass does NOT automatically decline with age. Rather, it declines with a sedentary lifestyle.
- Thigh muscle area did NOT decline with age.
- Quadriceps peak torque (a measure of strength) did NOT decline with age.
- As muscle bulk increased, peak strength of the quads increased.
- Total body fat percentage did increase with age, but there was no relationship between intramuscular fat tissue (this is fat tissue that has invaded the actual muscle) and peak torque of the quadriceps!
Bottom line of this study is that if you remain fit and active into your 80s, you will retain your quadriceps muscle strength! And the more muscle you have, the stronger it will be. And this is known to reduce your risk for falls. The author’s summary:
This study contradicts the common observation that muscle mass and strength decline as a function of aging alone. Instead, these declines may signal the effect of chronic disuse rather than muscle aging. Evaluation of masters athletes removes disuse as a confounding variable in the study of lower-extremity function and loss of lean muscle mass. This maintenance of muscle mass and strength may decrease or eliminate the falls, functional decline, and loss of independence that are commonly seen in aging adults
Our licensed physical therapists use a whole-body, evidence based physical therapy approach to help our patients become fit, strong and confident that they won’t fall. We don’t just treat injuries, we help you age confidently and prevent them.
Our PTs work to assess all of these for each person and develop a personalized treatment program that progressively treats all of these components to improve quality of life, restore balance, strengthen the body, build bones and build confidence. If this sounds intriguing to you, reach out to us at (616) 516-4334 or ask us a question here and we will call you.
WORK TO IMPROVE YOUR POSTURE
Maintenance of posture relies on proprioceptive input from three important regions: the sole of the foot, the sacroiliac joint, and the cervical spine…Humans use specific balance and righting reactions to maintain upright posture. The responses to changes in balance and posture are innate, automatic, and predictable in normal adults…Balance reactions can then be combined into higher level “strategies” to maintain postural stability in response to larger perturbations. These strategies include the ankle, hip, and step strategies.
Notice that the the Neck and SI joint are specifically involved in posture? Our pelvic floor, spine and TMJ specialization renders our licensed physical therapists equipped to improve posture and balance.
Improving our posture helps our balance, because our center of gravity will be more effectively positioned inside our body and easier to control when we move. Improving posture takes much more effort than simply sitting up straight. It requires adequate strengthening of the postural support muscles. Sufficient length of our fascia and muscles, so we are not too tight causing things to fall into a collapsed posture. Adequate posture also develops in response to our daily habits. Assessing our ergonomics at work or our habits with looking down or sitting in the car can be useful. Supporting the curvatures of our lower back is helpful. Patients often come to us with neck, SIJ, low back or pelvic pain issues. By addressing their posture, in conjunction with all of our other treatment interventions, they experience relief of symptoms and improved balance and posture. To learn more about working with our physical therapists, reach out to us here.
BENEFITS OF BALANCE TRAINING
Balance training confers numerous benefits beyond simply helping reduce our risk for falls.
Balance training is a useful intervention in rehabilitation of postural stability impairments as well as in training programs for performance enhancement.
The benefits of balance training include:
- Improved postural stability
- Better motor control: you can just move more fluidly and easily
- Fewer ankle sprains
- Higher confidence in doing things in life, such as kayaking, hiking down a mountain, carrying a child when getting up from the floor
- Better activation of the core stabilizers (pelvic floor, abdominals, low back)
- Improved athletic and sports performance
- Reduction in falls
- Greater confidence in your mobility and reduction in Fear of Falling. This has been shown to improve quality of life.
What to expect at Purple Mountain Physical Therapy, if you have balance, pelvic health, spine or TMJ concerns.
The emphasis that Temple University graduate Physical Therapy curriculum placed on balance, healthy aging, mobility, fear of falling and understanding how balance changes across the lifespan has greatly influenced the treatments provided at Purple Mountain Physical Therapy.
Dr. Maureen and all of our physical therapists are trained to include balance, motor control, movement impairments, postural assessments and manual therapies in every patient’s treatment plan of care. Many patients come to us with symptoms related to pelvic pain, chronic jaw pain, neck pain or headaches or low back pain. All of these pain conditions can be improved with our comprehensive physical therapy and each of these conditions tends to also cause a person to have impairments in their posture and balance. If you have bad balance and wonder what you should do about it, our PTs can help you.
People come to us knowing that we specialize in pelvic health, spine and TMJ disorders. In recognition of the important role balance, posture and strength training plays in healthy aging, pelvic health, spine and TMJ disorders, our treatments are more comprehensive.
Our licensed PTs specialize in pelvic health, spine and TMJ disorders and you may be surprised to learn that all of these conditions tend to have postural and balance impairments. Because of this, our patients receive a comprehensive evaluation that includes
- Movement assessments
- Mobility assessments
- Balance assessments
- Postural assessments
- Strength and deep core assessments (including the important pelvic floor muscles that are crucial for balance)
We also use a whole body framework in designing our patients personalized therapeutic treatments that meet their goals. Treatments often includes therapeutic exercises targeted based on your specific needs and abilities.
These will include
- Progressive static balance training on two legs, one leg, hands and knees, kneeling or other postures
- Dynamic balance exercises. Dynamic balance training can involve a variety of fun ways to “turn on” your body’s balance system. In particular, we use movements that involve trunk and neck rotation, unstable surfaces, strengthening & stretching.
- Whole Body Vibration Training: this helps wake up your balance system, increases activation of your deep core, improves lymphatic flow and has been found beneficial for bone health.
- Manual therapies, such as myofascial release, mobilization with movement, joint mobilization, pelvic balancing and therapeutic massage.
- Rehabilitative ultrasound imaging to assess and show you your pelvic floor, low back muscles and abdominal muscles are working (or impaired) because dysfunction here results in loss of balance, postural control and stability.
- Postural aligment and strengthening exercises
- Bone building strengthening program
- Personalized development and completion with proper form of what exercises to do longterm for your wellbeing and how to do these correctly.
At any age, balance can be improved, when you work on the right things. If your balance is bad and you don’t know what you should do, let us help you. Our licensed physical therapists will help you rebuild your balance, pelvic stability, reaction time, trunk rotation capacity, neck mobility, proprioception and so much more. To learn more about improving your overall health, so you can age fit, strong and be confident in your balance, call us at (616) 516-4334 to speak with one of our knowledgable team members or reach out to us here with any question and we will be in touch.
Peace,
Dr. Maureen O’Keefe, DPT Founder of Purple Mountain PT
You may be interested in checking out our physical therapists or other articles we’ve written. If you have questions, feel free to call 616-516-4334. We take great care to understand your needs to determine if we can help you. Our knowledgable team member can also answer your questions and help you learn more about the results our patients experience. All of our patients have the benefit of working with two of our specialist physical therapists, so they have a Team behind them. Our staff are regularly communicating behind the scenes to progress your treatment program and problem solve how to best help you.
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References:
DiStefano, Lindsay J, Clark, Micheal A, Padua, Darin; A Evidence Supporting Balance Training in Healthy Individuals: A Systemic Review. Journal of Strength and Conditioning Research 23(9):p 2718-2731, December 2009. | DOI: 10.1519/JSC.0b013e3181c1f7c5
Howe TE, Shea B, Dawson LJ, Downie F, Murray A, Ross C, Harbour RT, Caldwell LM, Creed G (2011) Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev 7:CD000333
Jiménez-García, J. D., Hita-Contreras, F., de la Torre-Cruz, M., Fábrega-Cuadros, R., Aibar-Almazán, A., Cruz-Díaz, D., & Martínez-Amat, A. (n.d. ). Risk of Falls in Healthy Older Adults: Benefits of High-Intensity Interval Training Using Lower Body Suspension Exercises. Journal of Aging and Physical Activity, 27(3), 325-333.
Rogers ME, Page P, Takeshima N. Balance training for the older athlete. Int J Sports Phys Ther. 2013 Aug;8(4):517-30. PMID: 24175135; PMCID: PMC3812830
Sherrington C, Tiedemann A, Fairhall N, Close J, Lord SR (2011) Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. N S W Public Health Bull 22:78–83
Trombetti A, Reid KF, Hars M, Herrmann FR, Pasha E, Phillips EM, Fielding RA. Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life. Osteoporos Int. 2016 Feb;27(2):463-71. doi: 10.1007/s00198-015-3236-5. Epub 2015 Jul 21. PMID: 26194491; PMCID: PMC4960453.
