My Army buddy from 1960 mentioned to me that he has problems with his balance and was using a Bosu* to try to regain his stability. Since balance is not one of my issues, I acknowledged his comment, but couldn’t empathize with him. That is until I got wobbly and pitched over a few times myself.
My problem was due to medication and easily resolved when I stopped taking it, but not before I experienced first-hand how dangerous a lack of balance can be. The first time I knew something was wrong was when I bent over to pick up something off the kitchen floor and pitched forward crashing my head into one of the cabinets. A shock for sure but no real damage.
It happened again while I was making a nighttime trip to the bathroom. This one could have ended badly. I suddenly found myself falling between the wall and the toilet and couldn’t stop my downward motion. As a I scrapped my shoulder down along the wall enroute to the floor, my other shoulder connected with the toilet seat and tank while my head continued on and only stopping when it hit the wall. Besides the difficulty of extricating myself, that fall left a few bruises and a heightened awareness of the role of balance. When a fellow Pentagon worker recently suggested I post a blog on “Seniors’ Balance,” I decided I better look into this while I’m still steady.
I’ve learned that one out of every four people aged 65 and older fall every year according to data provided by the Centers for Disease Control and Prevention. Additionally, one out of five of these seniors falling results in serious injury, with more than 800,000 seniors hospitalized annually due to hip fracture or a fall-related head injury.
Why does Balance Decline?
Muscle mass, which affects strength and agility, is essential for balancing and to avoid falling. As a normal part of aging, people begin losing muscle mass (sarcopenia) in their 30s.
Sarcopenia tends to advance more rapidly in people who are not physically active, but like bone loss, it occurs to some degree in everyone. Researchers believe contributing factors include:
· Reduction in nerve cells responsible for sending signals from the brain to the muscles to start movement
· Lower concentrations of some hormones, including growth hormone, testosterone, and insulin
· A decrease in the ability to turn protein into energy
· Not getting enough calories or protein each day to sustain muscle mass
What does it Feel like to have Balance Problems
“Have you ever felt dizzy, lightheaded, or as if the room were spinning around you? These can be troublesome sensations. If the feeling happens often, it could be a sign of a balance problem.
“Balance problems are among the most common reasons that older adults seek help from a doctor…and are often caused by disturbances of the inner ear. Vertigo, the feeling that you or the things around you are spinning, is a common symptom.
“Having good balance means being able to control and maintain your body's position, whether you are moving or remaining still. Good balance helps you walk without staggering, get up from a chair without falling, climb stairs without tripping, and bend over without falling (forward and hitting your head on a wall or cabinet). Good balance is important to help you get around, stay independent, and carry out daily activities. Balance disorders are one reason older people fall.
Causes of Balance Problems
“People are more likely to have problems with balance as they get older. But age is not the only reason these problems occur.
“Some balance disorders are caused by problems in the inner ear caused by labyrinthitis (inflammation of the inner ear).…and are typically accompanied by vertigo and imbalance. Upper respiratory infections, other viral infections, and, less commonly, bacterial infections can…lead to labyrinthitis.
“Some diseases of the circulatory system, such as stroke, can cause dizziness and other balance problems. Low blood pressure can also cause dizziness. Head injury and many medicines may also lead to balance problems.
Symptoms of Balance Disorders
“If you have a balance disorder, you may stagger when you try to walk, or teeter or fall when you try to stand up. You might experience other symptoms such as:
-Dizziness or vertigo (a spinning sensation)
-Falling or feeling as if you are going to fall
-Lightheadedness, faintness, or a floating sensation
-Blurred vision
-Confusion or disorientation
“Other symptoms might include nausea and vomiting; diarrhea; changes in heart rate and blood pressure; and fear, anxiety, or panic. Symptoms may come and go over short time periods or last for a long time, and can lead to fatigue and depression.
Some exercises help make up for a balance disorder by moving the head and body in certain ways. For example, the Epley Repositioning Maneuver is used to treat BenignParoxysmal Positional Vertigo.
“The Epley maneuver is designed to put the head at an angle from where gravity can help relieve symptoms. Tilting the head can move the crystalsout of the semicircular canals of the ear. This means that they stop displacing fluid, relieving the dizziness and nausea this was causing.” https://www.medicalnewstoday.com/articles/319171
Ear crystals… You have probably never heard of them, but you have them. If you are experiencing vertigo or dizzy spells, crystals may be the culprit. In fact, about 20% of all dizziness is due to loose inner ear crystals. https://uppercervicalawareness.com/ear-crystals-what-are-they-and-their-relation-to-vertigo/
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV occurs when tiny calcium crystals called otoconia come loose from their normal location on the utricle, a sensory organ in the inner ear.
If the crystals become detached, they can flow freely in the fluid-filled spaces of the inner ear, including the semicircular canals (SCC) that sense the rotation of the head.
Epley Maneuver
Tilting the head can move the crystals out of the semicircular canals of the ear.
Balance problems due to high blood pressure can be managed by eating less salt, maintaining a healthy weight, and exercising. Balance problems due to low blood pressure may be managed by drinking plenty of fluids, such as water, avoiding alcohol, and being cautious regarding your body's posture and movement, such as standing up slowly and avoiding crossing your legs when you’re seated.
Coping with a Balance Disorder
Some people with a balance disorder may not be able to fully relieve their dizziness and will need to find ways to cope with it. A vestibular rehabilitation therapist can help you develop an individualized treatment plan.
To reduce your risk of injury from dizziness, avoid walking in the dark. You should also wear low-heeled shoes or walking shoes outdoors. If necessary, use a cane or walker, and modify conditions at your home and workplace…by adding handrails.”
Improve Balance and Reduce your Fall Risk
Regularly engaging in exercises that strengthen your core can make a fall less likely both today and down the road. Below are some simple exercises you can do in your home. If you know you have problems with balance or if you have fallen before, it’s important to discuss these with your health care provider first.
What are Core muscles?
Core muscles are the 35 muscles in your torso. They include back extensors, abdominals, lateral trunk muscles and the hip muscles. Core muscles are stabilizers…responsible for proper posture and movement.
Equipment
By simply stepping on the balance pad when standing in one place or during exercises, you will notice the extra challenge to your body that requires frequent micro-adjustments by your legs and core to help you stay balancedand upright.
What is a Bosu Ball?
You’ve probably seen BOSU balls at your local gym and wondered what they are. The BOSU Balance Trainer is a two-sided fitness tool: One side is a solid flat platform, and the other is a soft dome resembling an exercise ball.
When will I see Results?
Thankfully, the body responds pretty quickly to exercise that is consistent. Balance can improve in just a few weeks by exercising at least twice a week. When it does, climbing steps shouldn’t be as taxing and sitting down or getting up won’t be as likely to cause a fall as it used to be.
12 Balance Exercises for Seniors https://www.ptprogress.com/balance-exercises-for-seniors/
If you go to the above website, the following pictures are animated to demonstrate the exercise.
1. Single Leg Stance
Instructions: Start with your feet at hip-width. While holding onto a counter, lift one foot off the ground slightly. Keep your body tall and avoid leaning onto your planted foot.
Advance this exercise by transitioning to one hand support and eventually no hand support. It’s always good to perform near a sturdy counter in case you need to quickly catch your balance.
Hold your foot up for 10 to 15 seconds. Repeat 5 times on each leg.
Why this is important: You stand on one leg every time you take a step or walk up and down stairs. Don’t underestimate the importance of the single-leg stance exercise!
2. Foot Taps to Step
Instructions: Stand tall, facing a step or cone. Beginners should use support from a counter or handrail until balance improves.
In a controlled motion, lift one foot, tap the cone or step for one second, then return to your starting position. As you repeat this motion, you should focus on consistency and control with each tap. Perform 10 repetitions on each leg. Repeat 2 to 3 times.
Why this is important: This exercise helps improve coordination for ascending and descending stairs. After strengthening your coordination with this exercise, you won’t catch yourself tripping on a step anymore.
3. Narrow Stance Reaches
Instructions: Begin with your feet together, or as close together as possible while still feeling stable. Stand tall and reach forward with one hand while holding onto a counter or solid surface for safety.
Alternate arms as you reach forward. Progress by reaching with both hands forwards. You can make this more challenging by reaching out to the side or in varying directions. Perform 10 reaches with each arm. Repeat 2 to 3 times.
Why this is important: Many falls occur while reaching for an item in a tight space. This exercise strengthens your balance for such scenarios.
4. 3 Way Hip Kick
Instructions: Stand with your feet shoulder-width apart. While holding onto a counter or firm surface, extend your leg forward and return to your starting position. Repeat this motion to the side, returning to the starting position each time. Finally, extend your leg back and return to the starting position. Perform each motion 5 to 10 times on each leg. Repeat 2 to 3 times.
Why this is important: This exercise builds strength in the hip muscles, which help maintain stability with walking, turning, and going up and down steps.
5. Standing Marches
Instructions: Stand with your feet shoulder-width apart. While holding onto a counter or firm surface, raise one leg in a marching motion. Alternate legs. Focus on smooth, controlled movements and keep your body tall to avoid leaning side to side. You can make this exercise more difficult by letting go of the counter or chair. Perform 20 marches (10 on each leg). Repeat 2 to 3 times.
Why this is important: This exercise is great for improving hip strength and single-leg balance. If your feet ever catch the ground while you’re walking, you’ll benefit from this exercise!
6. Mini Lunges
Instructions: Stand with your feet shoulder-width apart. While holding onto a counter or firm surface, step forward and bend your front knee slightly. Return to your starting position and repeat with the opposite leg.
The lunge does not need to be deep. If you experience increased knee or hip pain, modify this exercise by holding onto a counter and taking smaller steps. Perform 10 mini lunges on each leg. Repeat 2 to 3 times.
Why this is important: This exercise strengthens the legs while simulating a forward stepping motion. If you sometimes stumble forwards, this exercise will help you practice catching yourself before you actually fall.
7. Lateral Stepping
Instructions: Stand with your feet together. While holding onto a counter or firm surface, step to the side so your feet are just past shoulder width. Continue this motion along a counter, performing 5 to 10 steps on each side. Perform 5 to 10 steps. Repeat 2 to 3 times.
Why this is important: Unfortunately, many older adults fall due to poor coordination when turning and stepping in tight spaces. This exercise helps improve coordination for the many turns and side-steps you take throughout your day.
8. Squats
Instructions: Stand with your feet shoulder-width apart. While holding onto a counter, perform a squatting motion, as if you are about to sit down. It can be helpful to position a chair behind you for safety and accuracy. Perform 10 squats. Repeat 2 to 3 times.
Why this is important: If you’ve ever felt unstable when sitting or standing up from a chair, this exercise will help build strength and coordination!
9. Tandem or Semi-Tandem Stance
Instructions: Stand with one foot in front of the other so you are in a “heel-toe” position. If this is too difficult initially, move your feet apart slightly. Use a counter or chair for support, as needed. Hold this position for 10 seconds on each side. Repeat 2 to 3 times.
Why this is important: This exercise is great because it puts your body into a narrow stance. With a decreased base of support, you will challenge your muscles to keep you centered!
10. Heel Raises
Instructions: Stand with your feet shoulder-width apart. While holding onto a counter or firm surface, lift your heels off the ground. You should feel most of your weight shift to the front of your feet, as if you’re standing on your toes.
It’s ok to press into the counter with your hands at first; just make sure you are staying tall and not leaning. Advance this exercise first by reducing how much you press with your arms and eventually by letting go of the counter.
Perform 10 repetitions. Repeat 2 to 3 times.
Why this is important: Your calf muscle contributes to balance because it controls your ankle position. When you feel unsteady or need to correct your balance,you’ll use your ankle muscles to reposition. Stronger calf muscles lead to better balance!
11. Hamstring Stretch (Standing or Sitting)
Instructions: Stand with your leg on a step or on the ground slightly in front of your body. Keep your back straight and gently lean forward, feeling a stretch in the back of the thigh and knee.
Another way to stretch the hamstring is to sit and extend your leg, leaning forward until you feel a gentle, pulling sensation. Hold each stretch for 10 to 20 seconds. Repeat 2 to 3 times on both legs.
Why this is important: This is an important exercise for improving balance because the hamstrings can become very tight as we age. This usually happens due to sitting for prolonged periods. Improving hamstring flexibility can help decrease cramping or spasms upon standing up
12. Calf Stretch
Instructions: Stand with your foot against a step and gently lean forward while holding onto the railing or a countertop. You should feel a gentle pulling in your calf or ankle as you hold for 10 to 20 seconds. Avoid bouncing or rocking back and forth as you stretch.
Hold this stretch for 10 to 20 seconds each leg. Repeat 2 to 3 times.
Why this is important: Stretching the calf can help relieve soreness and cramps in the lower leg. If you’ve ever experienced a charlie horse in your leg that almost knocked you off your feet, this calf stretch will prevent that from happening again!
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