Understanding Balance

Balance is something we all take for granted. We don't think about it unless we don't have it. 

If we don't have it then simple tasks like walking, getting up from a chair or bending down to pick something up can become extremely difficult and scary.

Balance is controlled by three systems that provide information to the brain which then processes the information to make a decision on how to maintain balance. The three systems are: 1) Vision 2). Vestibular 3). Proprioception

Your eyes are a huge aid to balance and they are the system that we rely on more so than any other.  Seeing where you are, where you should place your foot, or what type of environment you are in can make balance much easier.  Any doubters need just stand on one leg with your eyes closed to see how difficult balance is without vision.

The vestibular system, referred to as your "inner ear" also aids in balance by relaying information about movements and positions of the head. When you spin your head and body around really fast like an iceskater doing a pirouette and then stop you get very dizzy.

That's because your body has stopped but your vestibular system doesn't react as quickly - telling your brain that you are still spinning. After a short time your vestibular system will go back to normal and the dizziness will subside. People who have vertigo feel dizzy often times due to a problem with their "inner ear" in which incorrect messages are being sent to the brain. The brain is being told that it is moving when in actuality it is not. That is why there is a feeling of dizziness, almost like you are standing on a ship out at sea, eventhough you are planted on terra firma.

Finally, the proprioceptive system refers to the body's ability to know where all of it's parts are in space.  WHAT??  Let me explain.  If you close your eyes, you can touch your finger to your nose because your body knows where your nose is even if it can't see it.

If you lift your foot up or point it down, your body knows which direction it is in (up or down) because it knows the position that the joint is in.  When you stand, your froot can "feel" the floor underneath it, whether it is a hrad floor or a compliant surface like a trampoline.

Every joint has proprioceptor sensors within it that relay joint positional and directional information to the brain.  Have you ever walked on a water bed or on an air mattress and realized how hard it was to balance. That's because soft and compliant surfaces make it difficult for your proprioceptors to work.  Often times when patients have an injury to a joint, their proprioceptors can become impaired.

This is why as a physical therapist, we have patients stand on those wobble boards or air disks - to improve and rehabilitate their damaged proprioceptors.

Balance is maintained well when all three systems tell the brain the same or agreeing information.  When one system is impaired and does not give accurate information, balance begins to suffer.  Unfortunately, as we age, all three systems can begin to deriorate.

The good news is that there are specific exercises that can be done to improve any and all of the three systems to help improve balance once we determine which system is impaired.

As always, comments and questions are encouraged.  Please check us out on Facebook and "Like" us (search for Next Step Phsyical Therapy Hicksville)

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Yours in Health,

Chris Ostling PT, DPT