Beyond the Gym Tulsa

Preventing Falls and Empowering Lives: The Role of Balance Training for Seniors

Senior riding a bicycle, concept of balance at an advanced age

Table of Contents

“Help! I’ve fallen and I can’t get up!”

While many may joke when referencing the old Life Alert commercials, balance issues and falls are no joking matter. Many older adults and seniors experience balance problems that can be concerning since poor balance could lead to a fall and/or other serious injuries. Balance problems can naturally increase with age but may also be caused by certain medical conditions, balance disorders, and even certain medications. Understanding how our balance system works as well as causes of balance problems is crucial to addressing balance issues and helping seniors maintain their independence and quality of life.

What is Balance?

Balance is your ability to keep your body positioned over your base of support.  Good balance requires the teamwork of three different systems: our vision, our sensation, and our vestibular system.

Vision

The first is the most obvious, our vision. Our vision provides us feedback about where we are in space. Our focus, depth perception, and ability to interpret our position in relation to other objects are all instrumental to maintaining our balance. 

Blurred vision, vision loss, dizziness, or vertigo – the sensation that the room is spinning – are all conditions that can affect our vision and our ability to maintain our balance.

Sensation

Throughout our body, we have sensory cells and receptors that contribute to our proprioceptive and kinesthesic sense. These complex systems allow us to move effectively in space.

Buzz Word…

What is Proprioception? What is Kinesthesia?

Proprioception is the ability of a joint or limb to determine its posture and position. Kinesthesia is our awareness of movement. These systems largely operate in the background of our brains, with little notice on our part. Both proprioception and kinesthesia, sometimes known as our “sixth sense,” allow us to maintain our balance during every single activity that we do during the day!

Vestibular System

The vestibular system in our inner ear is made up of fluid-filled canals and chambers that are lined with hair and other specialized cells that tell our brain how our head is moving and detects the direction of gravity.

All three of these systems work together harmoniously to help us stay balanced and help us move in a coordinated manner. Any compromise to one of these systems will inherently cause changes in our ability to maintain our balance. 

We need balance to carry out even the most basic daily activities (walking, climbing stairs, bending over to pick up something off the floor, getting in and out of car, etc.), so poor balance can affect your ability to maintain independence in older age.

What is Balance?

There are two modes of balance – static and dynamic. Both are important for our daily function. Static balance is our ability to hold our body steady in one position.  Rufus here demonstrates exceptional static balance!

Dynamic balance is our body’s ability to maintain our balance while our body is moving.  Typically, dynamic balance activities are more challenging for our body than static balance activities. It is easier to hold a stationary standing position than it is to bend over and pick something off the floor while standing. Thus, most falls and/or balance-related injuries occur during changes of position or with movement. Keeping this in mind, we can begin to piece together a plan to address balance problems.

Why Does Our Balance Worsen With Age?

There are a few reasons why our balance may worse with age.

  • Muscle Mass Loss
    As we age, we experience a natural loss of muscle mass and muscle size. The resultant muscle weakness, particular in the lower body, can make it challenging to maintain stability.
  • Loss of Flexibility
    Joints, muscle, and tendons tend to become less flexible as we grow older, affecting our range of motion and how much we can move and adapt our position.
  • Decreased Proprioception
    As we age, we experience a natural decrease in the number of sensory receptors we have. A decrease in proprioception means the body is less aware of its position and how our movement is affecting our balance, increasing the risk of tripping and/or falls.
  • Slowed Reflexes
    There tends to be a natural slowing of nerve function as we grow older so our body is slower to respond, making it more difficult for us to recover our balance.
  • Compromised Vestibular System
    A decrease in the number of nerve cells in the vestibular system combined with decreased blood flow to the inner ear as we grow older, affects the input and output signals our body uses to keep us balanced. Other medical conditions, damage, or injury to the vestibular system – such as Benign Paroxysmal Position Vertigo (BPPV) – can also cause dizziness and balance problems.
  • Impaired Vision
    Aging can lead to vision loss or deterioration, which can reduce our depth perception and cause difficulties in low-light conditions or with changes in light levels.
  • Disease and/or Injury
    There are certain diseases and/or injuries that can also affect our body’s ability to maintain our balance. For example, Type 2 diabetes, which continues to affect more and more people, is one of the most common causes of peripheral neuropathy, or nerve damage, that can result in numbness in the feet and can affect our balance. Some low back injuries can also cause nerve damage and/or radiculopathy, resulting in numbness or weakness in legs and feet.

How to Test Your Balance

If you want to test your balance, try these balance tests. Please be sure to do these near a sturdy object such as a chair, countertop, wall, or doorframe – something you can grab onto if you need to.

Feet Together (Romberg)

Tandem

One Foot

  1. 18-39 years-old: 43 seconds
  2. 40-49 years-old: 40 seconds
  3. 50-59 years-old: 37 seconds
  4. 60-69 years-old: 26.9 seconds
  5. 70-79 years-old: 18.3 seconds
  6. 80-99 years-old: 5.6 seconds

The Balance Myth: “I’ve Always Had Bad Balance.”

We’ve all heard someone say this before. Or perhaps, you have even caught yourself saying this.

Some people believe they simply were not born with the gift of balance. 

But did you know that balance is not something that you inherently have or don’t have? Balance is a skill. That means it’s something you can improve! But to do that, you must practice and actively work on it. Numerous studies show that you can improve your balance and decrease your risk for falls with just a little bit of work!

How To Prevent Falls

Physical Examination

Start by making an appointment with your health care provider. To assess your risk and discuss fall prevention strategies, your health care provider may want to talk about your medical conditions, any previous falls, and your medications and/or prescriptions.

Shoewear

Take a look at your shoe wear. Shoes with a higher heel, slippers, and shoes with slick soles are more likely to cause you to slip, stumble and fall. And walking around in your socks isn’t much better. Instead, wear properly fitting, sturdy, flat shoes with nonslip soles.

Fall Hazards

Take a look around your home for potential fall hazards. Consider making the following changes to make your home safer:

Light Conditions

Keep your home brightly lit to avoid tripping on objects. Nightlights in the bedroom, bathroom, and hallways are a great option for people that may have to get up in the middle of the night for the late-night potty break. And always turn on the lights before going up or down the stairs.

Assistive Device

Your health care provider might recommend using a cane or walker to keep you steady. Other assistive devices can help around the home too, such as grab bars in the shower, a raised toilet seat, or a shower chair, if necessary.

Stay Active!

Probably the best and most effective means of preventing falls is to stay physically active! Physical activity can go a long way toward fall prevention.

Workouts to Improve Balance

As we mentioned previously, one of the best ways to improve your balance is through exercise. There are several different types of workouts that seniors can do to improve their balance. Consider any of the following workouts for balance and stability:

Resistance Training

Resistance training and weightlifting are both incredibly helpful for minimizing age-related changes that may contribute to balance problems and/or falls in seniors.

The Beyond The Gym Difference

At Beyond The Gym, we are experts in managing injuries! Our goal is to bridge the gap between medical recovery and fitness in the Tulsa Midtown area. At Beyond the Gym there is a seamless transition from being a patient to independence in the gym. 

We get it. You just spent all that time working to get rid of your pain – the last thing you want to do is risk hurting yourself again. But you still want to get back to your life. You want to be healthier. 

Well, we work closely with our team of physical therapists to help you maximize your recovery after an injury! Our services and practices are designed to help individuals recover from past injuries and prevent any future issues caused by incorrect forms, stretches, or exercises.  If you are recovering from an injury or have certain health conditions that you are concerned about when it comes to starting a new workout program, we would love the opportunity to help you! Please contact us here.

Balance Training

Doing specific exercises to improve your balance and stability just makes sense when it comes to improving your balance. You will want to be sure your balance training program includes both static and dynamic balance exercises to make a well-rounded balance training program.

Beyond Physical Therapy

If your balance is especially impacted by certain health conditions or if you avoid physical activity because you're afraid you might fall, consider talking to your healthcare provider. Your provider may refer you to a physical therapist. A physical therapist can create a custom medical balance exercise program for you. 

At Beyond the Gym, we partner with Beyond Physical Therapy to offer comprehensive balance and vestibular training for patients with medical conditions that may affect their balance. Our team of highly skilled and dedicated Doctors of Physical Therapy (DPTs) will work with you on a variety of different goals to improve your confidence traversing different terrains, performing different daily tasks, and reducing any dizziness symptoms. Please contact us here for additional information.

Dance

Those that want a “fun” way to improve their balance might consider a dance class or dance lessons. Multiple studies have shown the effectiveness of dancing as a form of balance and coordination training. Dancing lowers the risk of falls by improving balance, coordination, lower body strength, and mobility.

Yoga

Yoga strengthens and stretches tight muscles while challenging your static and dynamic balance in positions you don’t normally do during the day.

Tai Chi

Tai chi involves gradual shifts of weight from one foot to the other, combined with trunk rotation and limb movement in different positions, offering a fun and functional workout for balance.

Balance Training Benefits

Balance training exercises can help older adults:

Balance Training Exercises

There is a myriad of exercises you could do to improve balance and stability. How do you know which ones are best? The best exercise(s) for you are ones that are challenging, but that you can still complete safely and with good form and technique. Balance exercises can range from very basic to nearly impossible. Please, rest assured, you don’t have to go crazy! We are not expecting you to be a trapeze artist!

Again, we recommend you include a variety of both static and dynamic balance exercises to make a well-rounded program.

Static Balance Exercices

Feet Together (Romberg)

Stand with your feet close together, with your ankles touching, and arms folded across your chest. Try and hold your balance in this position as best you can.

Semi-Tandem

Stand with one foot slightly in front of the other. Try and hold your balance in this position as best you can.

Tandem

Stand with one foot directly in front of the other, with the heel of the front foot touching the toe of the back foot. Try and hold your balance in this position as best you can.

One Foot

Stand on one foot by lifting the other foot off the floor. Try and hold your balance in this position as best you can. Do not let the lifted leg touch the standing leg – that’s cheating! Try not to use your hands to help.

Progressions

To progress any of these exercises individually, you could perform them: 

Dynamic Balance Exercises

Front/Back Weightshifting

Standing with your feet shoulder width apart, slowly shift your weight from the ball of your foot to the heel of your foot. Rock back and forth in a controlled manner. Try not to bend at the hips if you can. Shifting your weight to the heel while maintaining your balance is usually the hardest for most people.

Calf Raises

Standing with your feet shoulder width apart, lift your heels up off the ground, standing on the ball of your foot. Slowly lower your heel back down to the ground.

Standing Marching

Slowly lift on knee up high while standing on one leg. If you can, pause and hold for a second or two at the top for an additional challenge. Slowly lower your knee and foot back down. Repeat on the other side.

Heel-Toe Walk

Walking in a straight line, over-emphasize landing on your heel with each step you take. As you shift your weight onto your front leg, really push up onto the ball/toe of your foot. As we age, we tend to land more flat-footed so this exercise will ensure that you maintain strength in the muscles of your lower leg, ankle, and foot.

Tandem Walk

Walk in a straight line so that each time you take a step, the heel of your front leg touches the toes of the back leg, like you’re walking on a balance beam or a tight rope.

Grapevine/Braiding

Starting with your feet shoulder width apart, cross your trail leg it in front of the lead leg. Then, uncross your legs, returning to a normal stance. Repeat again, crossing your trail leg behind the lead leg this time. Then, uncross. Repeat, alternating moving in front and behind the lead leg.

Forward Lunge Walk

While walking, lower your back knee down towards the floor by bending your front knee. Your back knee should come close to, but not hit, the floor. Then, return to standing. Repeat on the other side, moving forward with each step.

Advanced Exercises

  • Design a program with the exercises, weights, sets, and reps to meet your needs and goals
    Exercise selection, resistance, and sets/reps/volume are the nuts and bolts of a workout. Your personal trainer will set up a program specifically designed to meet your needs and goals.
  • Reverse Lunge to High Knee
    Stand on one leg and reach the other leg backward as you bend your knee. When returning to an upright position, straighten your stance side knee and lift your other knee up to 90deg or higher, so that your knee is the same height as your hip.
  • Single-Leg Romanian Deadlift
    Stand on one leg and begin to hinge at the hips while you maintain a neutral spine. The first movement should be moving your buttocks and hips back, as if someone were pulling you backwards. Your back leg will lift behind you as your trunk leans forward. It is important to make sure you don’t hyperextend or round your back when you do this one! Once you feel a stretch in your hamstrings, drive your hips forward and shoulders back to return to the starting position. Please Note: This is an advanced level exercise and needs to be performed correctly to minimize risk of injury.

Equipment

For those that want an additional challenge or more variety, there is additional balance training equipment available for purchase that can provide an additional challenge to your balance. The idea is to change the surface or terrain to make the exercises just a bit harder to do. 

Please note that these pieces of equipment should be used with caution and only when physically appropriate. Measures should be taken to minimize the risk of fall or injury.

Safety Considerations

While we are ecstatic that you want to improve your balance, balance training must be done carefully. Safety comes first! If you want to try these exercises, please be sure you have something nearby to stabilize you, like a chair, countertop, doorframe, or wall. Take breaks if necessary and don’t do anything that would be unsafe or outside your capabilities. If you have any concerns about starting a balance training program or your experience pain doing any of these exercises, please consult your healthcare provider. And if you want more information or guidance in balance training, our personal training experts at Beyond The Gym are ready and willing to help!

Conclusion

Author

  • Emily Berberich, PT, DPT, SCS, ATC, CSCS

    Emily Berberich, PT, DPT, SCS, ATC, CSCS is an orthopedic and sports medicine physical therapist. She earned her Bachelor of Science in Athletic Training and a Doctorate of Physical Therapy from Marquette University. As an ABPTS Board-Certified Sports Clinical Specialist, she strives to incorporate sports science, biomechanics, and strength and conditioning principles into rehabilitation to bridge the gap between recovery and performance. She also has additional certifications in nutrition and sleep, stress, and recovery management that she uses to provide an exceptional patient experience, facilitate comprehensive functional health & wellness, and help her patients and athletes perform at their best! Emily's goal is to return her patients to their sport better than they were before!

    View all posts

Author

  • Emily Berberich, PT, DPT, SCS, ATC, CSCS

    Emily Berberich, PT, DPT, SCS, ATC, CSCS is an orthopedic and sports medicine physical therapist. She earned her Bachelor of Science in Athletic Training and a Doctorate of Physical Therapy from Marquette University. As an ABPTS Board-Certified Sports Clinical Specialist, she strives to incorporate sports science, biomechanics, and strength and conditioning principles into rehabilitation to bridge the gap between recovery and performance. She also has additional certifications in nutrition and sleep, stress, and recovery management that she uses to provide an exceptional patient experience, facilitate comprehensive functional health & wellness, and help her patients and athletes perform at their best! Emily's goal is to return her patients to their sport better than they were before!

    View all posts
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