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If you’ve ever watched a little one learning to walk, you very clearly see the progression of balance — from those first uncertain stands to a few wobbly steps to an evenly balanced walk across the entire room. We’re not born with the ability to balance: Our brains and bodies learn it. And unfortunately, if we grow too sedentary we unlearn it. There are definite correlations between poor balance and increased age and between good balance and an active lifestyle. The age factor, of course, you can’t do anything about. But you do have control over your activity level. In fact, a very active older person can have better balance ability than a younger person who leads a sedentary lifestyle.
Balance: A Sensory Experience
First, there are a couple of balance factors that aren’t related to strength: poor vision and inner ear issues. “You can’t train these things away,” says Heather Nettle, MA, coordinator of exercise physiology services for the Cleveland Clinic Sports Health and Orthopaedic Rehabilitation Center. We often don’t realize just how key vision is to good balance — until we close our eyes and try to balance! As you move through the world (or even stand in place), your eyes are continually finding points of reference, which provide your brain with info that helps keep you balanced. But once you close your eyes (or if your vision is very impaired), you have to rely on your muscle sensors alone, Nettle says. So if you are having vision issues, such as cataracts or severely diminished vision, the first step toward building better balance is to pay a visit to your eye doctor.
While the connection between vision and balance may seem fairly obvious, you might be surprised to learn that your ears play a role as well. The inner ear contains receptors that sense motion and orientation. When you have issues such as vertigo or fluid imbalances, or use cochlear implants, your balance is thrown off because the receptors in the inner ear can’t function properly. “Those with vertigo can benefit from vestibular rehab. With this therapy, the receptors can be reset, which will reduce the effects of vertigo, and individuals can experience full recovery with time,” says Jason Ebbing, PT, a physical therapist based in Cleveland. If you’re struggling with balance due to such issues, it’s a good idea to work on making your home as fall-proof as possible, with safety rails in your bathroom, banisters on all steps, nonslip rugs and clear paths through your home, without furniture sticking out into walkways.
Fast Track to Good Balance: Fast-Twitch Muscles
This scenario probably sounds familiar: You’re walking along, focused on something else instead of the ground in front of you, when suddenly you step off an uneven surface. Before you know it, you’re off balance and headed for splat city on the sidewalk. “If you trip, you have less than one second to catch yourself,” Nettle says. “It’s not a conscious decision. Your body just has to act.”
Ultimately, it’s your fast-twitch muscle fibers that will keep you standing. Skeletal, or voluntary muscles — the ones you more or less think about using, as opposed to involuntary ones, which line our organs and operate without conscious control — are made of two types of muscle fibers: slow-twitch fibers, the kind you use for sustained aerobic activity; and fast-twitch fibers, which are responsible for short bursts of speed and quick movements, like getting up out of a chair, climbing steps — or righting yourself after tripping over the hockey stick someone left in the hallway. This doesn’t mean you need to do sprints to build your balance (although interval training — in which you vary the pace of your workout between short high-intensity bursts and longer lower-intensity periods — does benefit fast-twitch muscle development). Rather, you need to challenge those fast-twitch fibers with activities that closely resemble things you do every day, like twisting, reaching, walking, balancing on uneven surfaces and even hopping.
Here are a few ways to incorporate balance training into your daily life and workout routine.
Use balance exercises to warm up for things like walking, running or biking. After establishing your balance on one foot (just holding still is a good first step), try raising and lowering your body on one leg, keeping your torso erect while flexing at the knee and hip. As you get more confident, add reps/sets, go lower or move your free leg into different positions.
One-leg balances make good stretches for post-workout as well. For example, try holding the classic runner’s quadriceps stretch (bend one leg behind you, aiming your foot at your buttocks, and hold your ankle with your hand. Be careful to keep your knees aligned) for 30 seconds on each leg, without relying on a chair or wall for support.
This dynamic balance exercise is great with a tennis racket or golf club in hand: Stand on one leg, holding the club or racket in the opposite hand; quickly shift your weight onto the other foot as you switch hands; stabilize and hold. Make it more difficult by hopping, adding pivots, swinging the racket or shifting focus.
At home, stand on one leg while doing dishes, brushing your teeth, fixing your hair or cooking. Once you get confident, you can also make it more difficult by trying to balance on an unstable surface, like a soft pillow.
It’s no coincidence that core training and balance training are often grouped together under one umbrella. A strong core — which consists of your abdominal, back and pelvic muscles — can function like an insurance policy against balance-related injuries. “When your core is strong, then your protective stabilizing muscles kick in and protect you,” explains Dallas-based Pilates expert Karon Karter, author of Balance Training: Stability Workouts for Core Strength and a Sculpted Body. Here’s a way to think of it: Have you ever been sitting in the passenger seat of a car or a bus when the vehicle suddenly takes a sharp turn that you’re not anticipating? Think about the muscles you use to stabilize yourself so that you don’t go flopping into the seat next to you, like your stomach and pelvis.
Balancing while standing is similar. Your core muscles and your fast-twitch muscles work as a package to pull your body back into line and out of danger. For pure core training, activities like Pilates and yoga are excellent: Pilates gives you a series of strength-based exercises that target your core, and many yoga poses force you to draw on core muscles to hold them. But you can also call upon those core muscles as you’re doing balance exercises, Karter explains. “You have to learn to tap into your core. I tell students to imagine their belly button piercing their spine when they’re doing something like standing on one leg,” she says. Another way to quickly locate your core muscles: Do a quick cough and notice how the muscles in your stomach tighten. By keeping that tight feeling in your abs when you move, you’re activating and strengthening your core. You can work your core throughout the day by simply holding it tight, especially when you’re walking.
Studies have shown that taking this holistic view of balance training — changing up your exercise routine to challenge both strength and balance and pairing it with core training and a smart nutrition plan — is probably the most effective route. A 2007 review by Victoria University in Melbourne, Australia, looked at all the recent studies that used balance training to reduce sports injuries and concluded that programs that combine balance training with other activities are more likely to prevent injuries than balance training alone.
Tai Chi: Go With the Flow
There is some evidence to suggest that older adults at risk for falls can benefit from practicing tai chi, a Chinese martial art that involves moving your body slowly and gently, in a meditative, purposeful way. “Tai chi forces you to move on and off of one foot from different positions,” says Lynn Millar, PT, PhD, FACSM, professor of physical therapy at Andrews University in Berrien Springs, Michigan; this foot switching is similar to what happens in daily life. Even though the moves are slow, you are working those fast-twitch muscles because you are forced to constantly change your center of gravity. There is an emphasis on control and being able to shift in all directions; there are moves that have you standing on one foot temporarily, and even making a 180-degree turn. “All of this will help with strength, balance and proprioception [the brain-body connection tied to balance],” Dr. Millar says. Additionally, tai chi trains you to focus and to be aware of surroundings and your body. Since we sometimes trip simply because we aren’t paying attention, this improved awareness can help decrease falls.
If you’re interested in taking a tai chi class, investigate the studios near you. Keep in mind that tai chi instructors don’t have to be licensed (though studios may have their own requirements) and there is no government regulation. Ideally, tai chi instructors study with a master teacher and receive a certificate of approval, but there is no standard. Talk with any potential instructor about their background and training before signing up.
Do this quick balance exercise: Start by holding on to a sturdy chair or a wall. Stand with your knees slightly bent and your eyes open. Slowly lift one leg. If you feel comfortable, let go of the chair and see how long you can hold the pose without counterbalancing with your arms. Aim for a minimum of 30 seconds, and try to hold longer each time. Once you’re comfortable with that, try the same thing — but close your eyes!
By Judi Ketteler