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Balance is such an important factor in health that the human body evolved several distinct systems to keep itself upright in all kinds of shaky situations. When one or another is compromised, the others kick in more efficiently to prevent falls, whether from tripping on uneven ground, slipping on a strategically placed banana peel or being over-confident on your circus-performer friend’s unicycle.

The eyes can help a lot. In fact many people do perfectly well standing on one foot until they try it with closed eyes. However, vision deteriorates with age and so does the eyes’ ability to assist with balance.

The vestibular system is what tells you which end is up and is sensitive to acceleration, rotation, and orientation to gravity

The vestibular system, located in the inner ear, is what tells you which end is up and is sensitive to acceleration, rotation, and orientation to gravity. It is the reason your head tends to right itself when much of your body is not aligned with gravity. However, the vestibular system also can deteriorate with age or through injury or disease.

The proprioceptive sense is one aspect of balance that can be maintained and even improved as we age. Proprioception is the sense of where we are in space and is supported by a variety of receptors located in various parts of the body, in the organs as well as in the musculo-skeletel system and the skin.

You can train your proprioceptors to be more efficient through balance exercises and in so doing, your reflexes will improve along with your general steadiness in unstable situations.

Balance challenges

It’s important to train in a wide variety of balance challenges, both static and dynamic. Here are a few things you can try, progressing from simple to complex:

Warm-up: walk on the edge. Walk about 6-8 yards in one direction, taking turns on each of the four edges of your feet, sensitizing the feet and warming up the muscles of the lower leg. Walk on the inner edges, the outer edges, the heels, and then the balls of your feet. Walk evenly on right and left edges, with controlled steps, and a supple foot. Let your feet feel as sensitive as your hands.

1. Stand near a wall, placing a hand on the wall for support. Lift one leg and balance on one foot, holding steady. Gradually take your hand away from the wall, one finger at a time and see how you do with one fingertip on the wall, barely touching. Eventually, take that last finger off the wall. Don’t discourage the wobbly ankle, that’s your brain receiving messages and working on balance. Repeat other side. Then try the same sequence with the eyes closed. Make it a bit dynamic by bending and straightening the knee of the standing leg.
2. Stand near a wall and place one hand on it for support. Lift up onto tippy-toes and hold for a few seconds and then lower back down. Practice 5-10 reps and then try with just one finger on the wall and eventually with no support. This one also builds strength in the feet and lower leg and will augment proprioception there. Try it with the balls of the feet up on a 4-inch lift so you can dip your heels down and get extra work for your calves. Try it with eyes closed, arms in various positions, etc.
3. Stand beside a sturdy, upright chair back and place one hand on it for support. With the leg furthest from the chair, take a step forward into a lunge, and then push off that same foot and step back into a backwards lunge. Get comfortable with the movement using support and then try without your hand on the chair. You can increase and/or vary the size of the steps. Focus your attention on the soles of the feet hitting the floor to improve your sensitivity. To increase the challenge, move faster and try closing your eyes when you feel ready.
4. Lay a 6-8 foot length of rope straight out on the floor. Stand with feet together on the left side of one end. Pick up your left foot and cross it over the rope, setting it down on the right side just beyond the level of the right toes. Your legs will be crossed with the rope between your feet. Pick up your right foot and bring it around, crossing in front of your left and placing it back on the left side of the rope. Continue crossing your shins with every step. Right foot will always land left of the rope and vice versa. When you become competent at doing this one going forwards, try it backwards. Try not to look at your feet, keep eyes ahead. Don’t forget to breathe!
5. This one gives you the chance to fall and catch yourself without getting hurt, helping to diminish fear of falling. Lie on the floor on your right side, as straight as possible with your right arm stretched up alongside your head. Balance on your side seam and rest your left fingertips in front of you to steady yourself. Come to one fingertip and eventually to balancing on your side seam. (If this is easy, you’re probably not straight enough.) Then practice falling backwards, catching yourself just in time to not end up flat on your back. Practice falling forwards a few times catching yourself with fingertips or strength of your core. For a challenge you can lift your top leg, wave your top arm and leg around, etc. Use your imagination. It doesn’t hurt to fall here, so take some chances and have fun with it.
6. Turn an area about 10×10 feet into an obstacle course by randomly throwing many items onto the floor. Boots, rolled up towels, books, tipped over chairs, your ancient cat, whatever legos may still be haunting the crevices of your home, lidless tupperware, etc. Make it messier than a teenager’s room. (Better yet, have someone else set this up for you so you have no idea where anything is.) Cover or close your eyes and walk around the space (no fair peeking), feeling with your feet, and negotiating the obstacles with control and caution. Feel, step on or over what you encounter. Let your feet experience different textures, levels, etc. Variations are endless here: walk backwards or sideways, try to memorize where certain stuff is and see if you can find it again after walking away, clasp your hands behind your back so you can’t use your arms to balance, etc, etc.

Some practical things you can add to every day life:

Stand on one foot or tippy toes whenever you have a brief wait: at the stove, in line at the store, waiting for the internet to load….put your pants or skirt on leading with the other leg….walk backwards whenever it makes sense, feeling with your feet….stand on just one foot when bending to pick something up off the floor, etc. Be inventive.

With all balance endeavors, remember to progress slowly so that real confidence can build. With less fear and apprehension on board the mind and body work more effortlessly in all movements.

Ann Constantino, submitted on behalf of the SoHum Health’s Outreach department.