The second leading cause of falls in the elderly population is a fear of falling. Among the general population, we psych ourselves, react badly, become easily distracted or, simply just accidentally fall. The leading cause of falls among the elderly is medication, and among the general population, well, certainly we fall when under the influence of substances that alter our sensorium. True disorders of balance are rare. Balance may be defined as a state of bodily equilibrium; to bring to or hold in equilibrium; or to arrange, adjust, or proportion the parts of symmetrically.
Increasingly these days people report more problems with balance, or are being told by physical therapists and exercise trainers that they have problems with balance. We interpret this to mean that we are having some neurologic disturbance, assume that as we age we lose dexterity and agility and for some minority of us, this is true. But for most of us, consider another possibility. Independent of age, related solely to conscious choice, most of us perform a limited number of similar actions daily, using the same motions, the same muscle groups repeatedly. We bend forward often, but backwards rarely. We lift loads upwards, but hardly press loads downwards. We practice moving our joints and muscles in only a fraction of their intended motions functionally. Over time, we develop an “imbalance” in strength and in flexibility. We are more practiced in moving forward than backwards, moving to the right than to the left (for the majority of us), climbing up versus descending downward and when we move in the more practiced directions we feel more surefooted.
This is in part neurologic but it is also strength, agility and cognitive feedback together contributing to a more complex motor planning.
In the absence of a true neurologic disorder, the most effective plans to improve our balance involve restoring normal mobility across the major joints and balancing the strength of the major muscles that pull across the joints. Performing exercises that use muscles in a functional capacity allows the muscles to be trained as well as strengthened. Muscle and nerve fibers have the capacity to “learn” and “remember” and we should capitalize on this concept. If one just walks for exercise, than all one is training for is walking. By adding some impact activity, by shifting direction, changing pace or plane in space, one trains the muscles, joints and proprioceptive neurons to remember that they all really do know how to do all those things.
Increasingly these days people report more problems with balance, or are being told by physical therapists and exercise trainers that they have problems with balance. We interpret this to mean that we are having some neurologic disturbance, assume that as we age we lose dexterity and agility and for some minority of us, this is true. But for most of us, consider another possibility. Independent of age, related solely to conscious choice, most of us perform a limited number of similar actions daily, using the same motions, the same muscle groups repeatedly. We bend forward often, but backwards rarely. We lift loads upwards, but hardly press loads downwards. We practice moving our joints and muscles in only a fraction of their intended motions functionally. Over time, we develop an “imbalance” in strength and in flexibility. We are more practiced in moving forward than backwards, moving to the right than to the left (for the majority of us), climbing up versus descending downward and when we move in the more practiced directions we feel more surefooted.
This is in part neurologic but it is also strength, agility and cognitive feedback together contributing to a more complex motor planning.
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| Add impact activities like skipping |
In the absence of a true neurologic disorder, the most effective plans to improve our balance involve restoring normal mobility across the major joints and balancing the strength of the major muscles that pull across the joints. Performing exercises that use muscles in a functional capacity allows the muscles to be trained as well as strengthened. Muscle and nerve fibers have the capacity to “learn” and “remember” and we should capitalize on this concept. If one just walks for exercise, than all one is training for is walking. By adding some impact activity, by shifting direction, changing pace or plane in space, one trains the muscles, joints and proprioceptive neurons to remember that they all really do know how to do all those things.
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| Move against resistance in varied planes |
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