Balance and Stability Training, an Overview

Balance and stability are interrelated qualities that make us more confident and relaxed during movement and also keep us from falling.

Falls are the leading cause of unintentional injury and occur three times as often in adults over 65 versus adults aged 55 to 64.  In the over 65 population falls result in 32,000 deaths annually.  95% of hip fractures are caused by falling.

Falls and disequilibrium might seem like a normal part of aging because they are so common, but are they really?

As with many other elements of physical function, balance and stability are qualities that can be enhanced with training.  Human beings become more dissimilar with age because of the accumulation of lifestyle factors and health challenges.  Some older adults remain quite nimble while others do not.

Balance and stability training can begin at any age.  According to research balance declines seem to become consistently measurable at about 50 years of age.

But having good balance and stability or not having it is due to many areas of function.

I’ll break it down into its components and offer an example for training each one.

Balance

Balance is the act of maintaining your center of mass inside your base of support.

There are three systems that help us do that.

1. The vestibular system (the inner ear).
2. Vision.
3. The somatosensory system, specifically the sensory nerves on the bottoms of the feet and around the ankles.

Each of these systems can be trained as you would any other physical quality–through specific, progressively difficult challenges. For instance, you can train your vestibular system by balancing on a foam pad with your eyes closed.  This removes the help of your vision and muffles the sensations from your feet and forces you to find your balance with only your inner ear.

You can massage the bottoms of your feet to help build sensory pathways.

You can try to walk a straight line while turning your head from side to side like a metronome with each step.

There are some good books that provide ideas for training the systems of balance.  Let me know if you want a recommendation.

Stability

Have you ever noticed someone walking with short steps while their shoulders sway from one side to the other?  That’s a sign of poor torso stabilization.  It’s a strength issue.  It might have originated from pain or injury, or just progressive deconditioning from an absence of stimulus, but now it’s a strength issue.  To correct it one would strength train the muscles of torso stabilization.

There are a lot of great exercises for training this.  My short list includes the side plank (a side flexion exercise) and the Pallof press (an anti rotation exercise).  Rather than describe them, just cut and paste the name of the exercise into a new window on the computer and watch the first video that comes up.  Bird dog, a single leg glute bridge and the Turkish sit up are also great strengtheners for torso stability.  The right one for you would depend on where you’re starting from.

Another element of stability is lower body strength, including all the joints of the leg and the hip.  Single leg exercises like split squats and slow step ups are great for training this area.

Stumble Recovery

At some point something will make us stumble.  Much of the time we catch ourselves and move on.  But the ability to catch yourself is also a trainable area of physical function.  Partly it’s about training your strategy.  Rather than reaching to catch yourself which often results in injury, train yourself to take a step.

But the ability to take a quick step comes from power training, that is, training your body to activate muscles rapidly and generate enough force to move a given mass quickly–or, strength + speed.

You can work on this both of two ways.  Quick stepping in agility drills, like the grapevine (or any kind of dancing).  Or lower body power training, like box jumps, jump squats or jump lunges (notice they all have the word jump in them:).

In summary, balance and stability training can be valuable at any age.  The degree to which we experience decline will vary from person to person.  We can regain the ability through training.

You can do a quick diagnostic to get an idea of which of the above areas might need the most focused training by attempting the following:

• Quick stepping
• Squat jumps or a 30 second sit to stand.
• A bird dog or other torso stabilizing challenge.
• Standing with eyes closed on an unstable surface.
• Walking with quick head turns.
• Walking heel-toe in a straight line.

Please don’t hurt yourself in the attempt.

If you’re into hiking you can check out this balance article I wrote, with video links to exercises, for the Washington Trails Association.  Hiking requires a lot of stability and the article is a good example of how this type of fitness training applies to activity.