Monthly Archives: February 2012

These are progressively difficult exercises that I am using to improve my balance. I practice several times a day for up to 30 seconds each time. The goal of the exercises is to improve my overall body proprioception and balance, as well as strength in my legs. Balancing will also improve core body strength.

The exercises increase in difficulty as balance improves. The levels are my interpretation of progressively difficult exercises based on my research. Hold onto something if necessary to maintain balance. I have used holding onto a chair, touching a wall, holding onto a low hanging tree branch, touching my foot on a step, and holding a broom handle.

Level 1: Stand with weight on both feet with eyes open on even flat surface.

Can you stand without wavering with your feet apart? With your feet close together? With one foot placed directly in front of the other foot?

– Try shifting your weight back and forth by leaning forwards, backwards and side to side and again find your center balance.

– Sway your body from your ankles.

– Next try with your eyes closed.

Level 2A: Stand on both feet with eyes open on even flat surface, then lift one foot up.

Can you stand for up to 30 seconds without wavering? If difficult, then just barely lift the foot up and feel the ground with tip of your toe.

– Try lifting the foot higher. I found that touching my toe lightly to a small step or against a wall helped because gave me more proprioception clues.

– As becomes easier, then hold the foot to the front, out to side, and behind.

– Next try with your eyes closed.

Level 2B: Moving exercises with eyes open on even flat surface

– Walk a line with one foot placed in front of the other forwards and backwards.

– Walk with legs crossing over to move sideways.

– Hop up and down on both legs about an inch or two high.

– Next try with your eyes closed.

* Please read my disclaimer.

Increasing rider confidence

I used to have good balance, but discovered a couple of months ago that I was rather unstable trying to stand on one leg. I was even unstable standing on two legs with my eyes closed. Balancing is more difficult on my right leg. My right knee was hurt this past summer. I had not noticed how much stiffer and weak my right leg had become compared to my left leg. The poor balance is surely a factor in my lower confidence level for riding my horse.

I have been practicing balancing several times a day. It is easy to find times to put in a bit of practice on balancing, such as waiting in line at a store or standing at the sink brushing my teeth. The goal of the exercises is to improve my overall body proprioception and balance, as well as strength in my legs. Balancing also will increase core body strength.

Gently holding onto a low overhanging branch of a small tree gave me a 3-D dynamic aid with balancing, which was more helpful in improving my balance than just holding onto a chair or touching a wall. I also discovered that lightly touching my foot to something helped with practicing with my eyes closed because the contact gave me proprioceptive clues. I have also been using a balance ball.

In my next blog entries I will share balance exercises that I have found through researching. These are progressively difficult exercises for me. I have used these exercises to improve my balance. About one month into my practice my balance made a jump in improvement, as if my body started to remember how to balance again. The exercises are also improving my right knee stability. In addition to the balancing exercises I am continuing to work on my yoga stretching. There has been improvement in stretch of nearly an inch in my Hero Pose position. My right leg is still tighter than my left leg.

I welcome you to join with me in improving balance. Make sure to have fun while you practice balancing!

Our balance depends on three main sensory areas: the vestibular system, the proprioceptive system, and the visual system.

With age, and with certain neurologic conditions, one or more of these areas can become compromised. People can often compensate when one of them is damaged. But when two or more are impaired, people can be at a greatly increased risk of falling.

David J. Thurman M.D., M.P.H

I didn’t feel particularly unstable riding in my saddle on Twistur at a walk, but I had my eyes open and wasn’t standing on one leg.

Strength and flexibility

My difficulty balancing on one leg is partly due to my leg and foot strength being unable to hold me when I start to tip. I watched a yoga instructor doing the one leg pose of Warrior III. Her foot and body muscles were working on small corrections to maintain her balance.

An important component of maintaining good balance is strength and coordination in the lower extremities. This frequently declines as we get older. As a result, our ability to react quickly to a change in posture is diminished.

David J. Thurman, M.D., M.P.H is an author of guidelines on recognizing fall risk for the American Academy of Neurology (AAN).

Vision

Balance can improve by consciously adjusting the body’s position based on vision. Closing the eyes removes this method of balancing.

Proprioception

Proprioception is the ability to identify the body’s position in space through special sensory stimuli. The sobriety test of closing the eyes and touching the nose is a test of proprioception. Where is your hand? Where is your nose? There are special sensors in the joints, muscles, and tendons that detect changes in your body’s movement and position. There are reflexes that compensate by responding to pressure on the joints and muscles to maintain posture. A person standing upright begins to lean to one side and the muscles reflexively contract to maintain balance.

Vestibular function

Vestibular balance comes from the inner ear that can detect body positional tilt and movement. Your vestibular system works together with your eyes in the vestibulo-ocular reflex to help keep images properly centered on your retina. When the head turns one way, then the eyes turn the other way to hold the image steady. The vestibular system can affect posture via a reflexive pathway. For instance a perceived forward motion causes a sway forward to maintain the support base. Various medications and high blood pressure can cause damage to the inner ear. Age is the biggest risk factor for vestibular disorders. Sometimes the body gets improper signals. Vertigo results from a mismatch of vestibular, ocular, and proprioceptive inputs.

The body needs input from the eyes, the feet, and ears (including the vestibular system) to stay upright. All of these systems decline during the natural course of aging, which can lead to balance problems.

Yuri Agrawal, M.D., an otolaryngologist at Johns Hopkins Medicine

There are several different balance tests. I wish there was a test to help me determine my likelihood of falling off my horse. I don’t want to take the test of “Horse sees scary monster, spins and takes off test”. That probably would be a test that I’d fail.

What I need to improve

One thing I do know is that I need to keep my eyes open! I rely strongly on my visual system for my balance. Closing my eyes makes me much more unstable standing on one leg, but I can walk down a dark hallway at night without much difficulty. I can tell when I am starting to tip over and where my body parts are located. With practice I can improve strength in my feet, ankles and core muscles that should help with standing on one leg and also general balance.

The preponderance of evidence shows fairly convincingly that strength and balance training can reduce the rate of falls by up to about 50 percent.

Dr. Thurman

How to get better balance?

There are many different exercises to work on the various methods the body uses to balance. This is good news for improving balance for riding too. Improvements in balance progresses in increments and may take as long as 3 months to notice a change. Professor Tracey Howe, of Glasgow Caledonian University whose findings are published in The Cochrane Library says to improve balance you should exercise at least 3 times a week and “combine activities, such as carrying things while walking or dancing which involves using various parts of the body.”

References:
(1) Neurology Now (American Academy of Neurology) April/May 2011 Volume 7(2) p 32–33 by Shaw, Gina

(2): From “The New York Times” article “Staying on Balance, With the Help of Exercises” by John Hanc Published: 09/15/2010

Tests:
Romberg Test, Clinical Balance Function Test, Berg Balance Test, Tinetti, Fullerton Advanced, Spring Scale, Y Balance Test.