0Do you have difficulty putting on your pants or underwear while standing, or feel anxious walking on uneven surfaces? Are you dependent on handrails when climbing stairs? Have you tested your standing balance? .

Reports have shown that falls are the leading cause of injury-related death for Americans over 65 and that more than 2.4 million people over 65 were treated in emergency rooms for injuries from falls in 2012. This represented an increase of 50 percent over the previous decade. Now might be the ideal time for all of us to implement a balance program to impact the decline of balance with aging and keep from adding to the statistics.

There are many factors that can contribute to issues with balance, and it is important to see a physician if you experience symptoms like dizziness, light-headedness, a sudden loss of strength, or have experienced illness or injury.  All of these can jeopardize balance. For many, however, a lack of focus on core strength, as well as maintaining – if not improving – standing balance, are the primary factors in play. And, the decline begins earlier than you may think.

Inadequate standing balance, – particularly as we age – can be due in part to a loss of muscle strength and endurance, increased visual impairment or even as a side effect of the interactions of multiple medications. Though hazard-proofing the home minimizes risk, the best defense is to also incorporate balance training into your daily routine – no matter your age. Even those who avoid exercise can find time to practice.

There are opportunities to work on balance throughout the day that don’t require even one extra minute of your time. Try practicing while waiting for, or riding in, an elevator, when brushing your teeth or while watching TV.  Though the higher level exercises may require equipment or a partner, so many others can be done at home and without any assistance or apparatus.

There are an almost unlimited number of ways to enhance standing balance. The important thing is to begin at a level that presents a degree of challenge yet is safe and pain-free. For many, that will mean skipping the lowest level exercises. Advance your program as you improve and gain confidence.

THE PROGRAM

Below is a menu of balance exercises that begins with simple activities and progresses from there. In all cases, be attentive to your posture, avoid looking at your feet and keep the weight-bearing knee(s) unlocked. This means that if your knees can hyperextend, maintain a slight bend or neutral alignment.  If your knees are locked out when in a neutral position, maintain them in slight flexion.

FOR BEGINNERS: standing on a stable flat surface in a doorway

NOTE:  The doorframe provides a support on either side should you need to rely on your fingers touching the wall to occasionally steady yourself. After gradually lessening your reliance on the wall, progress to a one-hand–assist – only as needed – at a railing or wall. When you feel more secure, avoid the back-up altogether.

Balancing while on two feet:

1.  If your balance is very impaired, begin your program while standing on two feet – approximately shoulder width apart – while gently touching the doorframe on either side. Gradually lessen your reliance on the wall for support until you are able to stand without using it.

2.  Continue to balance while standing on two feet, placing them closer together, gradually narrowing your base of support.

3.  As you become more comfortable, simply begin to shift your weight, placing more on one foot and then the other until you’ve progressed to using one foot merely as an assist. Alternate between your right and left foot as the primary support.

4.  Stand on two feet – this time with one directly in front of the other. Maintain your balance without weight shifting.

5.  Weight shifting on two feet – one directly in front of the other. Again, alternate between feet as the primary support.

6.  Maintain your stance on one foot with the other in toe-touch weight bearing.  You can do this either with your feet side-by-side or with one in front of the other.

7.  Add reaching in various directions – with both hands moving together across the midline of your body – while balancing on two feet.

BALANCING ON ONE FOOT – ON A STABLE SURFACE

NOTE: You may want to revert to standing in a doorframe when you advance to balancing on one foot to ensure that you progress safely to this next level. Again, begin with your fingers touching the wall and progress away from using this additional support.

For all exercises requiring balancing on one leg, avoid looking at your feet and touching one extremity to the other.

8.  With upright posture, maintain your balance while standing entirely on one foot.

ONE LEGGED STANCE ON A STABLE SURFACE WITH AN ADDED CHALLENGE

9.  Balance on one foot while slowly moving the other leg forward, backward and to the side (keeping the moving knee straight). This will increase the challenges to your standing limb. Perhaps do one or two sets of 10-15 slow leg lifts in each direction (without touching the moving foot to the floor until the end of each set). Or, mix it up.

10. Add a resistive exercise band to your moving leg in exercise #9 (with one end around your ankle and the other secured to a stationary object like the foot of a table). This will further test your balance. The standing limb will be working even harder than the leg pulling on the band. Both will get a workout!

11. Reach – with both hands moving together. The further you reach across the midline and away from your body, the greater the challenge. Reach up to the right, center and left.

12. Add bending while reaching. Reach – again with both hands together – high and low, to the right, straight up and to the left. When you reach low, bend the knee of your standing limb into a mini-squat position (keeping your knee behind the plane of your toes at all times). Mix up the directions so you don’t follow a set pattern – frequently alternating between low and high diagonals for the greatest challenge. If you have shoulder or knee problems, stay within pain-free ranges of motion.

13. Reach while holding a medicine ball. Again, the further from your center that you reach with the added weight, the more difficult the exercise. If you have shoulder problems, avoid the added weight.

14. Add an element of surprise by playing catch while standing on one foot. Throw and catch the ball with two hands. Both you and your partner should have to reach in all directions to catch the ball – make this as challenging as you like by throwing the ball further from the center of the body. You can do a variation of this exercise by yourself by throwing a ball against a wall.

15. Stand on one foot with hands clasped, arms reaching forward, elbows extended. Have your partner lightly push your hands in different directions – at all angles – first very lightly and then more firmly as your balance improves. Try to keep from allowing your arms to move as you balance and withstand this added force. Add even more difficulty by holding a medicine ball in your outstretched arms. Gradually increase the ball weight as able.

BALANCING ON TWO FEET – ON AN UNSTABLE SURFACE

Increase the degree of difficulty of exercises for balance on two feet by performing them on a half foam roll or on a BOSU ball (as below though while standing on both feet).

Other exercises, such as those with weights can also be performed on the half foam roll BOSU.

BALANCING ON ONE FOOT – ON AN UNSTABLE SURFACE

NOTE:  The less stable the surface, the greater the challenge. Here are some options, listed with increasing levels of difficulty. All involve standing on one foot (without the legs touching) and can be advanced by adding reaching alone, standing leg lifts, bending & reaching, mini squats, bounce passing, playing catch or other activities such as weight lifting.

16. Standing on a half foam roll with the flat half on the floor.

17.Standing on a half foam roll with the rounded surface contacting the floor.

18.Standing on a BOSU ball – which is designed for balance training and is shaped like a half ball.

19. Performing traditional exercises while standing on the half foam roll or BOSU.

WANT COMPANY?

20. If you prefer fitness classes, consider taking up Tai Chi, which entails slow movements that require and challenge balance.

Adding exercises focused on improving core strength to your program is also likely to boost your balance. If your lower extremity strength or endurance is lacking, addressing these factors will help as well.

Here’s to good health and fall-free aging!

 


About the author

Abby serves as the Injury Expert for CBS New York where, since 2010, her Injury Breakdown Blog examines injuries in professional sports. She also blogs on health & fitness as well as sports injuries for Huffington Post, and Recovery Physical Therapy.com, where her blog earned a top ten mention for physical therapy blogs in 2012 @ WorldWideLearn.com. In a ranking of the Top 30 Healthcare Blogs for 2012, Top Masters in Healthcare also rated Abby’s blog in the top three in Physical Therapy! Abby is the founder of Fit-Screen and she welcomes your comments and questions!

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