Age-Defying Fitness: Improving Your Balance

Summarized by Robert W. Griffith, MD
May 3, 2007

Marilyn Moffat and Carole Lewis are physical therapists who have been in private practice for a number of years. They have both published and lectured extensively, and have written "Age-Defying Fitness" based on their experience with their aging patients. Their aim is to inspire and motivate readers to do something good and long-lasting for themselves: exercise. We are pleased to post several extracts from their book. Here is the third. Robert Griffith, Editor.

Balance

"I smoke cigars because at my age if I don't have something to hold onto, I might fall down." George Burns

Many of us are looking for balance in our lives. Balance - in both the social and physical sense of the word - is indispen¬sable to healthy living, particularly as people live longer. In the United States, the segment of the population that has experienced the largest growth is composed of people 100 years or older. If we are going to live both long and well, a good sense of balance is essential.

Research shows that one-third of people over the age of 65 fall at least once each year, and these falls can have devastating consequences. But bruises and broken bones are not the only unfortunate results from a loss of balance. People prone to falling must limit their activities; many of them experience unhappiness, anxiety, loss of independence, and even life-threatening complications.

Ruby, a 67-year-old grandmother, greatly feared falling. Many of her friends had fallen and broken bones or ended up using walkers. Because she was so afraid of losing her balance, she was becoming less and less active and now passed up most invitations to go out.

Falls often lead to a vicious cycle: a fall results in decreased activity, which reduces stability, increasing the chance of falling again. Studies show that if you take care of yourself by improving your balance - as well as your posture, strength, flexibility, and endurance - you are much less likely to fall.

Proper Balance

Balance is the ability of your body to maintain equilibrium when you stand, walk, or perform any other daily activity. It is based on input from different body systems and is influenced by many different factors. There are 2 primary types of balance:

Static balance is the ability to maintain a position without moving. It allows you to balance on 1 foot while you pull on your pants, to stand upright for prolonged periods of time, or to reach away from your body in any direction without falling. Many daily tasks require steadiness while reaching forward, backward, to the right, and to the left.

Moving balance is the ability to maintain balanced posture while moving. It allows you to maintain an upright position while you walk or climb curbs, stairs, ramps, or a ladder.

Balance Changes

Many age-related changes may affect balance. Vision problems, including degeneration of the nerves between the brain and eyes, atrophy of eye muscles, cataracts, glaucoma, macular degeneration, and loss of eye lens elasticity, can lead to falls. Hearing problems, resulting from the degeneration of the nerves between the brain and ears, may also decrease balance.

Changes in your brain, including the thickening of its lining, a reduction in its total size, and an increase in fat in its pathways, may result in decreased perception. These changes, particularly in the lower portions of the brain, may lead to problems in coordination and timing of movements.

Reduction in muscle strength may force you to work harder to obtain the same results that you used to achieve with less work. Your reaction time may be delayed, which increases your chance of a fall. Decreased proprioception - your awareness of your postural alignment, movement, and position change - may also affect your sense of balance.

More than the other domains, balance problems can have devastating results, including falls that result in injuries, hospitalizations, and surgeries. With regular training, however, muscles, joint receptors, and other balance mechanisms can continue to perform at increased levels despite advancing age. We recently treated a 67-year-old woman whose balance problems led her to visit many different healthcare professionals for help; eventually she gave up and resigned herself to inactivity. Today after intense balance training, in a truly remarkable turnaround, she ice-skates semiprofessionally - an activity she had enjoyed with her husband when they were much younger.

Anatomical and Health Information

The central nervous, vestibular, proprioceptive, and muscular systems play important roles in balance. Each provides your brain with a piece of information about the location of your body in space, which allows it to react when balance is altered.

Central Nervous System

The central nervous system, or brain and spinal cord, is your body's central command post. It coordinates, oversees, and responds to input from the rest of your body and ensures normal synchronized functioning of all systems. Each brain component plays a role in balance, but the cerebellum is most important. It coordinates the muscle activity over which you have voluntary control. The cerebellum receives and interprets motor and sensory information from the cerebrum, the vestibular system, and special receptors located in the muscles, tendons, joints, and skin.

Vestibular System

The vestibular system is located in the oval cavity of a bony structure called the labyrinth, which is part of your inner ear. It maintains stability during head or eye movement and provides your brain with information about your head position, so that your body can react accordingly.

Proprioceptors

Proprioceptors are nerve endings found in muscles, tendons, joints, and skin. Like the vestibular system, they communicate information about your body's movement and position. Muscle proprioceptors detect length changes within your muscles. Tendon proprioceptors communicate tension and force. Joint proprioceptors detect movement, joint position, and specific ranges of motion within the joint. Skin proprioceptors identify environmental changes and provide information about your body's postural alignment. Problems with proprioception may result from aging, failure to stretch regularly, habitually poor posture, faulty body mechanics, a lack of muscle use, a general decrease in physical activity, and increased stress and anxiety.

Muscular System

The muscular system also helps maintain balance. Without adequate muscle strength, your body will not be able to respond quickly and efficiently to correct its position when you lose your balance.

Connective Tissue Tightening

Your muscles, ligaments, or joints are all composed of connective tissue. They are prone to shortening or tightening because of several factors, including aging, failure to stretch regularly, habitually poor posture, and faulty body mechanics. Decreased flexibility of these structures can lead to balance problems.

Health-related Conditions

Many balance problems are the result of aging, but other conditions can also cause them. As you age, your neck discs may become thinner and prone to degenerative arthritic changes. As a result, you may hold your head in a position that compresses nearby blood vessels. Certain movements, such as turning to look over your shoulder, tilting your ear toward your shoulder, or moving your head back (like when you get your hair washed), or a combinations of these movements, may decrease blood flow in the vertebral arteries, possibly leading to dizziness or fainting. Blood flow to your head may also be impeded if the blood vessels in your neck that lead to your brain narrow as a result of arterial hardening (atherosclerotic disease). If you experience persistent dizziness, please consult your physician immediately.

Using Visualization to Increase Balance

An impressive study in the journal Physical Therapy compared balance in two groups of women. As they performed various balance activities, the first group listened to a visualization/relaxation tape, the second to music. The researcher observed huge improvements in balance in the group that listened to the visualization/relaxation tape.

Positive visualization will enhance the balance exercises in this book. For example, while balancing, you could imagine being caressed by a cool, calm breeze, or while standing on one leg, you could pretend you are a brightly colored bird or a straight, tall tree. Think back to balance games you played as a child, such as walking along a curb or on the top of a low wall, and incorporate those images into your visualization.

Like the other chapters in this book, this one goes on to sections on self-assessment of balance, practical tips for balance exercises, and 8 great exercises for improving balance, each with explanatory photos.

Future extracts from "Age-Defying Fitness" will cover flexibility and endurance.

You can buy "Age-Defying Fitness" from Amazon or from Peachtree Publishers.

Source

• Age-Defying Fitness: Making the most of your body for the rest of your life. M. Moffat , CB. Lewis, Peachtree Publishers, Atlanta, 2006, vol. 1st edition

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