What helps us balance?

DEAR DOCTOR K:

What are the body parts, or systems, that help us balance?

DEAR READER:

You’re asking a very interesting question. I never even thought about it until I went to medical school. When I learned what I’m about to tell you, I thought it was interesting. However, I didn’t appreciate how important problems with balance would be for my patients.

A lot of people begin to notice subtle problems with balance when they enter their 60s. Over the next two decades, their balance can become problematic enough that it affects their health. Poor balance can cause falls that can lead to disability, and sometimes death. Good balance, by contrast, builds confidence and fosters independence.

Our daily balancing acts require intricate coordination between body systems. These include the central nervous system (brain and spinal cord), the vestibular system (brain and inner ear), the visual system (brain and eye), and a vast web of position-sensing nerves called proprioceptors.

  • A part of the BRAIN called the cerebellum oversees balance and movement. It receives sensory information, such as sight, sound and touch, from our nerves. Another part of the brain oversees other aspects of balance, such as attention, planning and movement. It also supplies memories important to balance. For example, when you face a balance challenge like a slippery sidewalk or rocky path, you have a memory of how you moved your body in the past to deal with such situations.
  • The SPINAL CORD serves as a bridge between brain and body. Nerves along its length receive feedback from the peripheral nervous system, a lacework of nerve fibers that branch out from the central nervous system to the far reaches of the body. The spinal cord also initiates reflexes, such as the quick-stepping response to an unexpected push. It delivers commands to the muscles too, telling them to make voluntary movements.
  • The body’s balance mechanism is called the VESTIBULAR SYSTEM. It is housed in the inner ear structure and is made up of three semicircular tubes. These tubes consist of bone-encased membranes filled with fluid and lined with hair cells. As you move, fluid in the canals shifts and bends the hair cells. This prods them to fire messages to the brain telling it how much you moved and in which direction.
  • In the VISUAL SYSTEM, the eyes send visual information to the brain, continually logging where you are in relation to surrounding objects.
  • The position-sensing nerves called PROPRIOCEPTORS are responsible for proprioception — the ability to perceive where your body is in space. Proprioception helps you stay balanced and move through your environment without stumbling or bumping into things. Found primarily in muscles, tendons and joints, proprioceptors stream information to the brain. The brain instructs muscles to contract in large or small ways as conditions change (when you’re on uneven ground, for example).

I’ve put descriptions and photos of two exercises to help improve your balance on my website, AskDoctorK.com. As I have grown older, I’ve come to appreciate how important balance is, and how helpful the exercises are. I think you will, too.

Exercise 1: Get up and go

Reps: 10
Sets: 1
Intensity: Moderate
Tempo: Go at your own pace
Starting position: Choosing a path free of obstacles, place a marker (such as a soup can or a small cone) on the floor about 10 feet from a chair. Sit in the chair with your hands on your thighs.
Movement: Stand up and walk forward to the marker. Walk around it and return to the chair. Slowly sit down in the chair.
Tips and techniques:

  • After rising from the chair, steady yourself if necessary before walking toward the marker.
  • Go at your own pace.
  • Breathe comfortably.

Too hard? Use your hands to assist you as you stand up and sit down, or do fewer reps.
Too easy? Pick up your pace.

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Exercise 2: Standing side leg lift

Reps: 10 on each side
Sets: 1–3
Intensity: Light to moderate
Tempo: 2–2–2
Starting position: Stand up straight behind a chair, holding the back of it with both hands. Put your feet together and evenly distribute your weight on both feet.
Movement: Slowly lift your right leg straight out to the side about 6 inches off the floor. Hold. Return to starting position. Finish all reps, then repeat with the left leg. This completes one set.
Tips and techniques:

  • Exhale as you lift your leg.
  • Keep your shoulders and hips aligned throughout the exercise.

Too hard? Just touch your foot out to the side on the floor.
Too easy? Hold your leg up for eight counts, or close your eyes.

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