Today, we will be continuing on with our training series with a post on balance. So far, we have covered mobility, stability, strength, power, and conditioning. If you have not had an opportunity to review our past few posts that cover these topics in depth, I would encourage you to go back and review these in their entirety. Some of the topics that we have previously covered in these past posts will have a presence with balance.
I want to include balance as a part of our training series, as I see it very frequently in my everyday practice during my evaluations as a chiropractor and strength coach. Balance is extremely important to our everyday well-being. We often take balance for granted until it starts to deteriorate. Loss of balance is a significant risk factor for injury and is in and of itself a sign of longevity. Remember the commercial, “I’ve fallen, and I can’t get up”? This can be a serious problem beginning with the fall as a result of a potential balance issue and then not being able to get up from the floor. In addition, loss of balance can also have significant impacts on our quality of life. Loss of balance can have multiple causes, some of which include:
- Neurological Disorders – most commonly Multiple Sclerosis, Parkinson’s disease, TBI (traumatic brain disorders), stroke, and seizures
- Vertigo (typically a result of inner ear dysfunction)
- Visual changes
- Changes in Proprioception – a portion of our nervous system that communicates with our muscles and joints to assist with body awareness and proper muscle coordination to maintain balance during motion or static positioning (standing, kneeling, etc.).
Balance is regulated and controlled primarily by 3 systems in our body. These 3 systems are vision, our inner ear, and proprioception. During this blog, we will be focusing on the portion of balance that is associated with proprioception. The other areas of balance related issues are pathological and are beyond the scope of this blog post, however it is important to know that balance can be related to certain pathologies or other limitations in these areas.
There are many benefits to balance training, some of which include:
- Increased Stability: The most obvious benefit of balance training is an improvement in stability. You’ll be less likely to wobble or lose your balance during various activities.
- Better Coordination: Balance exercises require precise control of your body, leading to improved coordination. This can translate into better sports performance and everyday movements.
- Stronger Muscles: When you work on balance, you engage multiple muscle groups, especially in your core, legs, and ankles. Over time, this leads to increased muscle strength.
- Injury Rehabilitation: If you’re recovering from an injury, balance training can aid in your rehabilitation by rebuilding strength and stability.
- Enhanced Focus and Mind-Body Connection: Balance exercises demand concentration and focus, promoting a stronger mind-body connection. This heightened awareness can benefit all aspects of your life.
In order to assess balance, we use a couple of tests to differentiate the possible causes for balance issues. At the most foundational level, we test single leg stance with eyes open and then eyes closed. As humans, we should be able to maintain balance for a minimum of 10 seconds with both our eyes open and our eyes closed. As stated above, balance is dependent upon 3 systems in our body, when we compare a single leg stance with eyes open versus eyes closed, we are removing one of these systems by taking away vision. This helps us to further differentiate balance, being an issue with the proprioceptive or vestibular system versus vision.
In addition to the single leg stance, test we will also utilize inline half kneeling to evaluate for balance issues related to core and hip stability. One of the primary functions of our proprioceptive system is motor control and muscle coordination to help improve stability and balance. In basic terms motor control occurs as a result of the information that our brain receives from receptors located in our joints, which are activated by movement, that it processes and then sends a message back to the muscle to turn on or turn off muscles to maintain balance, movement, and coordination. Narrowing our base of support through the half kneeling test, challenges this system and provides a way to test its ability to properly engage, especially the stabilization portion of this system, which is heavily provided through proper core stabilization.
Expanding upon the single leg stance and the inline half kneeling test, a portion of our functional movement screen, the hurdle step, is another test that we utilize to assess balance. We do not utilize this test individually but rather as a part of the functional movement screen that we utilize as a part of our fitness assessment (for more information on this screen, review our blog post on the hurdle step). The difference between the hurdle step and the single leg stance test is that with the hurdle step we need to balance through the movement and weight transfer of our opposite limb, as shown below.
Another test that we utilize for balance is the Y-balance test. We perform this test to assess our ability to balance and stabilize through our different planes of motion, sagittal (front-to-back), frontal (side-to-side) and transverse (rotation). This is important as proper coordination and balance in all three planes of motion is necessary for us to maintain good balance in our daily lives and activities. Since we as humans, primarily move in one plane of motion, the sagittal plane (with walking, running, etc.) it is not uncommon for us to be challenged within our other planes of motion, frontal and transverse, with movement and balance. The Y-balance test provides a method for us to assess and better understand how well we move and stabilize through these planes, which is an important factor when designing a training program. The Y-balance test is also a portion of our fitness assessment here at ChiroFitt.
Once we have a better understanding of how well one can balance and if balance needs to be a priority of their training program, we can then move on to building a program.
Here we will discuss some of the common factors that we address to help with improving balance. Understanding that we may not need to address all of these areas when training for balance, as we allow our assessment to determine what areas are involved and need to be improved through training.
1. Ankle Mobility
Proper mobility of the ankle is vital to balance. As previously discussed, proprioception and motor control are dependent upon the ability for the brain to receive motion information from receptors in our joints. The foot and ankle have a higher concentration of these receptors (mechanoreceptors) that provide the information from the joint to the brain. This makes sense as our foot and ankle are in direct contact with the ground during standing and walking. Therefore, if the foot and ankle are limited in function or mobility, there will be a disruption of this information from the foot and ankle, leading to a likely decrease in muscle control from the brain. This decrease in muscle control can result in issues with muscle activation and coordination increasing our risk of being able to maintain balance. For further information on how we assess ankle mobility, check out our prior post on screening ankle mobility and for more information on how we train ankle mobility, check out our prior post on training ankle mobility.
2. Core Stability
Core stabilization is vital to balance. It helps to provide a solid foundation to maintain good posture, which is important to balance, especially when standing. In addition, you need good stability at your core to have safe and effective movement at the hip, knee, and ankle, as the core provides the foundational anchor for our limbs to move. Obviously, the inability to properly move our hips, knees, or ankles will be detrimental to our ability to balance ourselves with movement. The core is also very important to our ability to maintain good posture and positioning, which obviously is important to us being able to maintain balance during times of standing and holding static postures during standing, such as bending, leaning, and turning. Positioning is important to our ability to maintain a good center of gravity and center of mass, which is very important to our ability to maintain balance. For more information on how we screen for stability, check out our blog post on trunk stability push up and rotary stability and for more information on how we train for core stability, check out our blog post on Core Stability.
3. Training Fascial Lines
In training the body from a functional perspective, we must be aware of and familiar with the fascial lines of musculature. Fascia is a thin membranous tissue that surrounds our muscles forming our muscles into functional lines. Think of fascia to muscle as ligaments (connective tissue that connect one bone to another) are to bone. An individual muscle, just like that of a bone, is not very useful from a functional perspective. A good example of the importance of a fascial line is shown in throwing a ball. If we attempt to throw a ball without the use of our lower body, just throwing with our arm we will get a much different result compared to throwing a ball using our lower body. Have you ever seen a major league pitcher stand still and throw a 90mph fastball? Of course not. The ability to take the energy that is created through our lower body and transfer it to our arm to effectively throw a ball is a result of fascial connection and good core stability that allows the transfer of from the lower body to the upper body.
Improving the ability of our muscles to work as they were functionally intended through training fascial lines provides improved stability and more efficient energy use for daily activities both of which help with balance. Below we will show a couple of examples of some modifications of traditional exercises that we incorporate in our training to focus on function through fascial lines.
A complete discussion of this form of training is beyond the scope of this blog, however we wanted to discuss this as it is a focus of our training plans here at ChiroFitt and plays a role in improving balance.
4. Training the Frontal and Transverse Plane
Since we spend so much time moving in the sagittal plane (forward and back), think walking in a forward or backward direction, we tend to become over dominant in this plane functionally. This is further the case in those that exercise but always focus on doing exercises that target the sagittal plane, which is often the case with isolated body part training, especially when utilizing machines as your training equipment. There is certainly a use with machine training, however it is typically with rehabilitating from an injury where isolated strength can be necessary to restore strength to a particular region of the body. They can also be useful for those who are amateur or professional bodybuilders as targeted training can help with muscle growth, or hypertrophy, in specific regions. However, they are not very useful with functional training such as when trying to improve balance. All that being said, placing training emphasis on the frontal and transverse plane both with stability and strength is integral to improving and maintaining our ability to balance. It is typically much easier to knock someone over by pushing them from the side versus from the front or back (if they are aware) as we tend to have less ability to stabilize ourselves side to side compared to front and back, as a result of this relative imbalance between our stability and strength in the sagittal plane compared to the frontal or transverse plane. Here’s some examples of some stabilization and strength-based exercises that we utilize in the frontal and transverse plane.
5. Unilateral Training
Unilateral training is important to improving and maintaining balance. This form of training often becomes the focus of balance-based training programs too soon as it is thought that in order to correct balance, we just need to force ourselves to be in positions that challenge balance. However, frequently we need to correct some of the previously discussed areas prior to beginning unilateral training as these are the issues that result in our inability to maintain balance when challenged in a unilateral position, such as having to stand on a single leg. In fact, forcing unilateral training in a case where any of these prior issues are present would likely result in training a client to compensate for these underlying issues, which could result in overload or overuse of an area and increase our risk for future injury. Once we have worked to improve the above areas, unilateral training would be appropriate and necessary to further improve balance. With unilateral training, similar to other forms of training, we will start from the ground and work are way up. Let’s look at an example of this:
This is just an example of how we can progress unilateral training from lying to a standing position. Specific exercise selection and progression for this form of training would be based upon the individual for whom we are training and their abilities.
If it is determined through our screening process that balance is an area that we need to prioritize with our training program, you can see there are a number of training principles that we need to consider. This is the importance of the screening process with our clients as we are better able to guide and prioritize their training programs to focus on their individual needs, ultimately giving them a better opportunity of reaching their individual goals. As stated above, balance can have many other causes outside of that which can be corrected through training for improvement. Therefore, balance can not always be corrected through training, however there is a lot that we can do to assist in improving one’s ability to balance and help to reduce their risk of injury associated with loss of balance.
If you are having any issues with balance or just want to learn more on how to maintain good balance, consider taking the time to come visit us for a fitness assessment. We are currently offering this as part of our No Stress Fitness Strategy Session, which comes with no cost or no obligation, other than 30 minutes of your time. Considering you took the time to read this article in its entirety, what is another 30 minutes to take advantage of this opportunity.
Our next post will review some of the principles that we have discussed during our training series by reviewing how we develop a training program. As always, we hope that this post was beneficial in helping to give you a better understanding of balance and how we can work to address and improve it, if necessary.
Till Next Time…