Dr. Dan Michael
Dr. Dan Michael

Do you have poor balance? We all have varying degrees of balancing abilities, and while some folks may deal with neurological or inner ear (vestibular) disorders that would prevent them from having what we might consider to be “within normal limits” for the average person, others may suffer from subclinical unsteadiness on their feet, which impacts their ability to move effectively in their daily life as well as their favorite activities like golf, tennis and pickleball.

A definition of balance is the ability to maintain a center of mass over its base of support, and so our ability to balance must begin with the ability you have to maintain control over your own center of mass.

Bipedal humans have a center of gravity (mass) that is located about the location of the naval, which brings us back to the topic of the core and what should be done to make it more fit for purpose.

To understand balance, we must first understand how our bodies accomplish such a feat. A simple explanation may be that the brain gets information from the inner ear, eyes, skin, joints and muscles.  With this information, the brain makes decisions to assist the executive part as it attempts to move the body at will. While the brain accomplishes much of the calculation needed to make movements precise at a subconscious level, there is great opportunity for supportive conscious control to boost our movement performance.

In one of my previous articles, “How to Get More Out of Your Core,” I differentiated between core coordination and core strength. Core coordination is what happens when you link your trunk muscles to work with your thoracic diaphragm (breathing muscle) and your pelvic floor.

Coordinating your core structures like this allows for a stable base of support for your hips and shoulders to pull from, all of which is essential for good balance.

Coordinating your core is like learning how to ride a bike, whereby your abdominal wall and pelvic floor expands and contracts as the breath goes in and out. Think of it like two ballroom dancers with the lead hands pressed firmly but nicely together as they dance gracefully. This is how our core should feel as we breathe and move.

How good is your balance? I’ve borrowed and modified a test from the Berg Balance Scale, which is a standardized balance assessment.

NOTE: If you have a high fall risk, do not attempt these assessments without supervision from a qualified professional. All others should take the necessary precautions to protect themselves from injury.

 

STANDING ON ONE LEG INSTRUCTIONS: Stand on one leg as long as you can without holding on.

4 — able to lift leg independently and hold longer than 10 seconds

3 — able to lift leg independently and hold 5-10 seconds

2 — able to lift leg independently and hold ≥ 3 seconds

1 — tries to lift leg, unable to hold 3 seconds but remains standing independently.

0 — unable to try; needs assistance to prevent fall

Score __/4

ADVANCED TEST: Repeat the above but with your eyes closed. This is very difficult, so do take more precaution than you think you need to prevent injury from falling or catching yourself.

If you didn’t score a 4/4, these are some tips that can help improve your balance. Assuming everyone has either played Jenga or knows of the game, think of those precariously positioned and stacked blocks of wood; now imagine that your torso (center of gravity) is like those blocks of wood. If your muscles around the torso are loose and sliding around like blocks made of gelatin, soon your anatomical game of Jenga won’t be balanced for very long; and yes, much like Jenga, it does help to hold your breath if you really need to feel more stable.

Secondly and similarly, the muscles around your hip, knee, foot and ankle need a similar level of dynamic stiffness to hold everything in exactly the right position while you stand on one leg. The muscles around these joints require what is called “co-contraction” to create stiffness instead of sloppiness.

To understand further what “co-contraction” is, think of a bodybuilder who is in the classic side chest pose and how the biceps and triceps fight against each other isometrically — that is co-contraction at the elbow and can be used from the torso all the way to the toes to create balance.

Finally, it helps to think about grabbing the ground with your entire foot — especially the sole, versus simply clawing at the ground with your toes only. Try instead to grab the ground with the entire sole of the foot, almost as if you could pick up a tissue with the center of the foot. If your feet are feeling soft and inactive, swap out those house shoes and socks for barefoot walking to help “wake them up.”

 

— Dr. Dan Michael is a Certified Chiropractic Sports Physician® at NW Sports Rehab in Madison Park.