Maintaining Balance in Your Life

Clinical Expertise

by Christopher Perez, PT, DPT | Sep 23, 2020

Balance is one of those things we seem to take for granted. It’s something we never put much thought into until we lose it or find ourselves feeling unstable. However, as our population grows older (it is projected that 23% of our population will be 65 years or older by the year 2060), we need to begin evaluating and improving our balance before we are at risk for falling.

Currently a quarter of adults aged 65 years or older will fall at least one time per year. These falls can lead to significant injuries that affect quality of life and the ability to do the things we enjoy. Each year, 300,000 people are hospitalized due to hip fractures with falls being the leading cause. Falls are also the most common cause of traumatic brain injury in older adults. Injuries like these can dramatically affect independence, lead to prolonged hospital stays and even can lead to surgery. The Center for Disease Control (CDC) reports there has been a 20% increase in fall-related deaths from 2007 to 2016. Those that have had a fall are also at a higher chance of further injury due to the fact that the biggest risk for falling is having fallen in the past.

Even for those who don’t have a serious injury, falling can have dramatic effects on our daily lives. When we fall, we naturally tend to become more fearful of falling again. We may start participating less in the activities we enjoy doing, leave the house less often and begin relying on others for assistance. This loss of independence and fear of falling can lead to a finding decreased joy in our daily life. Moving less can also lead to decreased strength and mobility, which can further increase your risk for falls and affect your freedom and independence.

So what exactly is balance, and how do we “lose” it? Or more importantly, how do we keep or improve it? Simply put, balance is our ability to remain upright and stable. Our balance is made up of three main systems: our eyes (visual system), our feet (somatosensory system) and our inner ears (vestibular system). Information from these three systems is transmitted to the brain, combined and used to ensure correct balance responses are made. When the information is used incorrectly, or our body is too slow to respond to the information, we lose our balance.

Unfortunately, as we age our three main systems of balance decline. Some examples include:

Eyes/Visual System

  • More difficult to adapt quickly from light to dark environments making it difficult to see at night – such as when getting up to use the restroom.
  • Decrease in overall vision making it more difficult to see obstructions in your path, or subtle changes in walking surfaces such as a break in the sidewalk.

Feet/Somatosensory System

  • Less sensitivity to movement, meaning we have to move more before our body realizes and can tell our brain. This could be why, at times, you may not realize you are losing your balance until you are already falling.

Inner Ears/Vestibular System

  • Less sensitive to movement, meaning we have to move more when we attempt to regain our balance. It may mean we can’t respond as quickly or as fine-tuned as before leading to an under-correction or over-correction of our balance.

 

While our balance systems do decline, falling is NEVER a normal part of aging. When challenged safely and appropriately, balance can improve at any age. Also, placing ourselves in less risky situations can greatly reduce our chances of falling. This can sometimes be as simple as taking more time, or asking for assistance with activities that are more strenuous and difficult to do alone. This also may mean evaluating or assessing your home environment. Some easy tips and modifications to reduce the risk of falling include:

  • Being seen for a vision assessment in the past year to ensure no changes in vision or if glasses may be needed.
  • Ensuring adequate lighting through your home. This includes the addition of night-lights to navigate safely at night. There are many night-lights that are motion sensitive to not disrupt sleep.
  • Removing tripping hazards in your home. This includes removing throw rugs, securing carpet edges and use of non-skid rugs in the bathroom.
  • Placing grab bars next to the toilet or by the shower.
  • Using an assistive device (walker or cane) if recommended by your physician.
  • Placing items on easily accessible shelves or cabinets that are near eye level to decrease reaching or use of step stools.

Small modifications like this can go a long way in helping to reduce your overall risk for falling. While reducing external risks, there are also many ways to improve balance. Beginning a guided strengthening or balance program reduces muscle loss and risk for falls, as well as fall related injuries. There are resources and community programs, including:

If you are concerned for your balance or believe it can be improved, speak with your physician. They can complete a balance screen, refer you to a balance specialist or educate you on other programs available in your area.

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