Improving Balance to Reduce Falls

Apr 28, 2022

ProActive Physical Therapy

by ProActive Physical Therapy

Balance is something we all strive to achieve.  Balance in our lives, balance between work and home, a balanced diet, we even want to make sure that our tires are in balance.  We have come to believe that if things are in balance…Life is good!

Balance is most important when we are talking about walking around the planet for one very important reason.  The law of gravity. Gravity is a law we cannot break, and without it, we would have a host of other problems. Because our planet has gravity, we are constantly being pulled toward the center of the earth. Without proper balance, it can lead to falls.

Balance issues and falls…..How big is it?

  • One in three adults age 65 and older fall each year.

  • Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death.

  • Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.

  • In 2009, emergency departments treated 2.4 million nonfatal fall injuries among older adults; more than 662,000 of these patients had to be hospitalized.

Older man doing exercises for balance on a gymnastic ball.

How Does the Balance System Work?

Your sense of balance comes from many different systems working together to create stability in your body and your vision. Good balance depends on correct sensory information, proper use of that information by the brain, and the right response from the muscles. The sensory information that is needed comes from your visual, somatosensory, and vestibular systems:

  • Visual system: Your vision provides important information to the brain about your environment, specifically where your body is in relation to the horizon while still or moving.

  • Somatosensory system: You have special sensors in your muscles, tendons, joints, and skin that are sensitive to stretch, pressure, vibration, and touch. These help your brain to know how your body is positioned.

  • Vestibular system: Balance organs in the inner ear tell the brain about the movements and position of your head. This system senses head movement and keeps your eyes focused. It can also tell the brain when your head is moving in a straight line (like when you are riding in a car or going up or down in an elevator) and sense the position of your head even when it is still (if it is upright or tilted).

Putting it All Together

All of these systems send information about your current state to the brain stem. The brain stem also receives information from other parts of the brain, mostly about previous experiences that affect your sense of balance. Your brain can control balance by using the information that is most important for a particular situation.

For example, in the dark, when the information from your eyes is reduced or might not be accurate, your brain will use more information from your legs and your inner ear.  Another example: If you are walking on a sandy beach during the day, the information coming from your legs and feet will be less reliable and your brain will use information from your visual and vestibular systems more.

Once your brain stem sorts out all of this information, it sends messages to the eyes and other parts of your body to move in a way that will help you keep your balance and have clear vision while you are moving.

Older woman sitting on fitness ball, stretching hands trying to balance.

How Can a ProActive Physical Therapist Help?

If you feel dizzy, off-balance, or have fallen, a physical therapist at ProActive can help to determine how well you are using these systems to keep your balance. The physical therapist may instruct you in specific exercises that address the problem and improve how your body uses all these systems together.

ProActive Physical Therapy has developed research-based assessments and programs and we offer a free balance assessment at each of our clinics.  In addition, physical therapists are trained to help you achieve optimal balance, reducing your risk for falls.

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