What is Balance?
Balance can be both a noun and a verb, but at the heart of both definitions is being able to distribute weight evenly along a surface to enable someone to remain upright and in a steady position so that they do not fall down.
Balance within the body is made up of three important systems that all work together, they are called:
1. Vision
2. Proprioception
3. Vestibular
First, let’s talk about vision…
Vision is probably the easiest and most straightforward to understand of the three systems. The visual system is your body’s ability to collect information in your environment through your eyes. That information then gets sent to your brain which then has to interpret that data and formulate an appropriate response. In order to stay balanced, we often use specific visual inputs which may include looking to see if the sidewalk is level as we are out for a walk, looking at the horizon if you are on a boat on the coastline, or focusing on a point off in the distance as a target to walk towards. If we can see a potential hazard in our path up ahead, our brain can send a message to the body to avoid this hazard and keep us safe (i.e. stepping up and over an uneven patch of concrete in the sidewalk).
Next, let’s talk about proprioception…
Proprioception is a fancy scientific word that describes the movement of the body in relation to the supporting surface. How does it work? Well, you have these little receptors throughout your whole body, but in terms of balance the most important ones are found in your feet. Those receptors in your feet collect data about the surfaces that you are walking on and send that information back to the brain so it can make adjustments to keep you balanced.
I want you to think for a moment about what it feels like to walk on a newly paved flat road – it’s very smooth, there are no cracks, breaks, or potholes yet because it is brand new – your body doesn’t have to make many adjustments because you feel pretty balanced already, right? Now imagine you are walking downhill on a grass field to get to your grandkid’s soccer game – there are usually divots in the grass or clumps of dirt that make it feel uneven and you probably have to slow your speed down so you don’t fall down since you’re walking downhill, right? In this case because this grassy hill surface is not as smooth as that newly paved road, your proprioception system is taking all of that information from those receptors in your feet and sending it back to your brain so your brain can make adjustments to things such as how fast you are walking, if you have to step up and over a divot in the grass, or if you have to change direction to avoid a clump of dirt.
Lastly, the vestibular system…
The vestibular system is the most complicated system of the three, but one of the most important. The vestibular system is a sensory system involving small crystals inside these canals within the inner ear. These crystals help detect how your body is oriented in relation to gravity for the purpose of coordinating movement and balance (basically they help determine which way is up and which way is down). Because the vestibular system orients us in relation to gravity, as long as the vestibular system is functioning properly, it is the most reliable of the three systems because we live on planet Earth which is full of gravity that we can’t get rid of.
How do all of these systems work together?
These three important systems all serve in a checks and balances type relationship with one another. If one or two of the systems are underperforming or have sent conflicting data to the brain, the other one or two systems can pick up the slack and essentially serve as the tie-breaker. Luckily for all of us, the body built these 3 systems to be redundant so we have a better chance of staying upright and avoiding injuries.
Imagine for a moment that you are floating underwater in the ocean with your eyes closed and you get jostled by a small wave on the shoreline that spins you around. You know that feeling where you can’t quite remember which way the surface is? That’s because all three of your balance systems have momentarily been confused due to the lack of data input to the brain (your vestibular system probably would have had the best chance of telling you which way was up if not for that small wave that just sent you spinning). Usually at this point, one of two things happen- you either touch your feet to the sandy bottom or you open your eyes. If your feet touch the sandy bottom, then your proprioception system is now able to give enough input to your brain to tell it “We’re at the bottom and have to go up to reach the surface”. Similarly, if you open your eyes your visual system takes over and gives input to your brain because you can now see sunlight at the surface which tells your body “The surface is that way”. This is why all three systems have to work together to keep us balanced.
Why does balance seem to get worse as we age?
As we age, all of these systems start to decline which results in reduced information being sent to the brain. Most people have visual changes that require the use of glasses or contacts as they get older. Many people have sensory changes in their feet which result in reduced input being detected and relayed by those receptors of the proprioception system. The vestibular system declines with age because those little crystals in the inner ear can dry out and lose their ability to determine which way is up and down in relation to gravity.
Luckily for us, balance is adaptable meaning it can be modified by experience and improved with practice. In short, it is possible to teach an old dog new tricks!
Here are a few things we can do to try to improve our balance systems:
1. Get your eyes checked yearly to keep glasses/contacts prescriptions up to date to allow your visual system to send your brain the best data it possibly can
2. Remove area rugs and raised thresholds in the house to reduce the number of uneven surfaces that your proprioception system has to navigate around
3. Exercise every day – strength and balance go hand in hand. If your muscles are weak, they can’t hold you up even if your balance systems are functioning perfectly. Incorporate balance exercises into your daily practice – balance is like a muscle that needs strengthening, use it or lose it! If you need help knowing which exercises to do, please schedule an evaluation with our team, we can help!
Life is all about balance and here at HUB PT and Wellness we hope to help you maintain yours!
About Caitlin Murphy
Caitlin Murphy has been a licensed physical therapist since 2015 and specialized in working with older adults. She specializes in working with orthopedic conditions and fall prevention & preparedness. She holds a Doctorate degree in Physical Therapy from Quinnipiac University and is also a Certified Fall Prevention Specialist. Caitlin is passionate about orthopedics and serving older adults and enjoys helping readers by sharing her knowledge and experience with those interested in improving health and function in their later years.