Factors Impacting Your Balance – Lori Ryan AEP

Maintaining balance is something we often take for granted, but it’s a complex process that involves several factors working together seamlessly. Three key components that play a significant role in our ability to stay upright are vision, the vestibular system, and the proprioceptive system.  

Our Vision provides crucial information about our surroundings. When we stand or move, our eyes observe the environment, including objects, landmarks, and other people. This visual input helps us orient ourselves and make necessary adjustments to maintain balance. For instance, if we see an obstacle in our path, we can step over it or change our direction to avoid stumbling. Our eyes also help us judge distances, which is particularly important when walking on uneven surfaces or reaching for objects. Without clear vision, it becomes challenging to perceive spatial cues accurately, making it difficult to maintain balance. 

The vestibular system, located in the inner ear, consists of tiny structures called the vestibular organs. These organs contain fluid-filled canals and small crystals called otoliths. As we move, the fluid and otoliths shift, providing information to the brain about our head’s position and movements. This allows us to have a sense of balance even when our eyes are closed. For example, when we tilt our head to one side, the fluid in the canals shifts, signalling to the brain that the head position has changed. The brain then signals the appropriate muscles to adjust our posture and maintain balance. The vestibular system also helps us distinguish between up and down, which is vital for standing upright against the force of gravity. 

The proprioceptive system refers to the body’s ability to sense its position and movement through receptors in muscles, tendons, and joints. These receptors, known as proprioceptors, provide constant feedback to the brain about the length, tension, and position of our muscles and tendons. This information is crucial for coordinating movements and maintaining balance. For instance, when we step on an unstable surface, such as an uneven or slippery surface, proprioceptors in our feet and legs send signals to the brain, alerting it to the changes in pressure and position. The brain then activates the appropriate muscles to stabilize the body and prevent a fall. 

The integration of these three factors; vision, the vestibular system, and musculotendinous proprioception, is essential for maintaining balance. They work in harmony to provide the brain with the necessary information to adjust our posture and movements. When one system is not functioning as well as it could be, the other systems must compensate to maintain balance.  

There are several factors that can influence these systems and impact our balance. Aging, for instance, can affect all three. As we get older, our vision may deteriorate, making it more challenging to perceive obstacles or judge distances accurately. The vestibular system can also become less sensitive, leading to balance problems and dizziness. Additionally, changes in musculotendinous proprioception can occur due to age-related muscle weakness or loss of joint range of motion, affecting our ability to sense and adjust to changes in body position. Certain medical conditions, such as inner ear infections, vertigo, or diabetic neuropathy, can affect balance as well. These conditions can disrupt the function of the vestibular system or damage peripheral nerves responsible for proprioception, leading to loss of balance. Treating the underlying condition or managing the symptoms can help improve balance in these cases. Environmental factors also play a role in balance. Walking on slippery surfaces, uneven ground, or encountering poor lighting conditions can challenge our balance and increase the risk of falls. Being mindful of these factors and taking precautions, such as wearing appropriate footwear, using assistive devices when necessary, and ensuring well-lit surroundings, can help mitigate the risk. 

Exercise plays a crucial role in improving and maintaining balance. Regular physical activity that focuses on balance, strength, coordination, and agility can have numerous benefits for balance, falls prevention, and overall stability. Here are some ways exercise can benefit balance: 

  • Strengthens Muscles: Exercise, especially strength training, helps to strengthen the muscles throughout the body, including those responsible for maintaining balance. Stronger muscles provide better support and stability, reducing the risk of falls. 
  • Enhances Proprioception: Exercise that involves movements and positions that challenge balance can enhance musculotendinous proprioception. By repeatedly putting the body in different positions and challenging stability, exercises like yoga, tai chi, and balance training can improve the body’s ability to sense and respond to changes in position, enhancing overall balance. Also practicing on different surfaces whilst in a controlled environment can be very beneficial, like the foam pads we often use in the clinic. 
  • Improves Core Stability: The core muscles, including the abdominal and back muscles, play a significant role in maintaining balance and stability. Exercises that target the core in different positions can improve trunk strength and stability, leading to better balance control. 
  • Increases Flexibility: Poor flexibility can limit range of motion and make it more difficult to maintain balance. Exercises that promote flexibility, such as stretching and yoga, can improve joint mobility, allowing for better balance and easier adaptation to different movements and positions. 
  • Enhances Coordination: Exercises that involve complex movements and coordination, such as dancing, can improve balance by enhancing coordination between different muscle groups and improving neuromuscular control. 
  • Boosts Cardiovascular Fitness: Maintaining cardiovascular fitness through activities like brisk walking, jogging, or cycling, or any activity that will elevate your heart rate for a prolonged period is also important for balance. Improved cardiovascular health enhances overall endurance and energy levels, allowing individuals to engage in daily activities with reduced fatigue, which can positively impact balance and reduce falls risk. 
  • Promotes Bone Health: Exercise that includes weight-bearing activities, such as walking, dancing, or impact-loading exercises such as stomping or jumping, can help maintain bone density and strength. Stronger bones contribute to better overall stability and reduce the risk of fractures in the event of a fall. 

Exercise is crucial in maintaining balance and reducing falls risk as your age. An Accredited Exercise Physiologist will be able to help design and implement a program to improve your balance that is targeted to your current fitness level. This will reduce falls risk, prevent consequential fractures, and improve your confidence in your ability to do the things you need and want to do.