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Equilibrium can prevent injuries, improve with practice

| Monday, Aug. 31, 2009

Balance isn't needed only by circus performers, gymnasts and ballet dancers.

When we work to maintain our muscle strength and flexibility through a yoga class, weight training or exercises on a stability ball, we also help to improve our balance.

It's especially important for older adults, for whom falls are the leading cause of injury deaths, according to the Center for Disease Control and Prevention, and the most common cause of hospital admissions for trauma.

"Balance doesn't get its due for some reason," says Leta Koontz, owner of Schoolhouse Yoga in the Strip District. "I think it's easy to overlook the importance of balance. When you're young, you don't see it as something to work on."

Koontz says most of the classes at Schoolhouse Yoga's four studios include at least one balancing pose. She says anyone, from students to senior citizens, can improve their balance through practice.

"I think there's benefits beyond not falling for anybody of any age, like helping to quiet and still your mind," Koontz says. "When you're standing on one leg and you think you're going to fall over, your mind is very much in the present."

We balance through an internal process called proprioception, where we unconsciously sense our own body in relation to space. Internal sensors allow us to sense that our arm is over our head, even when our eyes are closed.

A tennis player uses proprioception when they shift their weight from one foot to the other to return a cross-court smash. So does a hiker or trail runner whose feet "feel" the uneven roots and rocks and adjust without them having to look down. A person who steps off a curb at an awkward angle will unconsciously adjust their leg and ankle muscles to land properly.

But balance also incorporates the muscles, joints, the brain, inner ear, even our jaw and the soles of our feet.

"When it comes down to what exactly is balance, it's muscular control, and it's the way that all of the muscles work together to keep your body in a certain plane," says Tanya Hagen, assistant professor of orthopedics in sports medicine at UPMC Sports Medicine.

When rehabilitating an injured ankle or hip, staff at UPMC often prescribe exercises with a balance board, among other things, Hagen says.

"If someone has had a hip injury or simple ankle sprain, a lot of people think, rest the ankle and take Ibuprofen. But until you do some aggressive balance training, you're going to be at high risk for re-injury," she says.

"When you tear a ligament in your ankle you lose that brain-ankle connection that says if you go to step off a curb and you step awkwardly, your foot rights itself without you having to think about it."

Don Holl, football coach at Seneca Valley High School, has his players perform one-legged squats and other exercises that force the body to adjust its center of gravity.

"Most of the things in sports happen in a non-balanced, non-ground-based position," he says.

While grinding out bench presses can increase a player's strength, it doesn't replicate the conditions on the gridiron, he says.

"For years we've done a lot of training where we have our feet on the ground and our hips and shoulders on a bench," Holl says. "But most of the things that happen in sports happen on one foot or with your hands extended in front of you with just your feet on the ground.

"The core of your body has a lot more to do with receiving and administering force than your feet on the ground and your back on the bench," he says.

Jody Kromel, physical therapist at Excela Health's Barclay Rehabilitation at Mountain View in Unity, helps patients with balance problems that stem from weak muscles or lack of flexibility.

"We teach them exercises for flexibility, for strengthening for trunk stabilization or trying to decrease trunk rigidity," she says.

Some balance problems are neurological. We stand upright thanks to the vestibular system, which is housed in the inner ear and works with the brain to communicate with receptors in the eyes, muscles, joints, the tips of our fingers and the soles of our feet.

Some patients who have suffered a concussion may need vestibular therapy to regain their sense of balance. Diabetics, who often lose feeling in their feet, also may have balance problems.

Senior citizens can help maintain balance through yoga or Tai chi, Kromel says.

"Tai chi and yoga, they all incorporate stretching and core strengthening. That's where you prevent from having balance problems. All of those things together help to keep the balance at an area where it should be. "

How's your equilibrium?

Test your balance with this simple exercise from Ladies Home Journal:

• Stand barefoot on a hard flat surface with one foot in front of the other, heel to toe, hands crossed on your chest. (Make sure you're near something you can grab in case you begin to lose your balance.)

• Close your eyes and start counting slowly. When and if you lose your balance, write down the number you reached. Repeat three times and take an average of your three scores.

Scoring: If you made it to 48 without teetering, you've in a healthy balance zone. Anything less means you could benefit from some balance training.

Building better balance

These exercises from the American Council on Exercise will help you to improve your balance:

• Strength train your legs twice a week. Stronger muscles will keep you from falling.

• Stand one leg while talking on the phone. Start with your eyes open, then try it with your eyes closed.

• Stand on an unstable surface -- a rolled up exercise mat or towel, or a balance board -- and do squats or arm curls while holding 3-pound dumbbells.

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