Most of us take our balance for granted. When it feels easy to balance, and we’re not worried about falling, we rarely give it a second thought - but the internal processes our body uses to keep us balanced are complex. The brain is in charge of keeping the body balanced. It gathers information from several body parts to keep track of how the body is oriented, whether it’s staying still or moving, what sorts of surfaces the body is near and touching, etc. It then combines this information and tells the body what to do to keep itself safe and upright.
Balance typically worsens with age. This can happen for a variety of reasons, including normal aging, disease processes, and lifestyle factors. As the brain and the body age, the brain’s ability to gather useful balance-related information, process it, and react to it, can decrease. Common age-related challenges such as urinary incontinence, reduced vision, reduced reaction time, and muscle loss can lead to balance challenges. Disease processes such as arthritis, diabetes, Parkinson’s, vertigo, and cataracts can impair balance. Many medications can cause balance problems. However, many people are unaware that regardless of age or health challenges, balance is a skill. It improves with practice, and worsens without it. Even when there are changes in several of the body’s systems, with training, the brain can learn how to more accurately interpret the altered information it is receiving, improving balance and reducing the risk of falling.
This is good news. At any age, people can improve their balance by practicing balance skills they’re struggling with. The challenge is that people only reduce their risk of falling when they work on addressing their specific balance deficits. It doesn’t help much to practice standing on one leg if your balance problems happen when you turn your head while walking, walk on uneven surfaces, get distracted, or have to multitask. You need to practice the skills you struggle with to see meaningful improvement. If you’d like to learn more about the sorts of situations in which your balance is compromised, and get some exercises to work on to address your specific deficits, seeing a physiotherapist who frequently treats balance impairment is a good place to start. Once you know what to work on, the more often you practice the skills you’re struggling with, the faster you will see improvement.
Unfortunately, when people notice their balance beginning to worsen, they rarely decide to challenge their balance to try to improve it – instead, they typically do the opposite, and begin challenging their balance less and less. First they might give up doing things like hiking and walking on the beach because they’re worried about falling. As their balance continues to worsen, they might give up going out in the winter, going out after dark, going up and down the stairs, and eventually, leaving their home, or even leaving their chair. Unfortunately, this process of gradually doing less and less leads to deconditioning (weakening of the body’s tissues and systems), and actually increases a person’s risk of falling rather than reducing it. If you’re worried about falling, beginning to do less is one of the worst things you can do. It increases your risk of falling. Although it seems counterintuitive, what you actually need to do to improve your safety is move more and challenge your balance safely. Regular exercise is the most effective method of fall prevention.
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