By Katherine Spencer
Many people are aware that balance exercises can help reduce the risk of falling, but what might be more surprising is that these exercises can also help increase your core strength and reduce strain on your low back. “Balance training” is a term healthcare providers and fitness coaches use regularly. But what does this really mean?
Balance is made up of a complex system of environmental feedback, including cueing from your musculoskeletal, vestibular (inner ear) and visual systems. Balance exercises often target the muscles that help to support your low back, which is beneficial for everyone, from high-level athletes to older adults. While many people do not think of activities like climbing stairs, walking and bending over to tie your shoes as balancing, these movements and many other daily activities require a strong core and a good sense of stability to complete the task safely and efficiently.
When it comes to activating the core stabilizing muscles, some people argue balance training is just as beneficial if not more beneficial than traditional abdominal and hip strengthening exercises. Balance exercises are typically performed in positions that make your muscles and joints work in tandem, just like they do with daily activities. This is because balance exercises are typically performed in weight-bearing positions, making them functional as you are bearing body weight while, for example, walking or climbing stairs. When you are performing these activities, multiple muscles, from the large muscles of your core to the small muscles on the bottom of your foot, are activated. In addition, many balance exercises focus on maintaining a straight back with minimal bending, further reducing the stress on your spine.
The term “core muscles” typically includes the abdominals, low back and hip muscles, which have direct or supporting attachments to the spine and pelvis. Balance and stability training is an effective way to target and strengthen the core muscles, which is very important for people who experience low back pain.
A randomized clinical trial study published in the Journal of Orthopedic Sports and Physical Therapy compared the efficacy of trunk-balance exercises versus strength-training exercises for individuals with chronic low-back pain. The results showed trunk-balance exercises combined with flexibility exercises were more effective than a combination of strength and flexibility exercises in reducing disability and improving quality of life in patients with chronic low-back pain.
Choosing the correct balance exercise for you can be a tricky task. It is important that the exercise is challenging, but also safe. To ensure proper safety, always perform your balance exercises close to a sturdy surface such as a table or counter top. Hold on to the surface in front of you as needed with your hands to prevent a fall. You should feel moderately unstable while doing your exercises because the movement that occurs in your trunk, legs, ankles and feet required to keep you from falling is where the strengthening occurs. If you do not feel much movement in these areas, it may be time to advance your balance exercises to the next level.
You may see a lot of balance equipment in the gym, being sold in stores, online and on TV. While some of this equipment is very useful, there are many exercises you can do on your own at home. When I am working with a person who has balance issues, I usually start by having them stand with their feet pressed together with their arms crossed over their chest. If it is difficult for the person to maintain their balance in this position, I modify as needed and have them continue with the exercise until they are more stable. However, if the feet-together position is easy to maintain, I progress them to standing heel to toe and then to standing on one leg. Narrowing your base of support will make it more difficult to keep your balance.
It is normal to find one side is more balanced than the other and important that you do all one-legged exercises on both sides. There are many ways to further challenge your stability and activate your core muscles, such as standing on an unstable surface (like a balance ball), shifting your gaze while holding a position, closing your eyes, and adding additional movements into an exercise. A general guideline for balance exercises is to hold each position for 30 seconds and repeat at least three times once a day. Many people find that doing increased repetitions of a given exercise improves stability due to building muscle memory. If you feel uncomfortable trying balance exercises on your own, I highly recommend seeing your physical therapist, doctor or personal trainer for further guidance.
In addition to increasing core strength, balance training promotes coordination and concentration and teaches you how to shift your center of gravity. This is beneficial for reducing fall risk and aiding daily activities and can be very helpful in improving performance for athletes. Furthermore, concentration forces your mind to focus on one thing at a time, which has been proven to have a calming effect.
Last, balance exercises encourage a sense of humor, which is always a positive thing!
Dr. Katherine Spencer is a physical therapist and orthopedic certified specialist at Dee Physical Therapy in Shelburne. She lives in Burlington.