Hanging in the Balance

By Dr. Seth LaFlamme

The skies are gray, the sidewalks are slick and the front steps are caked with ice. Yup, it’s slip and fall season again.

Many of us hit the slushy puddle, pop back up and keep going, hoping nobody saw us. Of course the wet butt gives us away.
 
But for many of us, a fall is much more serious. As we head into our fifties and beyond, more and more of us are at risk for serious injury, or perhaps a broken hip. For still more of us whose balance may not be quite what it used to be, ice is not even needed to precipitate a fall. It may be nothing more than an uneven bit of ground, and down you go.
 
That raises some very important questions: What is balance, anyway? Why does it tend to decline as we age? What can we do about it to retain our mobility and independence?
 
Balance is a very complex interplay of many different systems. Here’s a quick rundown that is by no means complete, but starts to illustrate how many moving parts have to work together exactly right:

1. Vestibular system: fluid filled canals in our ears tell us about the position of the head. This is a critical part of the picture, but a small one. There’s the rest of the body to think about…after all, we’re not just Talking Heads. ;)
2. Proprioceptive System: Nerve fibers that wrap around our muscles to tell us how stretched and loaded they are along with more sensors living in the joints that tell us about their position give us proprioception, the sense of where our body is at all times. It’s how you know where your toe is when you wiggle it in the dark.
3. Vision: to help you see where you are in relation to the ground and surrounding objects. People with poor vestibular and proprioceptive systems rely much more heavily on vision and will notice greatly worsened balance in the dark or in high places where there is nothing nearby to gauge exactly which way is “up.”
4. Other sensory modalities such as pressure and touch: to tell how much pressure is on which part of the foot, or even which foot. Subtle sensory cues from hanging of clothes, etc.

The motor system: A complex array of outputs to muscle in (hopefully) perfect and perfectly-timed response to all the above sensory systems to keep you upright and out of the mud puddle, of the sidewalk, out of the E.R.

So in a nutshell, bad balance isn’t just a trait someone may or may not have. It’s a sign of potentially serious dysfunction in the way the person is perceiving the world, themselves in it, and the position and movement of their own body. There are potentially many other problems that accompany this, as nearly all bodily function involves proprioception and motor output—digestion, behavioral control, and appropriate modulation of pain perception to name just a few.
But let’s focus in on the obvious issues of staying on your feet and avoiding potentially serious injury. If you have bad balance this is a definite concern. Doubly so in the retired population.

 So, what can you do to maintain good balance if you have it, or try to keep it from getting worse, or maybe even improve it if yours is not so good?

 1: If you don’t use it you lose it! How many times has this been said? It’s one of the most truthful truisms that ever got labeled as truth. That holds especially true for the human nervous system. Be regularly, if not almost constantly, active to the safe limits of your current ability. If all you can do is walk with a cane, then walk the heck out of your neighborhood, and walk to the corner store instead of driving. If you can safely stand on one leg, do it for fun…watch people stare in the grocery line. Dance, move, shovel snow, juggle…do stuff! Living through little screens all day kills the parts of your brain that allow you to survive in the real world….literally. Our bodies are merciless in eliminating what it sees as waste, including unused muscles and parts of the brain. Very quickly, whole arenas of function get torn down and thrown out to conserve energy and raw materials (not such an issue in modern society, but your physiology doesn’t know that).
There are lots of great resources on the internet. Some more simple and effective solutions can be found here: https://www.prevention.com/fitness/fitness-tips/6-ways-improve-your-balance

2: Get checked! General self-care tips can only take you so far if you have specific systemic failures. Here at Great Works Chiropractic, we are trained in advanced functional neurological assessment and treatment to assess the sensory (proprioceptive, oculomotor, vestibular, etc.) and motor (muscle control and coordination) aspects of human function. If any of the systems if failing, we can create a program of in-office care followed by home care to strengthen them and get them back up to speed.

 After that, all that’s left is to run off and join the circus!

Or at least walk with confidence. Maybe the high wire next year. ;)
Questions? Curious? Mention this blog post to get a free 15-minute consultation with me in our office. Just call 207-704-0298 to set it up. We’d be happy to help keep you on your feet. Literally!