Feeling off balance? Why? What causes us to have difficulty keeping our balance whether we’re over 65 or in our teens? We have three systems that all work together so we have good balance.
- We have our balance organ, which is our vestibular system in the inner ear.
- We have our leg strength.
- We also have our visual component which we rely heavily on when something else is not working properly.
Let’s start by talking about balance in the older population.
When you are 55 and older, there are a number of issues that can arise that can effect balance. One common factor that can impact this population’s balance is medication use. As we get older, we have cardiac or visual issues for example that require medications. One of the main side effects for medications is feeling lightheaded. Think about blood pressure medicine. You’re trying to decrease your blood pressure so when you move quickly or change position quickly, your blood pressure decreases quickly causing you to feel lightheaded. When you get up from bed in the morning, you might feel this and are at risk of losing your balance and falling. This can be an especially common occurrence with patients we see who are in their 70s and 80s. Most of their falls occur in the home and a lot of that has to do with medication management.
The second thing that can impact the balance system in the older population is regular musculoskeletal issues such as arthritis, tendonitis and bursitis. These conditions cause pain in the legs. Remember, leg strength is part of the balance system so any kind of compromising effect on your muscle strength will affect your balance. Let’s focus on a condition like osteoarthritis. If you’re dealing with knee pain or hip pain because of that, your muscles tend to get weaker. So there’s decreased stability in those joints, which increases your risk for losing your balance possibly causing you to fall. Another aspect of these muscoloskeletal issues that can impact balance is an injury or surgery, such as a total knee replacement or total hip replacement. If you break your ankle, part of the body’s automatic healing process is active inflammation of the area. A lot of your muscles around the areas almost shut down so you don’t have that strength. You will then be relying more heavily on the opposite leg and other muscles. This compensation will cause you to be at an increased risk for balance problems because those muscles are not functioning properly.
The third common thing that can impact balance in the older population is diabetes. What happens with a diabetic issue is that you can start to lose sensation in your feet. Think about when you’re walking. If you’re not wearing proper shoes or if you’re walking on an uneven surface, you don’t have that sensation in the bottom of your feet to determine what is under you. You could might step on something on your might not feel that there is an issue with the concrete outside and you just will more likely stumble and lose your balance and possibly have a fall.
How can physical therapy address balance problems in the older population?
Physical therapy is a great option for patients who have musculoskeletal injuries whether it’s non surgical or surgical. We will help increase the strength in your legs, which then increases the balance. We also give you specific balance exercises, which challenge all the parts of your balance system. We can also educate you on the home modifications you need to make is there is anything that could be putting you at risk for a fall.
What about balance issues in the younger population?
The number one reason we treat kids and younger athletes for balance issues is due to sports injuries. At Loudoun Sports Therapy Center, we see a lot of high school students and middle school students with sports injuries. In many cases, these kids are participating in sports all year round. So if they sustain an injury, whether it’s an ankle injury, an ankle sprain or even a tear in their ACL, their muscles around the joint weakened after that because they are compensating fro that injury by leaning off to the other side. In addition to the decreased strength they now have due to injury, if there is any kind of ligament issue, there is an automatic loss of stability in the joint because the ligaments attach from bone to bone. For instance, if an athlete has an ankle sprain and they roll their foot inwards, those ligaments are overstretched. If they’re more prone to ankle sprains, the more you sprain something or overstretch some ligaments and tendons, the more likely you are to sustain an injury in the future. This all ties back to the balance systems in these athletes. By addressing their strength deficits, we are able to help them improve their stabilizing muscles so their balance is not compromised.
How can physical therapy address balance problems in the older population?
One of the ways we do this at Loudoun Sports Therapy Center is by properly addressing core weaknesses. A lack of core stability is a common issue we see in athletes and it can lead to many other problems up and down the chain. One of those being balance and stability. Your core is made up of the abs, your pelvis your hips and your back muscles and is your stabilizing area of your body.
With physical therapy, we’ll educate you on injury prevention. We will help you understand your injury and take you through targeted strengthening and stretching to help you return to sport and properly progress your exercises to prevent re-injury. Too often we see athletes get an injury like a sprain for example. They rest for a few days and then it feels better so naturally, they return to the sport. The problem is though they don’t realize how weak they’ve become in that area of injury. So they are more at risk for re-injury and get stuck in this cycle until the primary cause is addressed.
By Devin Wurman, DPT
