Balance is a complex system, so there is no one answer to the question, “Why am I losing my balance?” Listed below are six things the Physical Therapists at Hands On Physical Therapy look at during a physical therapy balance assessment. Losing balance when standing up or while walking can be frightening. The good news is that physical therapy exercises (this will be a link to the other article) can improve balance. Read on to learn more about the reasons you might be losing your balance.
1. Your sensory system isn’t working properly
Our sensory system plays a big role in keeping our balance. The sensation our brains take in from our feet, ankles, and leg joints orients us in space. Conditions like diabetic neuropathy, peripheral neuropathy, stroke, multiple sclerosis, and Parkinson’s disease can all lead to decreased transmission of sensory information from the lower body to the brain. Even a history of frequent ankle sprains can lead to impaired somatosensory input. This means that the brain isn’t receiving a full picture of the environment and can’t react as quickly to balance challenges.
2. You’re dizzy
There are many reasons why someone might experience dizziness, all of which require in depth assessment by a knowledgeable Physical Therapist, and possible referral to other medical providers based on symptoms. Common causes of dizziness include vertigo, orthostatic hypotension, dehydration, medication interactions, or even neck pain. For some people, “dizziness” might not mean a sense of vertigo, it might just mean feeling “unsteady” or “off”. No matter what word people use to describe their dizziness, a thorough evaluation and appropriate treatment can lead to a resolution of symptoms.
3. Your range of motion is impaired
Standing up from a chair or walking requires that our ankles, knees, and hips have a certain range of motion. Decreased movement at the ankles, knees, and even big toes can prevent proper biomechanical alignment when trying to stand or walk. An example of this is when older adults have decreased flexibility at the ankles, causing them to catch their feet instead of smoothly clearing the ground with each step. Physical therapy can restore optimal movement for joints to allow for easier standing and walking.
4. Your strength isn’t what it used to be
Aging leads to a decrease in overall muscle mass. There are many reasons to incorporate strength training into any exercise routine as you get older, but one major reason is that the muscles in your legs and core are crucial for balance. In addition to the large muscles of the legs like the glutes and quadriceps, small muscles on the front of your shins (the pretibial muscles) play a key part in keeping you from losing your balance backwards. Regular strength for these muscle groups doesn’t have to be intimidating, and a Physical Therapist can help put together a training program that is right for you.
5. You get distracted easily
Cognitive dual tasking is the technical term for being able to think about something while you are doing something else, like walking. Decreased ability to dual task – common with aging – can lead to falls because balance reactions become slower when the person is distracted by a cognitive task. If you feel like you have to stop walking to focus on what someone is telling you, or you notice clumsiness when you’re moving around and your mind is elsewhere, you might benefit from dual task training. Part of a thorough Physical Therapy assessment for balance should always include a test of dual task ability.
6. You’re too focused on balance
One mistake people commonly make when they start to feel off balance is they pay more attention to their balance. This seems counterintuitive, but it all goes back to dual tasking. When people focus more intently on their balance, they lose the ability to automatically respond to a balance challenge without thinking about it. Think about a person who trips, stumbles, and catches themselves – they likely didn’t have to think before putting their foot out to stop their fall. People who focus intently on their balance lose the inherent automatic balance reactions that keep them safe, and make themselves more prone to falling when distracted – another reason to make sure that any assessment of balance includes an assessment of dual task ability!
If you are interested in learning more about your balance, Hands On Physical Therapy offers a balance screening clinic: click here to receive more information!
If you want more information about balance, check out our other articles, including an overview of balance and exercises to improve balance.