Dr. Clint Woo, DPT, PT
Physical Therapy for Balance! Decrease Your Falls Risk!
Updated: Aug 3, 2020
Good balance is achieved through a combination of major factors such as your inner ear feedback (vestibular), proprioception (sense of where you are in space), and vision. Sometimes the cause of your falls may be easily attributed to a diagnosis (stroke, MS, Parkinson's, etc), but balance is also affected by range of motion (ROM) of your joints, strength, endurance, medications, coordination, etc. When you have poor balance, the ultimate fear is usually falling and hurting yourself or those around you. A fall can lead to severe injury and even death thus we must do everything we can to reduce our chances of a an accident happening. Physical therapy (PT) can assess one's fall risk through a variety of standardized tests. There are different ones to accommodate your physical situation and goals you want to achieve through PT. Then like with any other PT session, it is time to assess which, if not all, of the above mentioned factors play a role in your poor balance. While it may be that some of the issues need additional attention from other health professionals, PT is a major player in addressing the impairments!
Let's take coordination in physical therapy as an example. We can start off with simple seated lower extremity coordination activities whether that's tapping our feet in a specific sequence of moving them in a specific pattern. Then we can progress this activity to standing! Then in standing we can do single leg actives such as balancing on one leg to cone taps, etc. The activities get only more interesting from these basic ones!
Let's next consider things like balance control strategies for fall recovery. People often inherently show progressive strategies for when you start to lose your balance that range from ankle strategy, hip strategy, and finally step strategy. You can think of these in the order of "lines of defense". If you start to lose your balance only a little, you might just use ankle strategy as in move at those joints to regain your balance. So for instance if you start to fall forward, your toes will curl and dig into the ground while your calves activate to propel you backwards as a counter movement. If this fails, then hip strategy might initiate to prevent a fall. if the calf activation wasn't enough, the hips will extend thus throwing your trunk backward making your top-heavy to your advantage to regain your balance. Finally, if hip strategy fails, then step strategy can come into play where you essentially have to "throw out the bicycle kick stand to prevent a fall. I have noticed that those reporting falling lack these once automatic balance control strategies when we assess their walk. Training is useful especially in front of a mirror to at least show them what the strategies look like!
Overall, finding a physical therapist who has certifications such as the Neurologic Clinical Specialist (NCS) found at Woo Physical Therapy and Wellness can be extremely useful to address balance issues for you or your loved ones.
As a disclaimer, this blog post isn’t intended as professional clinical advice. If you’re in need of support, consider contacting us at Woo Physical Therapy and Wellness to evaluated.