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Training for Old Age – The Importance of Balance

Training for Old Age – The Importance of Balance
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By Kathleen Heins

Laurie Huseby, 48, of Greer, South Carolina recalls a mid-life visit to a roller skating rink that ended in disaster. Although her husband was ready to call it a night, she decided to go for one last lap. Losing her balance, she put her hand out to break her fall. “I immediately knew that I had broken something,” she recalls. “The pain was instantaneous and I couldn’t move.” A trip to the ER confirmed her fear; she had broken her wrist in two places.

Over 1.6 million older adults in the US land in the ER for fall-related injuries each year. According to the National Institutes of Health, falls are the leading cause of bone fractures, hospital admissions, and deaths among this group. While most don’t occur on the roller rink, balance is a part of everything we do from stepping out of bed in the morning to hitting the slopes.

Mentally we may feel as if we’re still in our 30s, but the decades do take their toll. “As we age we have changes in strength, flexibility, reflexes, coordination, and balance,” says Theresa Jacobs, PT, DPT, a board-certified geriatric clinical specialist in Rehabilitation Services at Newton-Wellesley Hospital in Newton, Massachusetts. “That’s why there are so few pro athletes over 40; Tom Brady is considered ‘old’ in the football world.” The reality is that most of us aren’t going to be able to perform the same at age 50 as we did at 25 so maintaining good balance is key to remaining independent.

Balance Compromisers

Poor balance can result from a variety of causes including health problems and medications as well as fatigue, slick surfaces, poorly fitting shoes, alcohol use and insufficient exercise. Poor vision is a big one, says Jacobs. “Vision is probably the most influential part of balance as we age,” she states.

For many, taking a fall turns an active and independent person into someone needing help to get through the day. In the best case scenario, this is temporary, but it’s not always the case. While some can make it through treatment and rehab, returning to life as they knew it, many find themselves needing long-term, if not life-long, care.

Huseby says that a year after her injury her wrist and arm still didn’t have the strength it did before but it was a far cry from when she first fell.  It was a rude awakening to experience firsthand just how debilitating a fall can be, she says. “It affected dressing, working, driving; everything I did,” recalls the surgical nurse. “I couldn’t even put my hair in a ponytail without my husband’s help.”

How Does your Balance Level Rate?

Convinced you don’t have balance issues? Don’t be so certain. Here’s a simple test you can do to check your level of balance. You’ll need to find a partner and a stop watch. Be sure to stand in front of a counter in case you feel unsteady. Here’s how to do it:

  1. Wearing flat shoes, stand with your arms folded across your chest. Keeping your eyes open, find an object to focus on. Raise one leg bending your knee at about a 45 degree angle.
  2. Remain standing on your other leg until you uncross your arms, start leaning sideways, move the leg you’re standing on or touch the floor with your raised leg.
  3. Repeat the test on your other side.

Compare your results to what’s considered normal for your age:

  • 20 to 59 years old (28 to 29 seconds)
  • 60 to 69 years old (27 seconds)
  • 70 to 79 years old (15 seconds)
  • 80 and older (six seconds)

Move it or Lose It

If your results were less than desirable, it’s time to do something about it! Exercise programs for improving balance, says Jacobs, should include stretching, strengthening, and aerobic conditioning, as well as balance-specific exercises.  Making certain your ankle, hip and core muscles stay strong is particularly important, she states.

Yoga is great for stretching and strengthening and there are even chair yoga classes available for those unable to practice on a mat. “Recently there has been a lot of evidence suggesting the benefits of Tai Chi for improving and maintaining balance,” says Jacobs.

Cardiovascular conditioning doesn’t have to mean a high-intensity aerobics class. Jacobs says that even going for regular walks can help. As you become accustomed to your pace, put some extra spring in your step.

For a simple balance exercise (also used to test balance), try standing on one leg for 30 seconds (by bending the opposite leg backwards) then do the same thing with your other leg. Repeat the sequence three times. Be sure to have something to grab onto if you feel unsteady.

Create a Fall Prevention Plan

Your fall-prevention plan (including any exercise regime), says the Mayo Clinic, should begin with a discussion with your doctor and include the following:

Overall health: Eye and ear disorders can increase your fall risk so make sure eyesight and hearing are checked regularly. Tell your doctor if you feel dizzy, shortness of breath, numbness, joint pain and any other unusual symptoms while walking or working out.

Medications: Review your prescriptions for those that may cause dizziness. Discuss whether alternatives are available.

Fall History: When have you fallen in the past and what were the circumstances?  Include times when you almost fell but were able to catch yourself.

Don’t ignore changes in walking patterns: If you begin to change the way you walk take note. If a once regular stride is reduced to “baby steps” or shuffling don’t wait to get assessed. Not only can this increase your risk of falling but it may be an early sign of dementia.

Check your Vitamin B12 level: Found in foods from animals such as meat, eggs, poultry and dairy products, not getting enough can affect your balance.

Fitness Level: Ask your doctor to evaluate your level of muscle strength and take a look at your walking style.

Walk this Way

You’ve gotten checked out, now take a look at your footwear. For starters, get some decent walking shoes. Ditch super high heels (bad for your feet anyway), shoes with slippery soles, clumsy clogs, falling apart shoes that you save for gardening and any others that increase your fall risk. Treat yourself to a pair of workout shoes designed for walking or cross trainers that can also work at the gym. Make sure all shoes provide some traction. Don’t take chances! Walking around in stocking feet, especially up and down stairs with no carpeting, may be asking for trouble; so put a spare pair of shoes near steps with smooth surfaces.

Conquer your Fears

Fear of falling is common as we age even if you haven’t experienced a major fall. If you are fearful about falling, talk to your healthcare provider. If you are having balance difficulties, you may even want to ask your doctor to prescribe some physical therapy sessions to improve your fitness level and give your confidence a boost!


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Kathleen Heins
Kathleen Heins has been published in Better Homes & Gardens, Woman’s Day, Ladies’ Home Journal, Good Housekeeping, Reader’s Digest, Runner’s World and USA Weekend, among other publications. She has also written for a number of major city newspapers. A native New Yorker, she now lives in Greenville, South Carolina.