In Part One of this series, we discussed what systems our body uses to help us maintain our balance and remain stable.  In this post, we’ll review how physical therapy can help address balance challenges and help you be more confident with your movements.  

Vertigo, Dizziness or Imbalance?

These terms are often used interchangeably by people that have a vestibular or balance problem.  The key to proper treatment is to determine if you have a sensation of spinning or if you are feeling unstable and off balance.  If you have a spinning sensation called vertigo, then a complete assessment by a certified vestibular physical therapist is critical to correctly identifying your problem.  “You want to ensure that you are being treated by someone who has extensive training in this area of care”, says Matt Whitaker, PT.  “Proper identification of your problem is essential to successful treatment”.

If the problem you have is a feeling of poor balance and being insecure on your feet then your evaluation will focus on assessment of your strength, agility, muscle length or flexibility and the range of motion of your joints.  A challenge with any one of these can create a sensation of poor balance and fear of falling.

What is Vestibular Rehabilitation?

Let’s take a closer look at what therapy entails.  If you have vertigo or spinning, treatment is often referred to as vestibular rehabilitation.  First we determine if the problem is peripheral or central in origin.  Generally this means it may originate from a problem in the boney loops in the inner ear (peripheral) as in the case of BPPV or benign paroxysmal positional vertigo or your brain may have trouble coordinating the information received from your vision, what you feel and your head movements (central).  For either problem you should see a physical therapist with experience working with neurologic conditions to receive very specific treatment to resolve your symptoms.

What is Balance Therapy?

If the problem is having poor balance without sensation of spinning you need balance therapy or retraining. Treatment will focus on your flexibility, leg, hip and core strength and your ability to control large or small movements of your body with and without foot movement.  It’s how you control those movements that makes your balance effective or not.  A complete balance therapy program will address all of these and potentially more.

Three Exercises for Balance

Matt Whitaker, PT states, “Not all balance problems are treated the same, but often they share a number of things in common that simple exercises can help.”  Below are three balance exercises that you can perform to start improving your balance right away.

Stretch the lower leg muscles

The “runner’s stretch” is a great way to keep your ankle joints and surrounding muscles flexible to help your balance.  You’ll feel the stretch in the gastroc or “calf” muscle of the back leg.  

  • Assume the position below with your hands on the wall or perhaps a counter, only for a little support.  
  • Apply pressure through the heel of the back foot as you push your hips toward the wall
  • Gently bend the front knee to increase the stretch.
  • Don’t let your back heel rise off the ground!  
  • Gently hold for 30 seconds, alternating each foot and repeat 3 times on each leg.  

Balance on one leg

Just as it sounds, you want to practice standing on one leg so your foot can control your balance.  Try to feel your toes and foot doing the work.  If this seems too hard, don’t feel bad about holding on to a counter or the back of a sturdy chair.  Over time gradually let up the pressure on your hand and control the balance through the leg only.  Set a goal of 20 seconds on each leg.  Repeat 5 times on each side.

Sit to stand transition

Finally, perform a sit to stand exercise from a medium height surface.  Follow the sequence below and try not to use your hands to rise.  If you need your hands, work from a higher surface.  If this is easy, try a lower surface which will make you work a little harder.  Also doing this a bit slower makes it more challenging!  Repeat 10 times, rest 30 seconds and repeat it twice more.

       

 

 

 

 

If you perform each of the exercises above you will have completed a stretch, a balance and a strengthening exercise and be well on your way to Move Better, Feel Better and Live Better!

Matt Whitaker, PT has been providing vestibular rehabilitation and balance therapy patients for 19 years with 10 years exclusively treating neurologic patients.  Call to schedule an appointment today for a balance evaluation and assessment.