From the time a toddler first learns to balance, the brain automatically puts together all the elements needed to maintain that balance. Better and faster than any computer, the brain takes information from all parts of the body, analyzes each of the thousands (if not millions) of bits of information, develops a plan and sends the message back to execute the plan by all the appropriate body parts to keep us on our feet. Think of what it must take to keep you from actually falling when you trip, much less for the gymnast to perfectly “stick” a landing after a double flip with a twist over a pommel horse!
Balance, once learned, is accomplished through what is called a motor program. Like a tape loop in an answering machine, once recorded, it pretty much stays there. Walking is also a motor program. That’s why we are able to walk and chew gum at the same time, without consciously thinking about it. Our brain just makes necessary corrections unconsciously.. and faster… then you could make them consciously. The main reason people often have balance problems when they get older is more linked to the old adage “Use or or lose it.”
As a young person, generally our muscles are more pliable, our joints less creaky and squeaky, our posture more upright. We walk and run confidently with our heads turned, arms and legs moving, even backwards … often while doing something else quite complex such as kicking or dribbling a ball while an opponent challenges our every move. Then life happens….
You take a bad fall off a bike and your knee is badly hurt. Your job requires repetitive motion and your shoulder becomes painful. Renovating the basement results in a back injury and you change how you walk. Then arthritis sets in. Or you have a surgery or a prolonged illness. Last check-up, the doctor says you’re spine is changing because you’re two inches shorter than you were five years ago. Then your leg buckles at the bottom of the stairs and you are so thankful it was at the bottom, not the top. But it scared you. You could have fallen and been badly hurt! And that fear of falling makes you more careful. First you modify or give up activities you used to enjoy. Then you start substituting more sedentary activities. Then maybe you start touching the wall or furniture when you walk…just to feel more sure on your feet. Maybe you start carrying a cane or holding on to a spouse or child’s arm. Now you stop before you turn around when someone calls your name instead of just turning your head to see who wants you.
With all these little changes to your movement patterns, your brain forgets a little more about what is used to do automatically. Now, granted, the information from arthritic joints is not as reliable as from those smooth, young joints. Swollen feet with poor sensation don’t give much useful information. Posture is less perfect so the brain’s perception of upright has changed. And there’s all that new information from hands touching the walls and furniture or a cane or walker that actually makes the brain lazy…all that extra support requires less effort to balance. So your brain starts to rely on other input and information for balance, from the quick, reflexive sources to the slower, less efficient sources. Balance becomes a more conscious activity. But the motor program is still there!
The brain can often tap back into those motor programs if you challenge it to do so …in a safe environment, of course. The brain uses information from your feet (somato-sensory), your eyes (vision or oculo-motor) and your inner ear (vestibular system for balance, not for hearing) and integrates these inputs to formulate a plan which is then executed through your musculo-skeletal system to keep you balanced. Some of these sources of input change with age and disease processes and cannot be returned to “normal”. For example, if you have diabetic neuropathy resulting in decreased sensation on the bottom of your feet, you will not likely improve your sensation dramatically. But we may be able to retrain the brain to use what information is available and/or to rely more heavily on one of the other systems because the somato-sensory system is not reliable. Or you may be able to develop a new substitute habit to decrease your risk of falling. For example, if you see poorly in the dark, turning on a light may greatly decrease your risk of falling.
Mederi Caretenders Home Health knows the best plan to keep you healthy is to PREVENT a fall. For that reason, our standard of care for EVERY senior includes the assessment and rehabilitation of all the systems that contribute to balance. Under the umbrella of Optimum Balance, our clinicians help seniors maximize their ability to tap into those old balance motor programs they learned as toddlers, perfected as children and teens and used throughout their lives as adults. The goal is to strengthen those systems that contribute to balance (the somato-sensory, oculo-motor and vestibular) as much as possible while maximizing the physical ability of the body to accomplish the “plan” the brain develops to maintain balance through strengthening, flexibility and range of motion.
If you are a senior at risk — if you are fearful of falling, have fallen or have some condition that has impacted your balance – we may be able to help! If you are wondering if you qualify for our program under your Medicare benefits, please contact Lori Key at Mederi Caretenders Home Health – 618.792.6547.
Thank you to our Guest Bloggers from Mederi!