On Balance

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A MEDICAL ANOMALY with unknown causes and no symptoms led me to “gait therapy.” (Peripheral neuropathy, probably caused by Lyme disease, caused numbness, actually an absence of symptoms, which my doctor thought I should tackle.) “Gait therapy” led to me balance.

First, the sobriety walk. I have often wondered, if my car was stopped for any reason and I was asked to walk the line, what would I do? I never mastered that heel-to-toe walk without weaving and stumbling. The first day of gait therapy, I was told not just to walk the line, but to close my eyes while doing so. I wove and stumbled before completing one step.

Turns out that balance is one of those things you should make an effort to keep or even improve, starting in your 30s if possible. But any time is better than not at all.

So, no more leaning on staircase bannisters or on armrests when rising from chairs, I get that.  What gait therapy didn’t teach me was what support to use instead, which I eventually learned elsewhere – hamstrings, glutes, stomach muscles. Those still need a lot of work.

To maintain balance, the brain’s cerebellum coordinates information from three of the body’s systems — the visual, the proprioceptive (receptors in joints and muscles that orient you in relation to other objects) and the vestibular (inner ear). Over time, people rely more on the visual system, which operates more slowly than the vestibular system, causing people to feel shaky, begin to distrust their balance and become more sedentary, leading to less use of sensory information and worsening balance.

Daily adjustments such as using stairs and chairs without holding onto something make a difference. Also practice getting up from a chair 10 times in a row, first with your feet in a wide stance, then with your feet together. And walk on uneven surfaces such as grass.  Between crumbling sidewalks and broken escalators, D.C. offers many opportunities to work on balance.

Practice standing on one leg while waiting in the checkout line, for the microwave. At home, stand on one leg on a thick pillow (or Bosu ball), then raise the opposite arm straight out in front, then add swinging the opposite leg back and forth.  Also standing on one leg, swing the other leg back and forth and side to side. Do these things with your eyes closed to lessen your reliance on the visual system. Also, do these using a stretchy band around a fixed object so that your moving leg pulls against the band in each direction.

In my gait therapy sessions, I spent a lot of time on the sobriety test walk: heel to toes, eyes open, then eyes closed. I also practiced standing still, one foot directly in front of the other, heel touching toes, for 30 seconds, and then switch feet. Then do both with eyes closed.  If you have a 2-by-4 board handy, try walking that, heel to toe. After many sessions with practicing in between, I could walk the line 20 steps, pretty well, with my eyes closed; eyes open, I was a master.

Yoga can improve balance because it increases flexibility and integrates movements that strengthen different muscles, Dr. Arlene Schmid at Colorado State University told The Wall Street Journal.

Strength training can help prepare your muscles to react if your balance is thrown off, as well as stabilizing joints and maintaining bone density, according to Lenny Bernstein in The Washington Post.

“Balance” on Wikipedia lists 12 uses, of which only one, “equilibrioception,” is the “physiological sense of balance.” Others include a mathematical puzzle, “one of the wine-tasting descriptors” and the name of a Moody Blues song from their 1970 album “A Question of Balance.”

For the average Moody Blues listener, however, the early 1970s were not a time of “working out,” nor jogging, nor strength training and never balance exercises. Even in the 21st century, who in their 30s worries about balance when they are still putting on their shoes while standing up? Now there’s a goal.

— Mary Carpenter