Balance is referred to as an individual’s ability to produce and maintain a stable posture. Although balance is not the main focus of most individuals training goals it has a great importance to everyday life. According to the ACC 2014 statistical data, falls are the most common injury in older adults. Many factors can cause the elderly to fall but the underlining cause is a lack of ability to balance. Not only can these injuries have long lasting effects, such as loss of mobility for the individual, but in some cases cause death. Most sporting situations require a degree of balance for success. Not only will increasing balance improve an athletes sporting performance but will also decrease the chance of injury caused by loss of balance during sport.
An individual’s ability to balance is affected by two main areas, sensing change in body position and the ability to affect change in body position. There are three systems used within the body to sense change in position, vestibular (inner ear), visual (eyes), and somatosensory (soma = body, sensory = sensations). The vestibular system is found in the inner ear, it senses change in motion and position of the head. The visual system provides information to the brain on the body’s position in respect to the external world. The somatosensory system is responsible for conveying sensory information from the skin, muscles and joints to the brain. All three systems are used in combination to help the body balance.
The ability to change body position, in order to maintain posture, can be controlled actively by thinking about it or passively without thought. Our bodies usually use a combination of the two. The nervous systems postural reflexes control posture passively (sub-consciously). The body’s muscles and nervous system are used to actively control body position; an example would be changing arm position when balancing on one leg.
When your goal is to improve your balance you must improve both your ability to sense change and your ability to affect change in the body’s position. There are many techniques used for improving balance such as exercising while standing on one leg or performing exercises with your eyes closed. In this article we will look at just one technique, overloading both the somatosensory system and the muscles controlling balance. To improve a physical ability you can overload (make its job harder) than normally experienced. A good technique, when training for improvement in the somatosensory system, is to increase the demand on the system by making the base of support (i.e. the floor) unstable. The most common pieces of equipment used in the gym are the swiss ball or the wobble board which both work in two ways. Firstly by creating an unstable base of support making it harder for the body to sense change in position relative to the ground which then increases this system’s ability to work during normal situations. Secondly, making it harder to change the body’s position by not having a solid platform to push against, this helps to increase strength and stability of the muscles concerned with control of balance. This is especially important for older adults when lack of muscle strength is a key factor in causing falls.
The Balance Exercises
The following exercises can be used in addition to an individual existing exercise programme. If you have any known physical or medical conditions see your doctor for clearance before commencing these exercises. If possible have a qualified instructor check your technique.
The Wobble Board
A wobble board is usually a disc shaped board with a smaller dome on the base creating an unstable platform, although they do come in many shapes and sizes. An air-filled plastic wobble board with a wooden disc for stability was used for the following example. The wobble board has been widely used by physiotherapists for rehabilitation of lower limb injuries. It can be used to help improve the nervous system and stabilizing muscles. Within gyms the wobble board has been used more and more in a range exercises such as squats, lunges and press-ups to help improve balance and create variation from traditional techniques.
Wobble board squat and one arm shoulder press is an excellent exercise for improving balance while still completing a resistance style exercise. You should do the exercise at the start of your programme when your nervous system is fresh. Because the exercise uses a large number of muscle groups it is great for warming up the entire body.
The Swiss Ball
The swiss ball is widely used for improving strength, increasing muscle tone, increasing flexibility and in this case improving balance. The same principles for improving balance with the wobble board apply to the Swiss ball.
Swiss ball balance exercises can be preformed at the start of an exercise programme to warm-up or at the end of a programme as a cool-down. Make sure there are no objects or obstructions within a falling radius that may cause injury. When you have mastered the level 1 exercise by completing 2-3 sets with good technique for 1min, move on to the next level.
Wobble board squat with one arm medicine ball shoulder press.
Starting position
Place wobble boards shoulder width apart. Use a 1-6 kg medicine ball depending on strength. Stand on wobble boards with medicine ball in left hand at shoulder level.
Down phase of the squat (left arm shoulder press)
Feet should be between hip and shoulder width apart, toes forward and slightly outward. Keep the medicine ball steady at shoulder level, eyes on the horizon and the chest up. Move with hips first then knees. Squat as if sitting into a chair, keeping the abdominals strong. Stop descent if the pelvis tilts backward or when the thighs are parallel to floor which ever comes first.
Up phase of the squat
Start the one arm shoulder press halfway through the up phase of the squat. Keep eyes on the horizon and the chest up throughout the movement. At the completion of the squat and shoulder press transfer the medicine ball to the right hand.
Down phase of the squat (right arm shoulder press)
Repeat steps taken for the left arm.
Up phase of the squat
As before, start the one arm shoulder press halfway through the up phase of the squat. Keep eyes on the horizon and the chest up throughout the movement. At the completion of the squat and shoulder press transfer the medicine ball to the left hand
Swiss ball balance exercise.
Level 1: Four point stance
Mounting the ball
Start in an open area with a flat level surface. Place knees shoulder width apart against the ball. Place hands slightly outside the line of your knees on the opposite side of the ball. Slowly transfer your weight over the ball until you are balancing on top of the ball.
Holding the exercise
You should have four-point contact with the ball using both hands and knees. Keep back and neck in neutral position during exercise. Draw bellybutton towards spine to keep abdominals strong. Hold position for up to 1 min.
Dismount
Slowly move your body weight backwards off the ball until your feet make contact with the ground.
Level 2: Three point stance
Holding the exercise
The same technique is used for mounting and dismounting the ball in three-point stance as in four-point stance. There is a difference when holding the exercise. Once four-point stance is reached, slowly raise your right arm until it is inline with your back. Keep neck and back in neutral position. Hold for half the time of the total exercise then slowly return to four-point stance and raise the left arm.
Level 3: Kneeling on the Swiss ball
Start with same technique as four-point stance. Then slowly rise up to a kneeling position with arms out parallel to the floor for balance. Keep eyes on horizon and chest up.
Level 4: Kneeling on the Swiss ball with one arm medicine ball fly
Start in the kneeling position on the Swiss ball. When you have reached a stable position with out stretched hands raise a 1kg medicine ball in front of you. Slowly move the ball in one hand out to the side until it is inline with your body then slowly move the ball back into the middle. Grab hold of the ball in the opposite hand and repeat step. Continue with movement until set is over.
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