Improving Your balance to Prevent Falls

Hi, I'm Doctor. Keller Wortham with another home edition of house call. And today, I wanna talk about one of the most common concerns I get from my older patients. It's that of instability.

I hear a lot of them saying, my balance is worse. I feel wobbly. I feel like I'm going to fall. And they are right to be concerned.

As you get older, falls can be very dangerous to your health. You know, every eleven seconds someone over sixty five is treated in the for a fall. Those falls can lead to broken bones, traumatic brain injury, neck, and back injuries, and they're risky if you're on blood thinners due to bleeds, And out of older adults, one out of every five falls leads to a broken bow. So it's clear it's very important to prevent falls.

And although a fall might seem like an unforeseen accident event, there's actually a lot you can do to help reduce your risk of a fall. So today, we're going to talk about some of the strategies to help reduce your risk of falling. And I'm going to show you some exercises to help improve your stability and your balance.

But first, you should know the risk factors for falls. So listen to these and see if any of these apply to you. The more you have, the riskier it is that you may have a fall. Number one, age. You know a lot you can't do about it, but the older you get, the more likely you may have a fall. Number two, previous falls. If you've fallen before, your risk of falling again goes up exponentially.

Number three, poor vision. Number four, low vitamin d, Number five difficulties with balance. Number six wearing poor or risky footwear. So make your decisions about what you put on your feet. And number seven, medications that affect your balance. If you're not sure about the medications you're taking and whether they may affect your balance, ask your doctor.

Okay. So before we talk about falls, we should probably talk about the way our body prevents them, our balance system.

Balance is a crazy complex system. There are a lot of components working together. I just want to quickly go through them so you know what we're talking about. Our central nervous system, which is our brain and our spinal cord, which helps process information and let our body know where it is, our vestibular system, which our inner ear that has these canals that let us know where our head is in space, our visual system, which gives us cues about the world around us and helps integrate our spatial information in our brain, and then proprioceptors, which are these little nerves we have, these nerve endings and sensors and the tendons and the joints especially in our feet, which kind of take information about where we are and send that back to the brain and also work in reflex arcs. Okay? Just help us react very quickly before the brain even knows what's happening.

So why do people fall? Well, generally it's when things interfere with these systems that I just mentioned. That can be things like disorders of the vestibular system, which can be in or benign paroxysmal position, positional vertical or BPPV, because that's hard to say, visual disorders, like cataracts that affect your site, arthritis that can affect the bones and make the muscles weak and damage the proprioceptors, peripheral neuropathy, which can happen from things like di beadies or high blood pressure, which changes your, perception sense of the world, heart arrhythmias that may kind of have you on meds that can affect your balance, and other neurologic conditions like MS or Parkinson's, or even just dementia, which can kind of hamper your processing.

So let's talk about the best ways to prevent falls. Well, globally, it's maintaining overall health of all these systems. Making sure your eyes are healthy. You've got good vision.

Making sure your ears are healthy and being aware if you have a cold or flu or allergies that you can get kind of vertigo or mixed signals from your vestibular system, making sure your muscles are strong. Now, we lose a lot of muscle mass as we age, but it's important to keep them strong with exercise and strength training. And that's what I'm going to show you when we get to the exercises. You also want to get good nutrition for your muscles in the form of vitamin D, and calcium, and all the other minerals that are important for muscle and bone function.

Maintain an ideal body weight Too much weight can affect your balance and your joints, and too little weight can put you at risk of fractures.

And then keeping your joints and your bones mobile and strong, maintaining a good posture, and keeping your, basically, your core and your leg muscles strong. These are all fundamental for maintaining a good balance and movement system. Now you can't control your age and you can't prevent some medical conditions from happening but you do have a lot of control over your muscle strength and your core strength. So that's what I want to focus on today. Some various exercises you can do to help improve your stability and your balance.

Alright. So let's get to some fundamental core exercises.

I really like yoga and mat pilates for things that help strengthen the core, kind of general exercises that help strengthen the core. And then other exercises like Tai chi or other kind of movement exercises that help help you, move through space in a controlled way. So the three core exercises I'm going to show you today are bird dogs, bridge poses, and plank position.

Okay. So you'll start with all fours on the ground here. Nice neutral spine. And then what you're gonna do is you're gonna extend one arm forward and the opposite leg backward. You don't want a bandana, your spine, you want to go kind of straight back, be thinking of length as you're moving back with your leg and your heel, forward with your hand. You want your palm kind of facing inward with your thumb up and then you want your toes kinda pointed downward, and you're gonna hold that, that's the position, and then come back down.

The movement doesn't have to be held that long. You basically can kind of go back to the opposite side, hold for three and then come back down.

Again, two, three, and back down.

Again, hold two, three, and back down.

This exercise helps strengthen the paraspinal muscles or those that big muscle, big long muscle group goes along either side of the spine.

I'm gonna move on to the second core exercise here, which is called the bridge pose.

In this exercise?

Wanna have your feet flat on the floor. So you can about tickle your heels. That's about how far away your head resting here relaxed. I'm tickling my heels. I've got my shoulders there nice and planted on the and what I'm gonna do here is just engage my buttocks, my hamstrings, and lift the pelvis up.

I'm gonna try to keep my neck neck nice and extended. I don't wanna be kinda crunching like that. Nice and extended. I'm gonna hold it.

And release it back down. My toes are pointing straight ahead. I'm not kind of turning them out like that. Toast straight at points ahead. Again, I'm tickling my heels.

I'm gonna raise up, hold for three seconds, two, three, and back down.

Okay? Again, you can do sets of ten of these.

One, two, three, and back down.

I'm engaging a lot of my core muscles and my, basically, my upper leg, my quadriceps, and my glutes, and my hamstrings. And working on basically those core muscles to strengthen and protect my back, which is going to help protect my balance.

The last and maybe best core exercise I'm gonna demonstrate in three different ways is the plank. The plank is great for overall core strength. So I'll show you kind of three degrees of difficulty.

The first is just your traditional plank pose. So you've got your body in a straight line.

You're engaging your core, so your buttock, your abdominals, and you're just holding that tank with your head straight. And all you have to do for this one is hold it. You can hold ten seconds. You can hold fifteen.

If you can hold twenty, go for it. This is your traditional plank. You don't want to let your body sag like that and you don't want to stick your butt up really high. You want to try to squeeze all those core muscles that you have that you've just kind of got a nice straight plank there.

Now that may be too difficult for some people.

So the next version is to do that same position on your elbows.

Now I'm in a plank on my elbows. I don't want my elbows to splay way out like that. I wanna base have my forearms parallel. My hands flat on the floor.

And again, I don't want to let my butt sag. That's bad for your back, and I don't want to up like that either. I want a nice core strengthening exercise here by engaging all of those pelvic muscles and abdominal muscles and squeeze you'll feel it. And again, you can hold this for ten seconds, fifteen, whatever you can do, and then relax and do it again.

If if that still too hard for you, then you can do the same thing on your elbows, but with your knees as well.

So now I've got basically of less of a plank, and I'm not letting my body sag here, kind of pushing away through my elbows with the shoulders, keeping my knees on the ground, keeping you nice and in line. I don't want to be splayed out.

Just basically like that. Again, holding this position for ten seconds, fifteen, whatever you can do.

And then relaxing.

Okay. So we did three core strengthening at sizes. Now we're going to do three that focus on the legs. Obviously, the legs are really important.

That's what we walk on. They're kind of the the main contact of the rest of our body with the ground. So we need to keep them strong and ready to react in case of a trip or a stumble So here we go. The first I can show you is just a standing side leg lift.

So you just basically can use a chair if you need to for some stability, and you're just gonna basically raise the leg out to the side and bring it back down.

Raise it out to the side and bring it back down. If you can't go that high, just go a little bit and back down. If you feel like it's too easy, you can get some nice ankle weights to pound or two, put them on, and you'll be able to kind of increase the challenge there. As with anything, you want to go slow, and you want to hold for three seconds up there and come back down.

For foot position, you're probably best to keep your toe kind of pointed forward and not be rotating out that way. And you'll notice your upper body will shift a little bit, but that's basically going to help strengthen the abductors of your leg, which are very important, a very important muscle group for stability and muscle control of your legs. So again, I like to do a set of ten for each side. I like focusing on one side first and then alternating.

So you really engage those muscles and work them before you let them rest. So just holding up. One, two, three, and back down.

One, two, three, and back down, sets of ten on each side.

Second exercise, to help, engage our calves or gastrocs, as we call them, is just heel raises. And I can use my chair here. I can show you kind of from the side, so maybe you guys can see a little better.

Just raising up on my toes.

Coming back down and resting.

Raising up on my toes, holding two, three coming back down and resting.

And again, up two, three, coming back down and resting. Very easy to do a set of ten as well there. Again, I'm trying to build up the strength in my legs because I know those are kind of the the first warriors when it comes to keeping me stable. And preventing falls.

The last exercise I'm gonna show you, and the most challenging is what we call a sit to stand. So now we're gonna sit on this chair And basically what you want to do is keep your hands in your lap or if you want to put them here to give you a little more, upper mobility. You can do that. And basically, you're just gonna make sure that your legs are nice and even with your hips, your toes are pointing forward. Your core is engaged. Your back is straight. And then you're just gonna stand up.

And then go back down. Again, this does not have to be a quick motion. In fact, it's probably more challenging to do it slowly. And stand back up and come back down.

If that's hard for you, put a pillow underneath you. Okay? Do the exercise, so you're not quite so low. Put a nice big pillow, and then you can stand up and come back down.

If it's hard that way, you can even use your arms to put out front of you. It gives you a little more kind of upward weight to use as leverage. That's gonna make the exercise easier.

Again, doing a set of ten of these is a great way to build up strength in your core and in your legs, your glutes, your hamstrings, and your quads.

Our last two exercise focus a little more on balance and less on actual strength. One is just standing heel to toe. Okay. So I'm going to demonstrate this to the side so you can see. It's basically just being in a standing position with one heel at the toe.

You can feel your body wobble a little bit.

You can put your arms kind of in at your core that help stabilized there. If you don't feel steady with this, put a chair in front of you and do it on the back of a chair. Okay? Just standing like this for solid thirty seconds, is gonna engage all of those micro muscles in there that need to fire to keep you nice and balanced. We're almost kind of rewiring our proprioceptors or the sensors in our legs to kind of know how to help us maintain that stability. Do it with one leg in front?

And then you're gonna switch, and you're gonna do it with the other leg in front.

Okay? Again, if you need to, you put a chair here.

And the second exercise is just a traditional one legged stand. Again, if you're not so steady on your feet, have a chair there so that you can hold on to it. I'm gonna just so you can see better demonstrate without the chair. And that's just standing on one leg with the other leg in a various position.

This is easier to do, by the way, without shoes on, but I'm just gonna show you since I got my shoes on here. One is just doing it with just one leg kind of just barely up and resting on the ankle. I'm keeping my arms here kind of in at my core to help it balance. So this is one way to do Okay?

And we're talking about holding this for a length of time. Thirty seconds I would say is the minimum or I'd like you to try. If you can do it for a whole minute, even better.

And just resting here. If you need that chair, you put it right in front of you. Okay? You'll feel the little muscles fire. Again, we're training the proprioceptors in your muscles to send signals to your brain and know how to adjust for these these micro movements there. If that's easy enough, the next step would be putting that on your calf. Okay?

And holding it there. Again, you can do this with a chair or just standing here. And if that's easy enough, you can put that and away up on your leg. You could keep your hand here to hold it, you can hold on to the chair with the other one. And there we go. Holding that position, like I said, thirty seconds, maybe up to a minute, just to allow the strength of these muscles as well as the training of those proprioceptors.

So there you go. We've gone through three core strengthening exercises three leg and and buttocks strengthening exercises, and then a couple of exercises more for actual balance and the proprioceptors.

Do that routine and you will help keep your balance center kind of in check and help keep your muscles strong and help prevent those devastating falls that can lead to all kinds of injuries. Alright. I'm doctor Keller Worham. Thanks for tuning in to another home edition of house call, and I'll be back next time with more exercises.