From time to time I am asked, ‘Why can’t I balance?’. The simplest answer lies in lack of practice. From as young as 30 our balance slowly starts deteriorating. If we lead relatively sedentary lives, walking from house to transport to work to shopping, all on flat surfaces, we will be quite unaware of this slow decline in our balance, until we go on holiday, go out for a walk and land on a wobbly stone, and whoops, we’re over. Its tempting to blame the wobbly stone, not ourselves. And so the easiest answer is to practice balancing on both stable surfaces, which equates to standing on 1 leg, and balancing on unstable surfaces, like a Swiss ball. If interested,we should be able to stand on 1 leg, aged 20 – 49 for 24 – 28 secs; aged 50 – 59, 21 secs; aged 60 – 69, 10 secs; aged 70 – 79, 4 secs; over 80 yrs, 0 secs. So along with the 10 yearly horror of turning another decade comes this sudden fall in the length of time we can stand on one leg! Extraordinary to think that the night before turning 60 we should be able to stand like a stork for 21 secs, then in the morning only 10 secs!
Facetiousness apart, the reasons for poor balance are many. The National Safety Council in America lists 25 different factors. The main ones listed by ROSPA are
- Physical ability and lack of mobility, balance and gait disorders.
- Nutritional status, lack of vitamin D and calcium.
- Medications, including painkillers and anti-depressants
- Acute and chronic disease and disorders, including stroke and heart disease.
- Being female.
- Environmental hazards
- History of previous falls. This leads to fear of falling, so less activity, increasing weakness and lack of mobility all of which mean an increasing chance of falling again. Vicious circle.
Expanding on the physical reasons for poor balance. Most people find they can balance on 1 leg better than the other, again there are multiple possible reasons for this. A major one is past injuries to the leg, foot or ankle. As I have said in the past, that time years ago we twisted our ankle, unless fully rehabilitated including the ankle ‘map’ in the brain, will have lead to the brain expecting pain whenever we stand on that leg, so it weakens us. Bends in the spine – scoliosis – make balance more challenging. Weakness in the muscles of the legs, hips and trunk means we lack the strength to right a major wobble. The most important factor to ageing well is to remain strong. Deteriorating eyesight plays its part – wearing varifocals means our vision around our feet is blurred. Another cause dear to my heart is loss of sensitivity in the sensory receptors of our feet, due to wearing stiff and cushioned shoes. And also due to diabetes causing nerves in the feet to die off, so again resulting in and increasing loss of ability to feel what is under our feet. In both cases, the detection of speed, gravity and motion has declined. And then there is obesity itself. Misinformed eating patterns is growing a nation of whales attempting to balance on their tail fins.
On top of all this comes trauma to the head, plus medications or habits such as holding the phone between the same ear and shoulder for lengths of time. All these cause inner ear imbalances, so it becomes entirely possible that, from the signals coming from the inner ears to the brain, the brain thinks we are turning to the right, whilst the eyes say we point forwards. Sounds alarming. The messages from the eyes take precedence over messages from the balance centre, but the confusion within the brain remains. And, to add to the puzzle, frequently part of the visual reflex is not working well, for instance, after a blow to the head, the part of the visual field where we were looking when thumped on the bean goes down. As I can testify, having suffered a severe blow to the right side of my head.
So why can balance be so difficult? The answers are many and various. To keep balance ability, practice it – the easiest exercise being stand on one leg when putting on socks and pants – there may well be some resultant hopping about, which has to be a bonus since this will raise heart rate. Look after ourselves to avoid taking pharmaceuticals as much as possible and keep ourselves strong. Contact lenses give better vision than glasses if they can be tolerated – but do avoid the current vogue of having one contact lens set for reading and the other for distance. This utter madness causes great disturbance to the brains visual centre, no matter what the optician says about the brain adjusting. Admittedly I only touched upon the visual reflex, but one eye constantly out of focus can only mess up this reflex – and mess up peripheral vision. Avoid diabetes – not so hard for type II and avoid getting so fat that the elephants in the zoo start giving us the eye. A final thought, according to the NHS, between March 2010 and Feb 2011, there were 20,800 hospital admissions due to falls involving a bed. It is entirely possible that this is due to the nation’s rampant sexuality or 20,800 of us fall out of bed in the morning in joy to rush to work.