Maintaining good physical balance is important to all of us, especially those over 55. We know that when our balance is jeopardized, even slightly, we lose confidence in our abilities.  This fear of falling and general loss of balance are more likely to result in a fall that causes minor or major injuries. So, what exactly is balance and how does it work?

Balance is defined as “the ability to maintain the body’s center of mass over its base of support”. Your balance is a complicated network within your body maintained by a set of sensorimotor control systems, including three main areas:

Vision (sight) – Your sensory receptors are located in the retina called rods and cones.  Rods are believed to help with low light situations such a night time whereas cones help with color and the finer details.  The rods and cones provide visual cues and send signals to the brain on how a person is in relationship to the world around them.  Shadows, lighting, depth perception, all factor in to your vision’s job to maintain balance.

Proprioception (touch, spatial awareness) – These are sensors all over your body that allows your brain to know its position in “space”.  For example, how your feet and legs are positioned compared to the ground and your head compared to shoulders/chest due to sensors sensitive to stretch/pressure in muscles, tendons and joints.  Without these “proprioceptive sensors” one would know if a surface was uneven or slippery and would not be able to multi-task, such as driving a car, eating or even typing this article as we would be too focused on using one body part at a time.

Vestibular System (equilibrium, motion) – Components in the inner ear tell the brain about the movements and position of your head. The inner ear detects gravity as well sends signals to the brain when there is movement, such as head rotation, etc.  When the systems are both working properly, they send symmetrical impulses to the brain to maintain balance.  Sometimes if someone has a virus or ear infection, it can cause vertigo due to the improper functioning of that particular ear.


How These Systems Work Together

With balance, it is sometimes difficult to know if there is an issue with one of these three systems, because they work together, and sometimes compensate for each other, to give you maximum support. A couple examples:

Example 1: If you are unable to successfully lift your leg to go up a 6” step without looking down, there may be a proprioception issue that needs to be addressed.

Example 2: If you can stand still with your eyes open, but seem dizzy or off balance when they’re closed, there could be a vestibular system issue that needs to be addressed.


Common Risk Factors of Poor Balance:

  • Lower Body Weakness
  • Foot Pain / Poor Footwear
  • Difficulty Walking & Balancing
  • Vision Issues
  • Medications Causing Dizziness Hypertension/Cardiac Conditions
  • Hazards in Your Home


Therapy Can Help Reduce Falls & Improve Balance

Maintaining proper balance and sense of body position is critical to preventing falls.  Therapy performs an individualized assessment on the entire person to determine the root cause behind a balance deficit.  A physical therapist works with individuals to identify risk factors and designs a customized program of exercises and activities with an emphasis on strength, flexibility, and proper gait.

Balance may be improved with exercises that strengthen the core, back, ankle, knee, and hip muscles along with exercises that improve the function of the balance system. Occupational therapists work with you to discuss changes and modifications that can be made around your home to help prevent falls from occurring. Some therapists are also certified in Vestibular Rehabilitation which can alleviate the symptoms and treat the inner ear/vestibular system.  If you have concerns about your balance act quickly.

Falling is the #1 cause for hip fractures and for a person living independently ending in an institutional setting such as a skilled nursing facility or long term care.  Falling is serious and expensive business.  Maintain your independence and good balance by addressing your concerns right away.  If you think about it, falling is the ultimate loss of balance.  There are signs and symptoms to balance loss that lead up to a fall.  Recognize the signs and symptoms and contact your doctor to request an appointment with therapy to assess your balance.   You can benefit from therapy to improve and maintain your balance.



Healthcare Therapy Services, Inc. has a comprehensive 16-part Balance Program that focuses on addressing the root cause behind balance deficits.  Our therapists and wellness coordinators are specially trained in a wide range of balance assessments, measurement tools and interventions to improve and maintain balance for each person they serve.  As a partner in therapy, HTS is deeply integrated in the fall prevention systems for our clients.  We have great success with reducing falls and implementing organization-wide strategies to address the complexity of falls at every level.  For more information about HTS go to

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