These past few weeks in my clinical rotation, I have been working with patients who have balance problems and who might be at risk for falls. Having good balance is necessary to good health and function, but it is sometimes overlooked.
So, how does your body keep itself balanced? There are thee systems that are involved: visual, somatosensory, and vestibular. The feedback that these systems give is integrated by your central nervous system (brain and spinal cord) and is ‘fed through’ your musculoskeletal system. Let’s break these systems down.
- Visual System = your body uses visual clues from the environment to help with balance. It’s a way for your body to orient to the surroundings. We all know that it is harder to stand on one leg with eyes closed; this is because you don’t have the visual clues to help with balance.
- Somatosensory = this system deals with bodily sensations like touch, pain, temperature, vibration, and proprioception in your joints, ligaments, muscles, and skin. Proprioception is your body’s ability to know where a limb or joint is in space. Have you ever tried to walk after your foot has fallen asleep? If you are anything like me, you might stumble or trip. This is because your body isn’t sure where your foot is in space.
- Vestibular = this system provides your brain and spinal cord with information about the movement and position of the head. Your inner ear helps to provide this sensory information. If this system is not working properly, you may experience vertigo, which is when the room begins to spin around you.
- You must also consider the musculoskeletal system when looking at balance. If your muscles are weak, they may ‘give out’ during walking or standing causing you to lose your balance.
Finally, there is a difference between static balance and dynamic balance. Static balance is your ability to keep balanced while in a stationary position, while dynamic balance is your ability to keep balanced while walking, moving, or doing another activity. Having great static balance is good, but dynamic balance is necessary for staying independent in your day to day activities like: grocery shopping, walking down the stairs, and jumping over a puddle in the road.
When you have poor balance, any of number of these four systems could be involved. During my sessions with patients, I perform a series of tests that look at each part of the balance to try and tease out what might be contributing to their feelings of imbalance. It’s like putting pieces of a puzzle together, and I find it quite rewarding.
What questions about balance do you have? Do you struggle with your balance?