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Balance Basics

Balance. What is it? According to Merriam-Webster dictionary, it is most basically defined as physical equilibrium. Further definitions include equipoise between contrasting, opposing, or interacting elements. I particularly like this definition as it leads well into the multitude of body systems which work together to help you stay upright and fight gravity all day. These systems include the musculoskeletal, neurological and vestibular, integumentary, and cognitive systems. Let’s break these down!


The musculoskeletal system is composed of your bones, tendons, ligaments, and muscles. Why does this matter? Because if these are damaged or not strong enough to withstand or correct against gravity, gravity will win.


You’ve probably heard about the nervous system. Its the crazy connection of nerves and signals leading from you brain down to your fingers and toes and vice versa. To overly simplify nerves, there are two types. Sensory and motor. Nerves designated as sensory focus on input of the 5 senses (see, hear, taste, smell, and feel). Sensory nerves bring input to the brain. The brain then processes this input and sends a signal back through motor designated nerves to react and respond to the initial input. Just to complicate things, some nerves complete both actions. And that’s just the nerves. The brain has books dedicated to its elaborate schemes. This is why traumatic brain injuries, spinal cord injuries, and other neurological disorders become so complicated.


The vestibular system is the connection between the eyes, ears, and brain. The eyes, of course, bring in information about your surroundings while the ears, via the 3 semicircular canals, determine where your head is in space. The brain receives this information and interprets this information to relay what the body should do. When this system goes haywire, it can mean some serious balance deficits.


The integumentary system is the skin and all its receptors. As we grow, our receptors become more defined. As we age, these receptors may be damaged or altered by disorders, disease, or frailty. For example, diabetes has a bad habit of altering sensation. If you can’t feel the ground under your feet, you can’t feel the uneven terrain, or the edge of the rug in the living room against the carpet, and may not respond appropriately causing a loss of balance.


So what’s left? The cognitive system. The brain and its ability to comprehend and respond to all of these other systems. Loss of cognition can lead to loss of balance due to decreased understanding of the environment, decreased reflexes and reaction time, and decreased ability to learn new things in order for the brain to adapt to new situations.


Physical therapists use a variety of tests and measures designed for particular populations. If you are having difficulty with balance or falls, we urge you to seek out further assistance.

All systems must work coherently to help you keep your balance Physical therapists are trained through rigorous programs to identify functional deficits related to balance impairments and help you improve upon these in order to retain or gain (depending on whether you are 9 months old, 43 years old, or 99 years old) your independence and motor function.


Age Fit's physical therapist is certified in Vestibular Rehabilitation by the American Institute of Balance and specializes in vestibular and balance impairments.

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