Exercising Your Bones: Part 3 of 3 (Balance)
By Rebekah Rotstein, NCPT
Throughout the last two articles in the “Exercising your Bones” series, we explored how exercise can cultivate bone strength. We also demonstrated the importance of alignment and body positioning in supporting your skeleton, especially prior to adding additional loads like lifting weights. That said, bone strength is just one component of the bone protection formula. Balance training is another.
Good balance enables you to reach for objects and walk without shuffling. It allows you to withstand missteps and move freely. In essence balance assists you in preventing injuries and avoiding falls.
Balance diminishes with age, and its decline can have dangerous ramifications to your quality of life. Falls are the leading cause of hip fractures, and according to the National Council on Aging, falls are also the main cause of fatal and nonfatal injuries for older adults. Furthermore, research has shown that the fear of falling actually increases fall risk, showcasing the need for balance confidence in addition to balance practice.
For those who think that falls are solely the concern of the elderly, note that the all-too-common wrist fracture is the #1 site of fracture for early post-menopausal women. This occurs when slipping, tripping or falling off-balance, as the natural instinct is to reach the hand out to protect one’s face. Extending the arms breaks the fall (preventing severe head injuries), but it often also breaks the wrist.
So how do you train for better balance? Here are several key tactics to try:
Change the sensory input
Your nervous system relies on different senses to maintain an upright and steady position against gravity. When you mix up the sensory input that you’re used to relying on for balance, you force your body to adapt and improve other modes. You can do this while performing any variety of exercises by closing your eyes, turning your head, or altering the surface you stand on.
Practice dynamic balance
You’re likely familiar with standing on one leg to test your stability. While this is an easy way to assess your static balance and can be helpful for maintaining equilibrium, it’s not representative of daily activities that demand balance with motion. Working on dynamic balance better translates what you practice in the controlled environment to the uncontrolled outside world. You can practice dynamic balance by simply maintaining stability with a changing center of gravity, base of support, or moving limbs. Try walking with one foot in front of the other as if on a tightrope, or lunging sideways and returning to one leg.
Add dual tasking
Ever notice how focused you are when you’re struggling to balance? Dual tasking takes it one step further by performing more than more task simultaneously. The secondary task can be physical or cognitive. For example, while standing on one leg, you could toss a ball. Or while walking on that imaginary tightrope, count backward by four from 50. Dual tasking increases the balance challenge and can improve performance.
Get going with strength and stability
Muscle strength and core stabilization play important roles in balance too. Refer to the Back Extension exercise from the last article in this series; when used in a 2002 study (with added weight) it was shown to reduce fall risk and improve balance. Similarly, the Abdominal Press exercise helps core stabilization, the control over the region of the abdomen and pelvis which facilitates postural control and balance. The musculature of the hips also provide stability to your pelvis and are key for maintaining an upright position. Try side stepping (walking sideways) to strengthening these muscles and notice when fatigue sets in. And don’t forget to practice the squat -- one of the most basic movements you do daily in getting up and down from a chair. Hold onto a handle in front of you if you need additional support and use a fixed chair behind you for extra security. Be sure to avoid rounding your back and also keep your knees tracking over your toes so they don’t collapse inward.
Don’t forget your feet
Not only are the feet your contract point with the ground, but they’re rich with nerve receptors and part of the sensory input mentioned earlier, informing your body of its positioning in space and of any small adjustments needed to stay upright. Be sure to keep your feet and ankles mobile, while also working them for necessary strength and stability to prevent twisting or tweaking (which can lead to a fall). Try calf raises (aka heel lifts) where you slowly lift your heels up and down, and be sure to keep your knees straight throughout.
Integrate and align
The alignment and organization of your body discussed in Part 2 of this series as part of bone loading optimization also plays out in your balance. The more aligned your joints, the less unnecessary tension your body holds and the greater chance of success you’ll have in your balance tasks. Additionally, keep in mind that everything in the body is connected and that an action in one area has an affect elsewhere. So when you’re practicing any upright exercise, try pushing through the ground, breathing naturally, and relaxing your shoulders. You’ll notice that balancing becomes considerably easier through this full body connection. It’s a much better approach than holding your breath, tensing up, and hoping for the best!
As you can see, exercising your bones entails more than one single activity and involves incorporating a variety of elements. Strong, healthy bones require specific, smart actions that you can always build upon. It’s never too late to support your skeleton. This is your body, and you have the ability and responsibility to take charge of it for the sake of your health and independence.
Remember, if you have questions about safe movement or if you’re trying something new, always talk to your healthcare provider first.
EXERCISING YOUR BONES SERIEs By Rebekah Rotstein, NCPT
Rebekah Rotstein is an industry leader for Pilates, bone health and movement education. She is the founder of Buff Bones®, a medically-endorsed exercise system for bone and joint health with on-demand classes and trained instructors in more than 30 countries. A former ballet dancer, Rebekah also worked in the Sports Medicine department of Smith College as a student athletic trainer starting in 1994. Her ongoing study of the body includes cadaver dissections along with coursework in fascia research, somatic studies and visceral manipulation. A diagnosis of osteoporosis at age 28 motivated her to advocate for others with low bone mass and to provide them with innovative education and programming. She has presented at numerous conferences in the Pilates industry, at the International Osteoporosis Foundation Worldwide Conference and for the International Association for Dance Medicine and Science. Rebekah is a member of the Ambassador Leadership Council for the Bone Health and Osteoporosis Foundation, an ambassador for American Bone Health and worked as a partner of the U.S. Department of Health and Human Services Office of Women’s Health. She also serves on the Bone Health Working Group for the Society for Women's Health and Research, contributing to the 2021 recommendations published in the Journal for Women’s Health.