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“As with muscles, the balance system needs to be challenged in order to improve.” Scott McCredie, Balance: In Search of the Lost Sense (Little, Brown and Company, 2007)


Unappreciated, Misunderstood—and Neglected

You don’t appreciate the importance of balance until you lose it. That was my case. I didn’t pay much attention to balance until I had a bout of severe vertigo several years ago. I got out of bed one morning and couldn’t walk straight. The room was spinning. When I returned to bed it kept spinning. I had to practically crawl to the bathroom and hold on to the sink to brush my teeth. I didn’t know what was happening, but it sure wasn’t good. It was downright scary.

It appears that an accidental overdose of sodium caused unwanted fluid to accumulate in my inner ear. Our family doctor examined me and prescribed Meclizine, an antihistamine used to treat dizziness and motion sickness. I assume it dried up the excess water in my balancing mechanism because I was back to normal in a day or two. I never took my balance for granted again.

Since that experience, I have made it a study of balance, and worked to preserve and improve mine. One of the best and most complete references I’ve found is Scott McCredie’s book Balance: In Search of the Lost Sense (2007). McCredie is an award-winning journalist whose interest in the subject began when he witnessed his sixty-seven-year-old father lose his balance and tumble off the top of a large boulder in the Cascade Mountains near Seattle. “He spun into a headfirst dive, disappearing from sight,” McCredie writes. Fortunately, only his pride was hurt. “It was an unsettling demonstration of his growing frailty, and dimming of his once dynamic sense of balance.”

What following draws heavily on what McCredie learned. Balance, it turns out, is a complex and fascinating topic.

Three Sensory Components

I'll do an overview of our amazing balance system and then we'll talk about how to maintain and improve it.

The system has three parts: vestibular (equilibrium), proprioception (body position awareness), and vision. The parts work together, contributing equally or relying more on one system or two, to keep us stable. Let’s look at each one, starting with the vestibular mechanism in the inner ear.

It was long thought that the only function of the inner ear was hearing. The inner ear, imbedded in the bone behind each ear, actually has two functions: hearing and balance. The cochlea, a major component of the hearing system, is situated in the inner ear. (You may have heard that Rush Limbaugh had a cochlear implant to restore his hearing.) Our concern, the vestibular system, is made up of three semicircular canals and the otoliths. “When a person’s head rotates, fluid moves in the canals, exciting minute hair cells,” McCredie explains. “Those cells send signals to the brain that tell it in what direction, how fast, and how far the head is moving.” The otoliths (Greek for “ear rocks”) are crystals of calcium carbonate attached to hair cells as gravity orientation receptors.

“The vestibular apparatus plays one of the most important roles in the balance system,” McCredie reports. “It constantly measures our body’s position in space, relative to gravity, and is the only organ in the body dedicated exclusively to balance functions.” The key is the orientation of the semicircular canals: up and down (like nodding yes), side to side (nodding no), and slanted (rolling the ears from shoulder to shoulder). Like a gyroscope, this arrangement is designed to keep the body aligned over the center of gravity.  

Our proprioception sensors are in the joints and muscles. They allow us to sense the position and movement of our limbs. It explains how we are able to close our eyes and still know what our body is doing.

The role of vision is probably easiest to understand. Our eyes tell us how our body is oriented with the ground. It helps us stay upright. We have only to close our eyes to appreciate the importance of vision; most of us start to sway ever so slightly. Now, keep your eyes closed and lift one foot off the ground; you’ll appreciate the stabilizing effect of vision in short order.  

McCredie tells us that pilots become disoriented when they lose sight of the ground or the horizon. Without instrumentation, they lose their sense of up and down in approximately three minutes. (That’s apparently what happened to John F. Kennedy, Jr.)

As noted earlier, the three systems (vestibular, proprioception, and vision) cooperate to keep us upright. Scott McCredie explains how brilliantly. (Excuse the long quote.)

“When we’re walking or standing on a hard, well-lit surface, information from all three sensory inputs is roughly equal. Vision tells the brain how the body is oriented in relation to things like trees or doorways, which are (usually) vertical. Proprioception provides information on the relative positions of legs and torso. The vestibular system sends signals about rotational or linear movement, or, just as important for orientation, whether there is no movement. But when the environment becomes more challenging—in rocky, uneven, or undulating terrain; or when the surface consists of sand, mud, or gravel; or if you attempt to balance on, say, a log floating on water; or if ambient light is poor or absent—the proportions of sensory inputs change. Under these conditions, vision and proprioceptive information becomes less useful in maintaining balance, and because gravity is the only steady, unchanging reference point the body has, vestibular information dominates. On stable, even ground, when the ankles flex it means the upper body is tipping forward or backward. But on unstable terrain, those same ankle flexes may be necessary just to keep the upper body vertical. The central nervous system compensates for this difference by relying more on vestibular inputs than ankle proprioception. In low light condition, CNS uses more vestibular and proprioceptive input than vision.”

Whew, that was long, but it sure does a great job of illustrating the wonderful redundancy and fail-safe nature of our balance system. Makes you want to maintain and protect it, doesn’t it? Let’s talk about that next.

Challenge Your Balance

Use it or lose it applies here just as it does in the case of strength and endurance. “Most authorities believe our ability to maintain equilibrium peaks in our twenties and then slowly begins to deteriorate until we reach our sixties, when it plummets,” McCredie writes. But, as in the case of strength and endurance, it doesn’t have to be that way. “Most reasonably active people can maintain their equilibrium without much effort until the age of sixty-five,” he adds reassuringly. What’s more, if we continue to use and challenge our balance, McCredie continues, “age doesn’t seem to have much power to degrade the adaptation, as evidenced by the longevity of most of the world’s supreme high-wire walkers.” McCredie observes that Karl Wallenda continued to perform on the high wire until he fell to his death at 73. According to his relatives, the wire had not been guyed properly. “The fall had nothing to do with a lack of fitness or bad technique,” McCredie reports.

Risking your life on the high wire is not required (or recommended), of course. Work on your balance regularly and it doesn’t have to take a lot of time. Simply make it a part of your daily routine. For example, make it a habit to stand on one foot when you bend down to pick up the newspaper in the morning. (Slow and and controlled is best.) That works all three systems: the muscle and joint awareness in your legs and back, the gyros in your head, and your vision. That, of course, may not a good place to start for many people. You might try balancing on one leg while putting on your pants or even your socks. Begin with moves you're comfortable doing, and be careful.

Here are some more suggestions for training your balance in the course of your daily activities.

If you train with weights, keep it up. McCredie says there is a definite link between muscle strength—especially in legs, hips and torso—and balance. If you allow your strength and muscle mass to decline, as usually happens with age, “then the body cannot respond to sudden changes in equilibrium, such as by slippery or uneven terrain.”

If you are a regular walker, try walking on the curbs in your neighborhood. (Again, be careful.) If you have access to rough terrain, as Carol and I do, take advantage of it to challenge your balance. Frank Forencich, an exercise expert and human biologist, told McCredie: “Every little rock, every uneven root, every slippery patch of moss…boosts the detection of tactile signals. [It] wakes up the sensory nervous system and makes your body smarter.”

Balance on one foot at every opportunity; for example, while shaving or brushing your teeth, standing in line or waiting for a friend

“One-legged standing exercises are among the most versatile and effective challenges,” McCredie writes. Doing it while keeping your body still relies mainly on proprioceptors in your feet, ankles, and legs to maintain balance. Closing the eyes makes it harder, challenging more receptors. “The vestibular system kicks in only if you struggle to stay still and need to make large hip and torso movements to maintain balance,” McCredie explains. That’s more likely to happen, of course, when you close your eyes.

Racket sports, such as tennis and Ping Pong, are excellent balance training. Dancing is also good.

Something I haven’t tried, but intend to explore is tai chi (pronounced tie jee), a form of exercise practiced widely in China. “At dawn across the nation,” McCredie writes, “nearly every city park fills with practitioners of the fluid, slow-motion routine, part dance, part ‘moving meditation.’” Many Chinese continue practicing tai chi into their seventies and eighties.

McCredie relates the response of an eighty-six-year-old man who was asked to demonstrate what he could do after four-months of tai chi practice. “The man smiled, then lifted up one foot, bent over, and took off his loafer while balancing on his other leg. Then still balancing on one leg, he stood back up, bent over again, and put his loafer back on.” (That story gave me the idea of picking up our morning paper standing on one leg.)

These examples, of course, only scratch the surface of ways to challenge your balance. You’ll find many more in McCredie’s marvelous book Balance: In Search of the Lost Sense (Little, Brown and Company, 2007).

The key is to keep challenging your balance. Do that, and you’re likely to keep it until the end of your days. That’s what I intend to do. How about you?

Remember: Age doesn’t matter—unless you let it.

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