Understanding balance and vestibular problems to avoid injury that may result in physical therapy or orthopedic surgery.

Understanding Balance and Vestibular Problems

It is estimated that 40% of people over the age of 40 have balance or dizziness problems. Balance issues are the #1 reason why people over the age of 65 will visit their doctor.  Approximately one out of every three older Americans fall each year and 95 percent of all hip fractures result from falls.
It is estimated that 25% of seniors who have a hip fracture die within one year of the fall.
You are considered a “Recurrent Faller” if you have fallen or nearly fallen two or more times in the last 6-12 months, even if you didn’t hurt yourself.

Recovery treatments for a serious fall can range from outpatient physical therapy sessions to major orthopedic surgeries. Understanding how balance works, then taking a proactive approach via balancing exercises, will help reduce the risk of falling. It may also be beneficial to have a physical therapist perform a balance assessment as well as provide a balancing exercise routine specific to your individual needs. Look for our next post, PT360’s Balance Workshop for some helpful exercises you can do at home.

So how do we stay balanced?

Sensory Systems:

The nervous system uses three sensory systems that feed our brain information that is first combined and processed then sent out to the rest of the body telling the appropriate muscles to fire to prevent us from falling.

Vision: We probably rely on this system the most. Our eyes are able to focus on an object or assist us in balancing by finding the horizon. We do this using our ambient (peripheral) vision as a point of reference.

Examples of skewed vision: cataracts, glaucoma, macular changes, and patients who are post-stroke or head injury

Somatosensory: Information is received through receptors in our body, particularly those that are in contact with the support surface (i.e. thighs, hands, and feet) and sent to the brain for processing.  For instance, without looking, do you know what position you are in or can you feel the floor under your feet? For some, this can be difficult, especially if they have poor sensation, painful or stiff feet. 
This also helps the brain distinguish where the movement is coming from.

Example: With bending your head forward, somatosensation will tell your brain if you are bending from the neck or waist.

Vestibular Information concerning where we are in space is also given to the brain from three sets of circular canals within our inner ears. These canals detect motion (head tilt, tip, or rotation) by displacement of a fluid within the canals. 
We also contain a reflex called the Vestibular-Ocular Reflex (VOR). This reflex connects information from the inner ear to our eye muscles, which assists us in stabilizing visual images on our retina during head movement. The result is clear vision also called gaze stabilization.

Examples of a vestibular disorder symptoms: there are multiple and differing symptoms of an vestibular orders, including but not limited to, vertigo, dizziness, vision disturbance, hearing changes, cognitive and/or psychological changes.

Tips for preventing falls

  1. Plan ahead
  2. Continually scan the area for potential obstacles
  3. Know your limitation, but Continue To challenge yourself with balance exercises in a safe environment
  4. Stand with erect posture
  5. Utilize your entire foot in your stance when walking i.e. not standing with more of your weight through the balls of your feet
  6. Strength of your body is important, but mostly your hips, lets, and ankles. Remember, if you fall, you also need your arms to be strong to get you back up. PT360 recommends practicing getting up and down off the floor EVERY DAY. This way if you do fall, it won’t be scary because you will have been doing it every day for years!
  7. Maintain your range of motion because you need motion and agility in your ankles, hips, trunk, and even your neck. Image trying to stay balanced if your neck is stiff and you need to turn it to talk to someone.

About the Author :