Improving your balance

Posted - September 2012 in Living with HSP - Management & Treatment News

Take the 30 day Balance Challenge

 

Many HSPers find themselves less steady on their feet over time and experience significant balance issues. However there is something you can do about it.

 

There are 3 types of balance work:

  1. on a stable surface
  2. unstable surface, and
  3. closed eyes.

Safety Warning!! Doing any of these balance exercises significantly increases the risk of toppling over and falling. Make sure that you do these exercises in an area free of obstacles, and with a firm structure within arm’s length to steady yourself if you need to when you lose your balance. Working with a bed behind you and a wall in front of you seems to work well.


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1. Standing with just one foot on the floor

Start by spending a few minutes every day balancing on one foot, changing feet to ensure both feet get about the same level of balance activity. At the beginning, the foot/ankle may well be quite stiff and fixed, and you can easily lose your balance. The secret to developing balance is to allow or make the foot and ankle wiggle and adjust to maintain balance in a series of constant small corrections. After a few days or weeks, you may notice that you can stand on one foot for a longer period of time. Note: do not lean against a wall or hold onto the back of a sofa, but position yourself to be able to brace against something solid to avoid a fall.

 

(Click on images to enlarge)

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2. Standing on an unstable surface

When you feel like more of a challenge and are ready to progress, practising your balance on an unstable surface is the next step. A balance pad is ideal for this purpose. They cost from $33-100 and are available in Australia from:

https://www.hartsport.com.au/products/6-711

http://www.physiosupplies.com.au/fitness/Balance-Pad.html

http://www.sportstek.net/prices/products.php?cat=14

http://www.empind.com.au/shop/item/balance-pad-shoulder-pad-yoga-cushion

Some of these sites also have useful instructional videos about the balance pad and its use.

Start by standing on the balance pad with both feet, and when comfortable on the unstable surface, progress to standing on one foot at a time, using the same routine as for the solid floor.

 

3. Balance practice with your eyes closed

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Depending on your level of skill and comfort, you may want to start the ‘eyes closed’ practice standing on both feet on a solid floor. When you get comfortable, try standing on the balance pad on both feet with your eyes closed.

To feel movement in the foot and ankle better, this exercise is recommended done barefoot or in socks.

Note: all balance work with eyes closed should be done with both feet in contact with either the floor or balance pad.

Warning!! don’t ever try eyes closed exercises on one foot as there is a high risk of falling.

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Here is one HSPer’s story of improving her balance:

“I have HSP and though I work out to stay fit and strong, I noticed my balance was getting worse. I was getting progressively more unsteady on my feet, and started using a cane most of the time. Though I put it off for years, I promised myself I would learn what I could and do some work to try to improve my balance.

I committed to adding three minutes of balance practice to my alternating gym routine of stretching/strength work and cardiovascular work. First I started just balancing on one foot at a time.  I learned quickly that just standing on one unmoving foot/ankle – like a dead stump – would have me toppling quickly.  I discovered – here’s the important part! – that we need to learn to wiggle around a bit on the standing foot and ankle. After weeks of this balance practice, I noticed improvement in my ability and felt I was ready for something more advanced. When I asked a physiotherapist about the possibility of improving balance, I was told there are 3 types of balance work:  stable surface, unstable surface and closed eyes.

To advance to ‘unstable surface work’, I added a balance pad to my daily routine. I stood with one foot on the wiggly pad and one foot lifted. This was more challenging than standing one footed on a stable surface but again, with time I got better.

Now the tricky part! I tried to find a way to do balance practice with my eyes closed and I did some things that were not pretty! Luckily I didn’t hurt myself! Eventually I found a good, safe, effective way to do more advanced balance work. Here’s what I did. I stood, with both feet on the wiggly pad and my eyes closed. I found a safe way to do this, with my pad on the floor, between my bed and a wall. I do the work standing, facing the wall and if/when I lose my balance I end up plopping down in a sitting position on the bed, without getting hurt.

So I stand on the Balance Pad on both feet (feet about shoulder width apart, pointing straight ahead, knees slightly bent and over my toes) with my eyes closed. I didn’t know if this would be helpful, so I decided to take the 30 day Balance Challenge and spend 10 minutes a day for 30 days as a trial to evaluate effectiveness.

Based on notes I took, as early as the first week of my trial, I noted: “more sensation in ankles prior to exercise”. All through the month I’d had significantly more feeling and warmth in my ankles, not just during or immediately after the 10min routine, but continuously. I didn’t realize prior to this work that foot to leg, I was quite fixed and inflexible. While doing this exercise I am quite aware of the movement of my ankles/ankle muscles and I’m also quite aware of my hamstring and gluteus muscles. Too, pushing my knees out, instead of letting them tip in like they tend to do, seems to engage certain gluteus muscles.

The results of my 30 day trial:

  • When standing I feel more stable.
  • I can walk across uneven surfaces with more stability.  If I do stumble I can move my feet quicker to regain stability.
  • In terms of using surfaces to steady myself, I would ‘surf’ when walking inside, using furniture to help maintain balance and I find myself using those surfaces to stabilize myself significantly less.
  • I seem to have more options as I walk or manoeuvre. For example I don’t just stand, then turn, then walk, as I used to before. I find myself combining things. I can turn and step backward in one movement. I can step sideways where previously I could not.
  • If I do feel unsteady or catch my toes, I can move my feet quicker to regain stability.
  • I have increased speed of response and increased flexibility of the ankle, allowing a greater range of responsiveness, which seems to increase stability.”

 

Here is how a physiotherapist describes what is going on:

With conditions like HSP there is loss of control and therefore fixing strategies at both foot and hip/pelvis/core. With fixing comes less information from the world around you, disuse is added to weakness etc and more reliance on fixing and holding on etc.  This can allow spasticity patterns to gain greater control too and reduces speed of appropriate responses.

The challenge to your nervous system to deal with the controlled instability of the pad in your progressive way was exactly what your body needed to wake up resources that are still available to you.

 

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