Why you may need to improve your balance:

Numerous scientific studies have shown a correlation between your ability to stand on one leg and maintain balance and your risk of falling in the future. More significantly, your ability to balance on one leg has been shown to be a predictor in injurious falls.

Not an elderly person and don’t think you’re at risk for falling in the near future?  Well, not only is balance important for fall prevention, but it’s been correlated with being more at risk of spraining an ankle in healthy high-school and college athletes. (see below for reference)  It’s also one of the first things I’ll start working on with my patients after an ACL or other knee injury.  Being able to stand on one leg (or along a line) requires your trunk and frontal plane muscles (the muscles that control your side to side sway) to engage.  By maintaining proper upright alignment with all your exercises, your muscles will work more efficiently and you can prevent yourself from compensating and cheating through certain exercises.

HOW TO IMPROVE YOUR BALANCE

Step 1: DOMING

Start by standing and looking at your arches.

1) ALWAYS try to keep your entire forefoot and heels on the ground.  Make sure that the forefoot that is right behind your big toe (the end of your 1st metatarsal), stays on the ground. This is underlined in green on the picture.

Side view of foot
Side view of foot

In addition, make sure the arch stays up nice and high. You may need to see a physical therapist or a podiatrist to help you with this if you can’t seem to move it on your own.  Highlighted in yellow up above is a bone called the navicular. Physical therapists look at this bone to assess how high or low your arch is. Try to stand and keep your arch up high when you balance, when you rise onto the balls of your feet, and even when you squat.

Lastly, try not to overuse your toes! Your toes can be relaxed while you do this (definitely not scrunched in)

Tip: One cheat to help you get into this position is to pull up your big toe. If you have a health foot (and an intact and non-stretched plantar fascia) than your arch will rise and your foot will shorten. Try to maintain this as you let your toes relax back into position.

Practice: Single leg balancing in 3 positions.  Goal: Hold each position for 30 seconds

Single Leg Balance: Hip hinge
Single Leg Balance: Hip hinge
SLBstork
Single Leg Balance: Stork position Raise the opposite knee high to further engage your glutes. Remember to stand tall!
SLB-squat
Single Leg Balance: Squat position This is the best position to test your hip control as well. Make sure the middle of your knee points IN LINE with the 2nd toe.

Advanced: Try all the above positions again, but with your eyes closed. Often people will have decreased balance control without visual assistance.  This will increase the need for your to really feel your feet and leg positions and will provide a better test for those who can do all of the above with their eyes open.  With this practice, your balance in the dark or in dim lighting will also improve!

If you can do all three above with your eyes closed for 30 seconds, than your doing pretty good.  At this point, consider using other devices if you still want a challenge (air discs like Dynadiscs, Bosu balls, wobble boards, etc)

Step 2: Specific muscle training

At the lowest level (maybe recently after surgery to the foot), you may need to start strengthening the intrinsic (small and inner) foot muscles as well as your ankle muscles (posterior tibialis and peroneals). If you can stand and maintain a good arch and foot shape, you can probably skip this step. If you can’t stand and prevent your arch from collapsing, you will need to perform specific exercises (see next post) to strengthen your ability to do this.

Step 3: Hip Strengthening

In addition to the muscles of your foot, you cannot forget about the hip and the trunk muscles. Scientific studies have also demonstrated that fatigue in the hip muscles impair postural control MORE than fatigue in the ankle muscles. So make sure you strengthen the hips so that you don’t break down later in a game when you start to fatigue. (for hip strengthening, look at previous posts)

My favorite frontal plane hip strengthening exercises for improving balance: Sideplanks, Monsterwalks, Continuous slow sidekicks (for my martial artists out there)

Step 4: Upright exercises

The progression here is to integrate your balance exercises into your normal workout. For instance, when doing farmer’s carries, attempt to walk in a straight line with minimal sway.  Or when doing your basic rotator cuff exercises, stand on one leg to decrease your overall stability, and this will help draw in your trunk muscles more as they have to deal with the extra challenge of your body’s sway.

Advanced Foot exercises: Single leg hinge and row into overhead press

1. Try the single leg hip hinge. When at the furthest point (when your hip can no longer flex), maintain position and perform a row. Then return to standing stork position with your leg in the air.

SLB - Hip hinge with weight
SLB – Hip hinge with weight

2.  Then once in the stork position (high knee), maintain your balance as your press your weights above your head before slowly lowering them back down. Repeat.

SLB - with overhead press
SLB – with overhead press

Try sets of 10 on each leg, and your feet will get an excellent workout!

Common tips:

Always be safe when performing balance exercises! Either be in the corner or next to a wall, or something heavy and study (kitchen table, counter, etc)

Try not to rely on more than just the tip of one of your fingers to assist.  You shouldn’t need more than that. If you do, the position may be too hard for you.

Sources:

1. T H Trojian, D B McKeag. Single leg balance test to identify risk of ankle sprains Br J Sports Med 2006;40:610-613 doi:10.1136/bjsm.2005.024356

Advertisements