I Have Fallen and I Can't Get Up

Exercise and Balance

We are all aware that balance and recovery when balance is lost is a major concern in the health of older adults. Falls among older adults are frequent; so much so that they provide sufficient concern for a very effective advertising campaing; i.e. “Help I’ve fallen and I can’t get up.”

Most are far less aware that falls can be mitigated, if not completely prevented, with regular physical activity and strength training.

Balance is controlled by the cerebellum that acts in response to the information it receives from sensors throughout the body. When we think of balance, or compromised balance, the first thing to come to mind is the middle/inner ear, the vestibular system that sends signals to the eye and the muscles in the body that keep us upright. But what happens in the dark when you can’t see? How do you manage to get dressed in the dark? And what happens when you lose your balance?

Without getting overly technical, throughout the body we have proprioceptors, golgi tendon organs that despond to tension on the tendons and muscle spindles that respond to the speed of muscle shortening/lengthening or muscle stretch. By sensing tension and stretch, these specialized neural organs send information to the brain about where our bodies/body parts are in space as well as a sense of the relative position of body parts to one another. The brain then sends information back to the muscles get back into neutral alignment. That is a simplified explanation but sufficient. And that explains how, without constantly watching our hands, we get food to our mouths rather than our ears or over our shoulders. If you have ever watched a child learning to eat or walk, you realize that not only do these organs and the muscles they send signals to control have to be trained but having been trained the muscles that control balance must be strong enough to respond with sufficient force to maintain balance and recover lost balance. We have all seen toddlers who clearly realize they are losing balance but do not have the muscle strength or control to regain it.

When children are learning to walk, they are developing the neural pathways to and from these organs and the brain and to and from the brain to the muscles so that we can walk about with consciously our every movement to assure the legs and feet or doing what they should be doing.

However, just as these pathways can be developed, they can become deconditioned from lack of use.  And  we can not only lose proprioceptive sense, when they have warned us we are falling, we can lose the strength to react with sufficient force to correct our body position and avoid a fall.

Regular physical exercise, exercises that require us to stabilize our bodies while performing them, exercises that challenge different body positions and multi-joint exercises are crucial to maintaining a healthy balance system and providing the strength to recover balance when it is lost. Regular physical activity and strength training is a crucial part of maintaining independence as we age.

If you have an opportunity to learn a few balance training exercises, take advantage of that opportunity. Life is much better in an upright position.