Guest Blog: Improve Your Balance Using These 3 Restorative Exercises
When working on balance, our goal might be task driven (walking, skiing, hiking), whereas the goal of the Central Nervous System is to keep us safe and protected. In that sense, your nervous system has a lot of tools at its disposal including the muscular system, the nervous system, the vestibular and visual systems, and proprioception. For example, you have abundant sensory nerves in the sole of your foot that send information to the brain to map the ground under your foot, enabling the various joints between the foot and the brain to adjust accordingly. That is not a conscious decision on your part but it is one way our bodies maintain equilibrium that is often stifled in our modern world by thick, stiff soled shoes and an environment that never changes (flat level and hard concrete in the case of an urban sidewalk).
Ironically, as we age, we are often told to wear safe shoes that support our feet and to remove any tripping hazards from the home. This is effective at removing the danger but does nothing to improve your skills, leaving you at a disadvantage should you ever want to leave the house or visit another! But we can’t simply throw our shoes aside and start walking on rocks and paths overnight; that would be foolhardy. We must gently introduce movement back into the various joints and muscles of our feet (over 30 joints in all) in a controlled fashion that allows us to move within our abilities. For that reason, my first choice for balance training is foot mobility.
Exercise # 1. Regain Foot Mobility
Start seated and place a soft ball (or even a wadded sock, or dryer ball, for sensitive, stiff feet) under various parts of the foot and allow the foot to mould over this shape. Placing the ball under the centre ball of the foot (under the “knuckles” or metatarsal heads of toes 2-4) lifts this transverse arch and allows space between the long bones of the foot leading to the toes - an area often compressed by the narrow toe box shape of our shoes. Gradually move the ball down the length of the foot to the front edge of the heel, adding some ankle mobility into the mix. This work affects more than the muscles and joints, it wakes up those sensory nerves and creates more space between the metatarsal heads where the nerves that lead to the toes are often compromised by narrow toe boxes, leading to a neuroma. This work eventually allows us to navigate obstacles such as uneven ground, natural surfaces, carpet edges, rocks and roots in a path, and so on, decreasing our dependence on prepared and “safe” environments. We can also use our hands to manually spread the toes and mobilise the foot by “holding hands with our feet” and “wringing” the forefoot relative to the back foot. And lastly, restore control over the toes by adding toe lifts, together and individually. Often clients are used to wearing arch-correcting orthotics in their shoes and we can move towards decreasing our dependence on them by strengthening the arch muscles (and ultimately the hip muscles). This work is further supported by using shoes that allow the foot to move - shoes that have a more flexible sole, a wide toe box and most importantly, no added heel height, known as a “zero drop” shoe. It can still have the cushioning required to walk on hard urban environments.
Walking is not falling
You might have heard that walking is simply controlled falling. In fact, this is how most people are walking - but it doesn’t have to be that way. If your body is lurching forward in space and your legs are basically catching up all the time, statistically you will end up on your nose at some point. In a vicious circle, our stride length shortens as we attempt to stay balanced and because our stride length shortens, we lose the ability to stay on one leg longer and end up shuffling and unable to deal with obstacles. The calf musculature on the back of your lower legs is shortened when we wear heeled shoes and sit (one of those muscles crosses both the ankle and the knee). When these muscles are short, the heel has to leave the ground sooner as the muscle’s lengthening potential is reached, and this both shortens our stride and decreases the amount of hip extension we get with each step. Longer calves allow us to move with a fuller expression of the ankle, knee and hip joints and improves our balance as with each step we are not getting lurched forward by acceleration forces from the calf!
Exercise # 2. Calf Stretch
The aforementioned zero drop heel is crucial in restoring length to the calf group, as any amount of heel (however seemingly benign) shortens the Achilles tendon to which these muscles are attached. As well, we can add “calf stretch” to our movement practice by stepping the ball of one foot up on a folded blanket, and dropping the heel to the ground. The first time I introduce this exercise, I make sure the client is beside a wall or chair for support as it can be surprisingly challenging to stand with one foot going “uphill.” The foot that remains flat on the floor starts behind the stretching foot, for balance and to allow the CNS to relax and not have to resort to strategies to deal with this sudden challenge. Such strategies come in the form of tension in the thigh muscles and other places. The key is to be able to relax and not be fighting for balance, so back the other foot up as much as you need to when starting out. This puts you back on your heels and requires the support of the muscles in the back of your hips and thighs to balance instead of the ones in front when you walk-fall. Strengthening the hips is one benefit of getting longer calves, but keep in mind the sensation of the stretch is not the objective here, but the ability to relax when standing with one foot going uphill. You may or may not feel a stretch sensation and that’s ok!
Start with the feet side by side and pointing straight ahead, and with the folded blanket in front of one foot, step forward and place the ball of that foot on the blanket edge and drop the heel back down. Both feet remain pointing straight forward; you might be surprised by how tempted you are to turn the back foot out to retain your balance!
Walking is a Single Leg Activity
Now we can focus on the role of the hip muscles in walking. I mentioned that we often end up in a gait that resembles shuffling (indeed, often referred to as “senior’s gait”) where the time that we are on one leg is decreased, leading to less contribution from the big strong hip joint as a result. The muscle mass on and around your hips is much greater than that of your foot and ankles and should be your first line of defence in maintaining equilibrium when moving about the planet. We often define balance as the ability to stand on one leg, but did you know - this is the defining characteristic of walking? Walking is an activity where you are on one leg while the other swings through. The shorter your stride, the less time the leg is in the air, and the less time you spend on one leg ultimately leads to weaker hips! You may have experienced a loss of balance simply by putting your feet straight for the Calf Stretch. We often turn our feet out in an effort to increase our “base of support” - if the toes point out, we are standing on a broader base and can then rely on our hip muscles less. When we turn our feet to point in the direction we are going, we load the hip muscles on the sides more, so although this might initially result in a loss of balance, ultimately it will increase our hip strength and ability to move our feet independently.
Exercise #3. Hip List
Because this is standing on a decreased base of support on one leg, I always start beside a wall or chair for support until the confidence in the hip muscles is restored. Start with the feet pointing straight ahead and hip distance apart (directly under the hip joints and not too wide or narrow). With one hand on the wall or chair, shift your weight over the right leg and push that right foot into the ground. This should activate the muscles on the side of your hip and push your foot down, your hip in and your head up! This will lift the heel of the left foot and then you can simply pick up the ball of that foot and stand on the right leg for up to one minute. (You’ll probably start with a few seconds at a time but work up to a minute on each leg). Both knees are straight. Repeat on the other side. Just like the Calf Stretch, it is the ability of the body to remain relaxed that is the hallmark of a good List. You don’t want to have to grip the chair, tighten your core or wave stiff arms out to the side. The hip muscles are working hard, but the rest of you can remain at relative ease. This is what allows us to use the hip muscles to stand and walk but the rest of the body is able to respond immediately to any possible outside influence (such as a strong wind, sudden slip, a jostle, or a branch in the face!). This is of course a very basic list of balance exercises. Balance is not just the ability to take part in a yoga class, it’s how we navigate our world and we want our world to remain as large and accessible as possible as we age. So make sure to take your feet, calves and hips outdoors for lots of walks that includes hills and natural terrain to use all your parts as much as possible!
Carol Robbins is a Restorative Exercise Specialist and movement educator in the beaches area of Toronto. She teaches Dynamic Ageing and runs a movement membership for women 50-70 (ish) online at https://www.carolrobbins.ca/
You can follow her on Facebook at https://www.facebook.com/AlignmentREScue or on Instagram at https://www.instagram.com/alignment_rescue/
