by Mia Bremer
This is the first of a four-part series on how to improve balance as we age. Why is this
important? Because every 11 seconds in the US, an older adult is treated in an emergency
room for a fall related accident. Every 19 seconds an older adult dies from a fall. One in four of
us will have a fall this year. Falls are the leading cause of death for older adults and leading
cause of non-fatal trauma-related hospital admissions.
As we age our many aspects of our physical health change, including our balance systems.
These changes happen whether or not we make efforts to reduce the effects of these changes.
As a balance and mobility specialist, I offer a workshop called, FallProof ™ . The workshop is
an overview of a longer program which was developed at the Center for Successful Aging at
California State Fullerton where I was an expert trainer. In the next months we will look at how
balance is affected by age and ways to adapt and improve our balance in spite of these
naturally occurring physical changes.
Balance is defined as the ability to keep our center of gravity (COG) over our base of support
(BOS), whether we are standing still or moving (or even sitting). Your base of support is your
feet is you’re standing. Your bottom if you’re seated. The COG is the heaviest part of the body.
For most people born female it is the area from the naval to the pubis. For those born male it’s
a little higher. COG changes depending on where you carry body weight, if you have
osteoporosis with curvature of the spine which moves the COG forward or any physical change
that moves the COG away from the centerline of the body.
In a standing position, when we are perfectly aligned (see handout Lottery Ticket Stance) our
muscular activity is minimized while maintaining an upright stance. We don’t have to work as
hard! We are also more easily able to keep our COG over our BOS whether standing still or
walking.
Being aware of your posture is a starting point, but for most older adults, resistance training to
address weaknesses and muscle tightness that throw our COG off kilter are needed. See last
month’s article on Upper Crossed/Lower Crossed Syndrome.
The way we unconsciously keep our COG over our BOS is by implementing one of three
strategies: ankle, hip, and step strategies. Here is a very brief explanation of each one.
Ankle Strategy:
Even when we think we are standing still, as we do in a line at the bank or grocery store, our ankles are always engaged in keeping our center over our feet. Stand still and notice the
movement in your ankles as your body sways very slightly in all directions. As we age, we may
have ankle weakness, tightness or even surgeries that affect our ability to sway.
Hip Strategy:
If our COG moves further outside the “sway envelope” created by our ankles, we will implement
the hip strategy unconsciously. Have you seen someone “log roll” where they try to stay upright
on a log that is floating in water? You will notice their hips moving forward and back to keep their
COG over their constantly moving feet in this unbalanced position. In the hip strategy, hips
move forward or back to change the position of the COG. As we age, this is the strategy we
often have trouble performing and move directly into the next strategy, the step strategy. The reason for this is complex, including hip/glute weakness and tightness, slowed processing
speed, fear and disease states.
Step Strategy:
We implement this strategy when neither the ankle nor hip strategies suffice. In this case, our
COG gets so far outside our BOS we need to take a step. As we age, we often go right to this
strategy right away. That’s a problem because when we skip the hip strategy, we tend to scale
the step inappropriately, either too big or too small a step.
Even though we aren’t consciously performing these strategies, we can do conscious exercise
that improves our ability to act quickly in the event that our COG does move past our BOS.
Included is a short handout with simple exercises that challenge your Center of Gravity.
Upcoming FallProof!(TM) Workshops can be found at www.miabremerfitness.com
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