by Mia Bremer
This is the second in a four-part series on the systems that affect our balance as we age. Last month (October 2024), I wrote about Center of Gravity Training. This month, I am covering our sensory systems; how they change as we age and what we can do to improve each system with specific exercises.
The three sensory systems, visual, somatosensory, and vestibular, all change over time. There are many reason for the changes such as the drying out of tissues, slowed processing speeds and reduced sensitivity to touch among others. These changes happen slowly over decades and while they are happening, for the most part, our brain adjusts and we don’t notice. Eventually, however, we can no longer “not notice” some of these changes as we age. The good news is we can affect these changes by making a purposeful effort to do so.
Safety caveat: when doing any of the exercises described under each sensory system, make sure you have a safe space to practice the exercise such as in the corner of a room with a wall on each side of you (especially for eyes closed exercises) or with a countertop or railing to grab for walking exercises. Work at a level that causes you a little wobble but is doable. You will progress over time.
Visual
The Visual System is the most used balance system. We use it more than the other two systems and generally use it first. It reacts to light and tells us what is in our environment. We can see obstacles and thus, hopefully, avoid them or respond to them safely. Our visual system lets us know that we are moving from carpet to wood floor. That there are steps in front of us. That we will have to adjust our body to climb a hill or avoid a puddle.
The changes that occur include reduced clarity, lower levels of light allowed to enter the eye, a smaller visual field and less contrast sensitivity. Add to these natural changes, diseases such as glaucoma or retinal disorders such as macular degeneration or diabetic retinopathy, and this system can be very compromised.
Visual balance exercises must be done on an unstable surface or on a firm surface in an unstable stance. For example, standing on one foot or in a tandem position and focusing on a vertical target (anything in the room or outdoors that is vertical such as the edge of a doorframe or a tree). The reason we do this is because we want to remove the somatosensory system (below) and force the visual system to work harder. You will always have your eyes open when doing visual exercises, of course.
- Focus on using and finding vertical targets – this can be done while walking down a hallway or sidewalk or stationery while standing in a narrowed stance.
- Walking on an unstable surface such as a yard, barefoot on carpet – find a vertical target. Look up and look down occasionally to scan your walking path.
- Static Balance Stances on a stable or unstable surface such as a balance pad or pillow while focusing on a vertical target
Somatosensory
This is your “feeling” system. It responds to touch. This is your second most used system. Your muscles, joints and brain are in constant contact with each other to let you know where your body is in space. Your feet are in contact with the ground which provides information as to what kind of surface is beneath you. As we age, the information we receive from the surface under our feet changes and we are less aware of the surface. We also have less sensitivity to changes in movement around the joints.
Exercises for the somatosensory system should be performed on a firm surface, feet on the ground, indoors or out (not grass or sand) and involve noticing pressure and joint changes, sensing body alignment. These exercises are done both with eyes open and eyes closed keeping safety in mind.
- Static Balance Stances (attached) with eyes open and eyes closed
- Dynamic Weight Shifts such as you find with Tai Chi or simple weight shifting with eyes open and closed.
Vestibular
This is the system in the ears that acts like a carpenter’s level to help you find true vertical. It is the least used balance system but is essential, especially when walking in the dark and on uneven or soft surfaces such as carpeting. The vestibular system reacts to movement of the head. As we age, ears in the hair that help us with maintaining equilibrium dry, crack and/or fall out. We have reduced sensitivity to head movement and increased sway while standing and walking, particularly when one or both of the other systems is unavailable or distorted. Add to that diseases that affect the vestibular system such as Meniere’s Disease, Benign Positional Vertigo and Otoconia (calcium crystals found in the inner ear that become displaced), and this system is compromised even more.
In order to challenge the vestibular system, you must have your eyes closed (or distracted) and be on an uneven/unstable surface. This way we remove the other two systems and challenge the vestibular system.
- Static Balance Stances with eyes closed on a pillow or balance cushion (in a corner)
- Walking on an uneven surface (across a lawn) wearing sunglasses
- Walking with head turns – disrupting vision
A great tool for challenging the visual and the vestibular systems is a balance cushion. These can be purchased online at Amazon or locally at OTPT.com
Look for, Airex Pad when searching for this item.
Taking ten minutes a few times a week to enhance these balance systems may help you avoid falling, or help you catch yourself sooner. For more information, I teach Fall Proof! ™ in Minneapolis and a few of the eastern suburbs. www.miabremerfitness.com
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