One of my much repeated mantras is that if you want to secure your future confidence and independent movement, invest in maintaining your balance. Loss of balance capability is one of the most significant influences on functional independence in older people, but our balance starts to insidiously erode decades earlier, and can start to influence our activity choices without us realising.Illness or injury can disturb our balance, but so can our daily lives unless we actively seek challenges. We choose to walk on flat footpaths, lean against the side of our beds to put our socks on, and hold on to railings and handles whenever they are offered. Gradually we make sure that we avoid uneven footing, heights, narrow paths and any chance of the unexpected until we have sanitised our environment to eliminate the feeling of uncertainty and even fear that a balance challenge can provoke. Our own window of capability shrinks right along with it, so it takes less and less to provoke a balance challenge.
What happens when we feel that uncertainty, the sudden wobble? We tend to tighten up, stiffening ourselves to contain the unexpected motion. Unfortunately, this makes our balance worse, as we are unable to adapt, absorb and adjust to the motion in order to recover our equilibrium. This makes us more anxious, and more likely to avoid the situation that provoked it.
Anxiety and balance have been linked in studies like this one.
OK, this is about mice, but it is interesting to see the link between anxiety and balance, especially as the anxiety diminished as balance improved.
A little while ago I read an interview with Shirley Sahrman, the legendary physiotherapy lecturer who is still zooming about the world, demonstrating movements on her courses and generally presenting a picture of confidence in her 70s. She commented that when she rides the bus, she practises not hanging on to anything in order to challenge her balance. She knows the value of expanding and maintaining her window of capability.
This past week I met a British lady in her 70s in a little hill town on the sparsely populated Greek island of Alonyssos. She moved permanently there from Britain, and every day she walks down the long donkey path to buy her groceries in the village at the bottom of the hill. Every day, this path challenges her, as it involves uneven rocks, tricky footing and the endurance to manage a long and steep decline. That donkey path is maintaining this lady’s functional window every day, and quite probably extending the years that she will remain independent and able to enjoy the beauty of her Greek home.
So, what can you do? Start to build little balance opportunities into your daily life, in the home or outside. Don’t worry about the wobbles and sways – if you stay soft in your joints and allow your body to experiment with finding its balance, this is a good thing, as it is expanding your capability! Start at a level that challenges but doesn’t scare you. Choose a bumpier path and feel your body responding, stand on one leg when dressing instead of leaning or sitting, walk one foot in front of the other along a line in the car park, and take advantage of the opportunities that the environment offers you.
This is what I am doing here on the boat in Greece – the gently undulating surface in the bay gave me something to respond to as I practised grounding and smoothly moving my body parts in balance. There is always an opportunity to maintain and expand balance!