Home Exercise and Rehab
is a Pilates Practitioner and Registered Osteopath who has spent many years offering help and advice, especially to the over 50 age group.
She is founder of The Osprey Clinic in the St. Johns Wood area of London and now specialises in Home Exercise and Rehabilitation Programmes. For further advice on exercising safely, and a selection of exercise films for general fitness and medical conditions, visit the website: www.home-exercise-rehab.com
This month: Exercises to help with balance disorders
Q: With the improvement in the weather, I would like to get out and about more, but I am nervous about falling or tripping. Can exercise help to improve my confidence with walking outside?
If you have a balance disorder, it is understandable that you are anxious about increasing your activities. Dizziness or vertigo, i.e. feeling that the room is spinning, nausea, lightheaded, disorientation or faintness are common symptoms. But, if you experience any of these symptoms it is important to see your GP to investigate whether they are caused by a serious health condition or if you need to change any medication which you have been prescribed.
Our sense of balance involves our inner ear and its neurological connections with the brain. It also involves neurological sensory pathways which pick up stimuli from around the body and pass this information to the part of the brain, known as the Cerebellum, via the spinal cord. A balance disorder may be caused by an ear infection, blood pressure, an obstruction to normal blood flow to the brain or certain neurological disease or medications. Balance disturbance may also be a consequence of the aging process.
You may be anxious about tripping of falling if you have been recovering from surgery, especially if you have undergone a knee or hip replacement. Our sense of balance starts with neurological messages being conveyed from specialized receptor cells, known as mechanoreceptors which react to pressure or distortion of the skin, ligaments and tendons around the lower extremity joints. Specialised mechanoreceptors, such as muscle spindles and Golgi tendon organs, give us a sense of the functioning or position of our joints. This is otherwise known as our Joint Position Sense, or Proprioception. Interestingly, mechanoreceptors are also located in the Cochlea of the inner ear and respond to a change in air pressure.
It is not uncommon for the more sedentary winter months to bring about muscle imbalances which affect our confidence and ability in standing and walking. Sitting for long periods, especially twisted or asymmetrically, creates an imbalance in spinal muscles which impacts on posture when standing or walking. Also, reduced blood circulation into the limbs will make the hips and knees feel stiff and weak.
The following exercises will help to improve your confidence with walking when practised regularly.
This exercise improves the balance of the spinal muscles and helps to strengthen and improve the stability of the hip and pelvic muscles.
Lie face up on the floor or a firm bed with your knees bent and your feet in line with your hip joints. Pull in your abdominal muscles with maximum effort, while you exhale to lift the pelvis and spine, no further than the shoulder blades, to form a bridge position. Inhale as you hold the position and exhale again as you lower your body again. Try to wheel the spine, vertebra by vertebra, back to the start position.
Repeat 10-15 times.
Bend Stretch Rise
This exercise will help to improve the blood flow into the calves and ankles to reduce stiffness, while also strengthening the leg muscles and improving balance.
Start by standing with your right side close to a wall, and place your right hand on the wall for support.
Lift the right foot, hooking the toes behind the left ankle. With your weight now taken fully onto the left leg, gently bend and stretch the left knee, and then rise up onto the ball of the left foot. Hold the position for a few seconds before lowering the heel to the floor again. Keep your back straight throughout the exercise and pull in the abdominal muscles with maximum effort. Repeat up to 20 times and repeat the exercise on the right leg.
If you have difficulty in standing on one leg, the exercise can be done facing the wall, with both hands on the wall for support and work both legs at the same time.
Sit to Stand
Sit on the edge of a chair and position our feet hip width apart and incline the body forwards at about 60 degrees. With your arms relaxed at your sides, pull in the abdominal muscles firmly, press down the shoulders towards your hips and try to rise to standing while keeping your back completely straight. Work into the buttock muscles and push down into your heels as you rise to standing.
Repeat 5-10 times. If you have mobility problems you may need to rest your hands on the back of a chair or on a walking stick in front of you, to help you to stand.
See all Gina's Home Exercise and Rehab features
Please send your questions for future columns, or feedback, by email to Gina John on firstname.lastname@example.org
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