2 weeks ago I slipped on black ice. Ironically, the paint markings on a handicap parking spot were icy as heck, and as I stepped over it from my car….boom….. I went down hard. I twisted my knee underneath me, but besides some swelling and mild pain, no other injuries. I feel very lucky. I have 2 other friends who fell this month and got seriously hurt. One broke her arm, the other broke her hip. These kinds of accidents are just that…an accident… but I wonder whether my good balance, flexibility and strength helped me and whether a lack of balance, strength and flexibility hurts others?
The topic of balance becomes more and more important as we age. Now that I am in my “middle-aged years”, I am well aware that any slip or fall could result in serious injury. What differentiates those who fall and seriously injure themselves and those who don’t injure themselves is mainly luck… but also involves bone density, reaction time and age. One of my friends who broke her hip has osteoporosis. I have 2 other clients who had fallen in the past and broke bones, and they also had poor bone density. So, maybe, besides luck, it seems like strength, bone density and reaction time are injury prevention attributes?
How do YOU fair with these fitness attributes? If you are a woman and are underweight and do not perform consistent strength work, your bone density may be poor. If you are a man with poor flexibility, (which is common in older men) you too are at risk. If you are anyone who is not paying attention to your footing, who is distracted, or carrying too many things at once, you too are at risk. But, there are things you can do to reduce your risk of falls and injuries.
In Part 1 of this blog, I discussed what balance really is and what internal systems are related to balance, in order to give you a broader understanding of how you can help your balance. Now, let’s discuss what specific exercises can help balance.
As I discussed previously, I believe that a baseline level of good strength is the foundation of good balance. So, if you are not doing strength work, start now. Strong muscles= strong tendons and ligaments= strong bones. Bones are strengthened by strength training too! Your routine should include single leg strength exercises as well as bilateral leg exercises, core and upper back strength work and some exercises which challenge balance and stability. Shown below are my favorites:
Bird Dogs– A lower level exercise, but one which is usually massacred by most. When performing Bird Dogs, never lift the arm or leg above the level of the back. The low back should remain totally still. Engage your anterior core ( abs) by isometrically pulling abs in and/or creating tension between the hand on the floor and knee on the floor. This will engage abs too and will stabilize your low back.
Lunges– All kinds. I often start with Reverse Lunges, which are more glute dominant than quad dominant. Many of us are too quad dominant anyway, so getting your bum strong is very important. If your balance is very poor, you can use tubing for an assist during your reverse lunges. I also like Lateral Lunges which load one hip as you lunge, and occasionally walking lunges for more quad and balance work.
Dead lifts– These exercises work the glutes and hips. There are many safe types of dead lifts that are great for core stability and glute strength. Single Leg Dead Lifts are very helpful, but challenging. Start with a reverse lunge to begin the glute strengthening process, then add these in as well. A favorite glute killer- Reverse Lunge to Single Leg Dead Lift. Strong glutes= good balance.
Bowler’s Squats or Anterior Medial Reaches– These are both single leg balancing and reaching exercises, with slightly different applications. Either way, standing on 1 leg and reaching with opposite arm helps the glutes, anterior core and hips learn to hold you as you lean forward.
Step-ups– Single leg balance and strength work all at once. Use a step or box that puts knee at 90 degrees as you start. Always perform this on a stable surface, not a bosu ball or balance pillow or via some other circus-like trick. I never recommend unstable surfaces for strength work, as adding instability to a strength exercise is not always helpful.
Standing anti-rotation abdominal exercises with tubing or cables– Also called Palloff Presses. I love the idea of getting core engagement when standing. This makes a lot of sense, and working the abs when standing is highly functional. Prone planks/ forearm planks work the abdominal muscles in a very similar way, but Palloff Presses also work 1 side of the body more than the other.
These are just a few ideas for improved balance. They are easy to do, require very little equipment and can be regressed or progressed depending on your baseline fitness level and balance skills. Remember that machine strength training exercises like leg extensions, leg press, abduction/adduction machines DO NOT functionally assist with improving balance. Sure, they may isolate a muscle and strengthen it, but our bodies muscles never work in isolation. Never. So why waste your time with those non-functional exercises? After all, it’s more important to have good function and move well than it is to have a big honking muscle from an isolation exercise.