Staying Balanced: What Keeps You on Your Feet

By Amy Blanford, PT, DPT
Midwest Rehab at OCI

balanceWhat are YOU afraid of? For those with balance problems, fear of falling is a very real and scary problem. Emergency rooms nationwide treat a patient every 15 seconds for a fall related injury (most of whom are in the 65+ age range). These falls frequently result in injuries that can have a lifelong impact. For those who fracture a hip, 20% end in death within the next year.

Balance is a very complex series of constant adjustments that help us stay upright. There are three systems that work together to maintain balance. Vision, sensory input from the legs and feet and the vestibular system of the inner ear all function in tandem to allow adaptation for changes.

The eyes help us stay oriented to the horizon ahead. When vision is impaired or if we have to function in the dark, the brain has decreased input to process for balance. As an example, if a person stands with their eyes open, it is usually easy to maintain quiet stance with no wobbling. If the same person closes their eyes and tries to stand quietly for 20-30 seconds, they will sense their body swaying slightly to try to adjust balance without visual input.

Sensory information from the legs and feet is critical for adjusting to changes in surface. Walking on a firm, flat concrete driveway is fairly simple. Crossing the yard requires constant alterations in balance to accommodate the bumps, slopes and holes that are common. If the sensation from the feet is impaired, the brain does not get clear messages about the surface under the feet. Sensation from the feet can decrease due to problems such as peripheral neuropathy, back problems and diabetes. Weakness in the lower extremities can also slow or decrease the balance reactions. Strengthening and proprioceptive training in physical therapy can help improve awareness and reaction time for the legs.

The vestibular system is located in the inner ear. Its primary job is to send information to the brain about where our head is positioned in relation to both the body and the ground. As we move our head, the vestibular system provides information about current position. During transitions from lying down to sitting, the inner ear is responsible for sensing when the body is erect. This prevents tipping over from sitting or overshooting the desired upright position. Conditions in which this system does not function correctly can cause dizziness with positional changes or head movements.

The staff at Midwest Rehab are trained to work with patients who have balance and dizziness problems for a variety of reasons. Often times treatment techniques include strengthening and stretching for the lower extremities. Balance and proprioceptive exercises help improve awareness of sensation from the feet and improved reactions to correct missteps and changes in the surface under the feet. Vestibular exercises and treatment can decrease dizziness with changes of position and head movements. Physical therapy can help to address balance and dizziness issues. So, don’t get scared, get STEADY with help from Midwest Rehab’s physical therapy staff.

Learn more about Midwest Rehab at or call (217) 547-9108 today to schedule an appointment with a therapist.

This article was published in the January-March 2014 edition of ”FYI from OCI”, a quarterly publication created by the Orthopedic Center of Illinois. To see the full publication, click HERE.

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Midwest Rehab is located in the Orthopedic Center of Illinois
1301 S. Koke Mill Road, Springfield
At the corner of Old Jacksonville and Koke Mill Roads
(217) 547-9108