By Dr Kelly Starrett And Juliet Starrett For The Mail On Sunday
22:31 25 Mar 2023, updated 22:55 25 Mar 2023
- Good balance is the most unsung physical skill and is key to helping prevent falls
- New book reveals the best exercises to try to improve your balance
Good balance is the most unsung physical skill – it affects our ability to perform many daily activities, as well as being the key to preventing injury and falls.
Today, in the second part of the serialisation (which started in yesterday’s Daily Mail) from our new book Built To Move, we reveal simple tests which determine how well you can balance and why any wobbles you experience are a marker of accelerated ageing that require urgent attention.
Many health problems that arise after midlife occur because most of us don’t move enough, or not in the ways we need to.
Over time, our bodies adapt to a sedentary, chair-bound life and compensatory changes happen in the muscles, joints, ligaments and even the brain and blood vessels, which can set in motion a chain of negative effects that impact health and longevity.
Better mobility puts all those systems in sync, allowing us to achieve agility, ease and quickness of step and avoid unnecessary restriction, rigidity and pain.
But balance plays a crucial part in this, too.
Maintaining it is a complex task needing co-ordination from our muscles, tendons, bones, eyes, ears and brain.
There are three main systems involved: the inner ear, which is highly sensitive to different types of motion; sensors in the muscles, joints, ligaments and tendons which send information about the body’s movements to the central nervous system (via a system called proprioception); and vision.
All of these weaken as we get older because, without practice, the functioning of our sensors declines and the central nervous system becomes less efficient at processing the various signals it receives.
Age-related changes occur in the inner ear which leaves us depending heavily on our vision for balance – and our vision also goes into decline, further affecting our equilibrium.
These factors come together to make it more difficult to stay steady as we get into our 70s and 80s, which is why falls are the leading cause of injury and injury-related death in older people.
But declining balance should not be accepted as a price tag of ageing. It can be retrained and regained. And here’s how:
HOW TO SCORE
Add up the number of times you reach out for support or touch your foot down to regain balance.
No touches means you have great mastery of balance. Practise the test every day to maintain it.
One or two touches is pretty good. You will certainly improve with a little practice.
Three or more touches suggests your balance needs work. See the exercises that follow.
The Closed-Eye Balance Test
How steady you are on your feet depends on eyesight, your inner ear and the sensory receptors in muscles, tendons and joints.
With your eyes open, it is easier to stay steady because you know where your body is in relation to your surroundings.
But remove your ability to see and you depend on your body’s other balance tools which is why this test should be done with your eyes shut to measure how well they are working.
Repeat it frequently and you’ll see how, with a little training, you can become proficient at this difficult task.
What to do:
Stand barefoot on the floor in an open, uncluttered space.
Close your eyes, bend one leg and raise your foot off the floor as high as you can comfortably.
Hold your balance for 20 seconds, then switch sides and repeat.
If you feel uneasy, stand next to a wall or in front of a sink.
The ‘Old Man’ Balance Test
Don’t let the name fool you – this isn’t easy for anyone, young or old! But if you master this dynamic test (and maintain the skill), you’ll have the balance, flexibility and mobility of a fit and healthy youngster, which will help to protect you from pain and injury.
HOW TO SCORE
Add up the number of times you touched the floor with your foot to regain balance.
Assess each side separately. No touches shows you have good mastery of balance.
One or two touches is acceptable – you will certainly improve with practice. Three or more touches means your balance needs work, but it can be improved.
What to do:
Stand barefoot, placing a pair of lace-up shoes and socks on the floor in front of you. Balancing on your right leg, allow the left leg to extend behind you as you reach down to pick up your shoe and sock. Return to an upright position.
Next, raise your left foot and put on your sock and shoe. Tie your shoe, then return your foot to the floor. Repeat on the other side.
How to improve your balance scores:
Even if your balance seems poor, you can switch the support mechanisms back on. Take every opportunity to balance on one leg – while brushing your teeth or washing the dishes, for instance.
Another effective exercise is to hop on one leg back and forth over an imaginary line.
Try breaking down the sock/shoe balance test one step at a time, first working on picking up the sock and shoe while standing on one leg, then practise just putting on a sock and so on until you’ve mastered each stage.
Go barefoot as much as possible
Our feet are the foundations to effective balance. There are important sensors concentrated in the soles of the feet, and large parts of the brain devoted to the information these sensors send.
But because we spend so little time barefoot, tend to walk on smooth surfaces and stuff our feet into comfy shoes, we are robbing our brain of much of the input which helps build balance.
To contribute to balance effectively, feet need to be both strong and super-sensitive to stimuli.
So take your shoes off and go barefoot whenever possible.
To ease tension in tired feet, sit on the floor or sofa and pull one foot up and massage the heel, arch, ball and top of the foot. Use your fingers to spread your toes and to twist the front of your foot back and forth. Try to wring your feet out, bend and extend your toes. Spend as long as you like on one foot, then switch sides.
Stand more, live longer
Studies show that prolonged sitting can lead to impaired vascular function, high blood pressure, poor blood sugar metabolism, inflammation and reduced blood flow to the brain. It can even blunt the beneficial effects of exercise.
Start skipping…even without a rope
Skipping keeps your balance systems in shape and gets the organs in the abdominal cavity moving around, which helps to improve bone density.
It also gets your heart rate up, blood flowing and burns calories. If you don’t have a rope, try these:
- With your hands resting lightly on a counter or one hand resting on a wall, rise on your toes and quickly bounce up and down 50 times.
- Next, bend and raise your left leg slightly and bounce 25 times on your right foot. Switch sides.
Women and men who sit more than six hours a day are, respectively, 37 per cent and 18 per cent more likely to die before people who sit less than three hours a day. One reason for this is because, when you’re seated, your leg muscles become very passive and don’t require much energy, so blood flow and sugar metabolism slow down.
However, if standing, your legs are loaded, working to support your upper-body weight. This taxes the system for the better.
Given the alarming statistics, aim to curb sitting to six hours a day.
It’s not just about minimising sedentary time either – you must maximise the benefits of moving, too, because standing is a gateway to movement. In fact, for comfort’s sake, it requires that you move.
You might sway your hips, shuffle your feet around, bend one knee, then the other, shift your weight, find something to lean on or cross and uncross your arms.
Fidgeting, too, ups energy expenditure and helps counter stiffness incurred by sitting.
Researchers in Japan have found that workers who decreased their sitting time also reduced their shoulder and neck pain. Other studies have found that using adjustable sit-stand workstations leads to less back pain.
Significantly, it is now known exercise does not cancel out the time you spend in the warm embrace of a chair, so it is a good idea to aim to stand for increasing proportions of your day.
The airport scanner test
Watch people in airport security scanner machines and you’ll see how hard it is for many to hold their arms above their head without contorting their neck, arching their back or hoiking their shoulders up around their ears. The fact is that many of us have a restricted range of motion in our shoulders.
Shoulder immobility gradually creeps up on us when we work at a computer for hours hunched over the keyboard with our upper back rounded in a C-shape.
This slouched position disrupts the rotator cuff muscles which support the shoulder, reducing its range of movement.
Additional problems occur if you frequently look down at your phone while your body is slouched.
The muscles and connective tissue around the shoulders and upper spine are forced to stiffen in an effort to hold your heavy head up.
You might not know you’ve got a problem until you struggle, for example, to stack towels on a high shelf in the bathroom, or to lift your bag into an overhead luggage locker.
Unless you work to keep some mobility in the shoulders, matters will get worse until you can no longer pull a jumper over your head or wash your own hair.
What to do:
Take a broomstick, or a rolled-up tea towel. Lie face down on the floor with your arms extended straight overhead in front of you, hands holding the broomstick or clutching either end of the tea towel.
Point your thumbs toward the ceiling and allow the stick or tea towel to rest in the crook between your thumbs and forefingers.
Keeping your forehead and belly in contact with the floor, arms straight (parallel) and thumbs up, pull your shoulder blades back and down and lift your arms up as high as they’ll go. Hold for five inhales and exhales. Don’t hold your breath or bend your elbows.
If you can’t lift your arms, your shoulder mobility is way below what it should be.
If you can lift off the floor, but only for a few seconds while holding your breath, your shoulder mobility is restricted but be encouraged by this small amount of movement – there’s plenty more where that came from.
One to two inches off the floor is a sign that you can access the position, but there’s more work to be done. With practice, you should improve not only your range of motion but your stamina as well.
Two or more inches off the floor suggests a lack of shoulder flexion is not your problem.
Keep working to maintain your shoulder flexibility.
How to improve your score:
Tension or stiffness in the shoulder and neck is a signal that you need to move more:
Take every opportunity to reach up high.
Whe0el your arms around when you get out of bed in the morning.
When sitting, consciously roll your shoulders back.
Instead of using your car’s reversing camera, turn around to look behind.
Repeat the airport scanner test weekly to track improvements.
Squeeze your bottom to protect your back
One of the fundamental jobs of the buttock muscles (the glutes) is to control the pelvis so it doesn’t tug on your spine, protecting your back from strain and instability.
Glute weakness is associated with knee injuries, chronic lower back pain, shin pain and falls among the elderly. Conversely, glute strength has been shown to remedy many of these problems.
For this reason, it’s important to be able to activate your buttocks when needed.
Squeezing them every so often is a good way to reset, especially if you are standing or sitting for long periods.
Just 15 minutes of seated or standing buttock squeezes every day (five-second squeezes with a brief relaxation in between) is enough to increase the muscle size and change your body shape.
Adapted by LOUISE ATKINSON from Built To Move: The 10 Essential Habits To Help You Move Freely And Live Fully by Juliet and Kerry Starrett, to be published by Orion Spring on April 6 at £18.99. © Juliet & Kelly Starrett 2023.
To order a copy for £16.14 (offer valid to 08/04/23; UK P&P free on orders over £20), visit mailshop.co.uk/books or call 020 3176 2937.