- Oh, excuse me.
I just wanted to say, as we age,
particularly after age 50, we become more unstable.
It happens to everyone, I noticed at about 55
and I work my stability all the time.
The big problem with being unstable
is a risk for falls
which is a big thing we wanna avoid.
- However, if you understand
the reasons why you're falling
you can help prevent them from happening.
And the best part is we're
gonna show you how to do that
and it doesn't take much time
or effort to fix these problems.
- That's right.
(upbeat music)
All right. As therapists myself, Mike, and Bob,
over the last many years
have worked with countless number of individuals
with their balance in keeping them upright and safe.
- Falls can occur for many different reasons,
and we're gonna talk about seven common reasons they happen,
seven, and figure out how
to prevent them from happening,
or what you should do to fix this problem.
- We're also gonna discuss
some of the other benefits
of working on your balance,
some things that you probably aren't aware of.
For example, you're gonna have less joint pain,
less muscle pain,
and you're gonna actually look
and be taller and look better.
It'll all be explained very clear in the next few minutes.
- So these seven balance issues
are not in any particular order
and they may not all pertain to everyone.
Just pick which ones pertain to you
and hopefully it'll help.
- That's right.
It's gonna be very clear,
and let's go to the first one, Mike.
- The first one is vision declining.
Obviously if you can't see
where you're going, or your surroundings,
you're more likely to have a fall.
- And this doesn't mean just blatantly not seeing,
but if your vision changes over time
and you need new glasses,
or you don't have glasses
and you do need glasses,
you're not aware of it
can make a significant difference on your balance.
And once you get your glasses
things will change a lot for you.
- Yes. - In many ways.
- So the solution is: you have to go see your eye doctor,
because we are not licensed to give advice on this.
- That's for sure.
I can hardly see myself!
No, I need cheaters, that's all.
Anyways, let's go to number two.
Alright, number two.
Now this one is something many people are not aware of,
but your ear health!
What happens in your ear,
or not what happens,
But what is in your ear is the vestibular system.
It houses kind of like a little balancing system
that talks to your brain
and lets you know if you're upright
and controls a lot of your balance.
So if you've had a history,
or recently have had a ear infection;
if you had anything related with your ear,
even the ear impaction,
in other words your ears get plugged up,
get that checked out by the doctor,
make sure your ears are in good health.
It can make a big difference on your balance.
- So a good solution to this, like Brad said,
is to go visit your doctor
to make sure that isn't causing your falls.
Typically there's dizziness associated with this problem.
We do have a video,
much more in-depth with another physical therapist,
called, "Understanding Causes of Dizziness and Vertigo:
All You Need to Know."
and we'll link that down below
in the comments section.
Just click on it if you wanna
find out more information about this problem.
- Right. And that actually,
I think that's with Sherry, right?
- Yep. - She is an expert on this
and she does an excellent job
describing the problem
and how to work with it.
- Reason number three for falls,
is typically poor posture
like this when you're standing.
Now this happens commonly as we age,
leaning forward like this,
this will shift the center of gravity
and make you more likely to fall over
causing imbalances in your muscles
and can even cause some back pain.
So we want to try to straighten you up.
- Right? This is so critical
and I want to emphasize this posture as we age,
you notice it with a lot of people.
They start walking this way,
gravity takes over, everything starts pulling down.
And the muscles in the back are particularly,
can be the joints and the knees and the hips.
That stresses everything, causing pain
associated with tippy balance.
So we're gonna show you one quick simple exercise
to improve this.
- So the solution for this,
if you have rounded posture like this,
is to do a simple posture check against the wall.
So what you're gonna do,
is put your buttock against the wall.
If you're forward like this,
it might be hard just to try
to get your shoulder blades back.
The goal is to try to touch
the back of your shoulder blades
to get better posture.
Once you can do this comfortably,
try to bring your chin like this, back,
and touch your head to the wall.
So you want to try to get nice, flat and upright.
Your feet can be out further.
They don't have to be touching the wall,
that's going to possibly cause you to fall
if you have poor balance.
So, remember: buttock first,
try to bring the shoulder blades
back for good posture,
and then the head.
- Now I'm gonna mention,
some people who have been
forward-slouched for a long time,
may not be able to touch,
go ahead and touch the back?
Oftentimes I've seen patients be able to do this,
but, touching the head,
the neck has become so contracted
or tightened up over time.
That takes some time.
That may take some weeks,
actually, you know, a few days,
possibly some weeks to get this back.
You can take your hand
and do some gentle, what we call "chin tucks."
Gently stretch it out to get that head to come back.
Sometimes I've had people
make progress all the way to touch.
If they're very, if they're older,
in the seventies and eighties
and had real bad habits,
that never comes back;
but you still work with it.
Alright, number four,
we're gonna talk about lack of sensation in the feet.
In other words, numbness, tingling.
If you're diabetic and you have neuropathy in your feet,
you know exactly what I'm talking about.
I've worked with a lot of patients who have that;
they don't feel or have sensation in your feet.
When that happens,
there's no feedback from your feet to your brain,
in the balance centers,
and your balance becomes much more difficult.
Now, you can also have similar problems
just by the shoes you wear.
If you have thick shoes,
your feet are not gonna sense and feel the ground,
particularly if it's unsteady ground.
If you have shoes,
like Mike and I have these really thin soled shoes,
they're called "zero drop" and,
- "Barefoot shoes," - "Minimalists,"
that can help.
However, we understand that certain people,
these are just not comfortable.
Perhaps you have feet problems and you need the support.
So that's okay.
We're gonna show you some exercises
that you can do very simply
to improve your balance and proprioception.
Did I mention proprioception?
- You maybe did.
- Ah, did I? - I wasn't listening.
- Anyways, that is what it's called, technically.
"Proprioception."
And we're gonna get right with that.
Okay, we're gonna show you the option
to do some exercises.
Now, if you have neuropathy,
this is something you definitely want to do
if you decide that you don't want
to go with these thin shoes
to get a more feel of the ground or proprioception,
you're gonna stick with your
comfortable, soft soled shoes.
That's okay, you're gonna wear those
when you do this exercise.
You could do it barefoot as well.
So the thing that you want to do,
is go to a corner like this.
Now the reason we're using the corner
is because this is gonna make you a little unstable
and we obviously do not want you to fall.
So when the corner's there,
you have all these directions
that you're stabilized by the wall.
Going forward, you are not stable.
So like Mike has a cane,
you could use a walking stick,
you could use your stretch-out stick
or booya stick, whatever you have.
You could actually put a chair in front of you,
so the back of it you can grab onto.
- So to work on this in the corner,
make sure you have your cane,
or if you want a chair like this,
just position it in front of you
and you can hold onto this as well for more support.
So to start, just stand with your feet wide apart,
as long as you feel safe this way.
You can bring your feet closer together,
eventually try to touch them.
Stand like this for 30 seconds
and you can repeat it three times.
Once this becomes easy,
another progression to do
is to stand on one leg.
The higher this leg is up,
the more it will challenge the balance.
Make sure to work both legs
three times for 30 seconds as well.
Now if all this is too easy for you,
you can also take some type of cushion, pillow, balance pad,
whatever you have laying around, something soft.
Put it on the ground and you can stand on that.
Again, start with wide base of support,
feet further apart.
Then bring your feet closer together
for narrow base of support
and you can progress to one leg as well.
- Now let's look at this a little bit closer.
Let's use a Pete's Choice.
This is what we use in the clinic,
they work very well.
This is from my seat, my Audubon seat at home.
So whatever works for you,
there's a lot of things.
If you zoom in on this ankle,
now watch as he stands on one foot.
This ankle is working back and forth
and is really focusing a lot of energy to stabilize Mike.
This is a type of thing we wanna work on
for that proprioception.
That's critical for your balance.
This little thing is what you will not get
without a cushion to unstabilize your support.
So that's why we use it.
If you don't feel comfortable with it, don't use it.
Alright, number five.
This happens with a lot of people as we age,
in our fifties and sixties,
is simply a decline in strength in our hips,
legs, feet, and ankle.
Oftentimes because we become a little more sedentary,
don't get out and exercise as much,
so things weaken as a result.
Weaker legs, hips, et cetera
result in being a little more unsteady.
The body just cannot control itself as well,
particularly walking on uneven terrain.
- So the solution for this is to strengthen your legs.
You can do this in a variety of ways,
but we have a video we've done in the past.
We'll link it down below in the top comment.
And it is called, "Three Best Beginner Senior Leg Exercises
Using A Kitchen Chair, Improve Balance, and Walking."
That is a long title.
(laughter) You will need a chair for it,
the video explains how to do the exercises.
So if you wanna start strengthening your legs,
just watch that video.
- Right, and again I wanna emphasize,
if you're not sure where to go,
right below the video, it's comments.
It's gonna be a first comment always.
And there's actually other videos
that we are referring to in that location.
- Yeah, both videos will be there.
- Yep, it's very easy.
- So reason number six that your balance isn't improving,
or reasons you can fall,
is because you're not challenging your balance enough.
So that means standing up,
doing standing activities,
going for walks outside;
Maybe not just on a sidewalk,
but maybe take some hikes on the grass or gravel
or even going for a hike.
Challenging your balance through everyday activities
is gonna help improve it.
- That's right.
And I'm gonna actually recommend
you go out of your way to do this.
Have good judgment,
make sure you're not going on a trail
that has rocks and three foot elevations
to negotiate over, good judgment.
But things that you have to actually
think about where you're walking,
you're placing your feet to get around rocks,
stumps, uneven terrain like the lawn
that is gonna make you think.
And when you do this, probably use
a walking stick or a cane,
something that assures you're gonna be safe.
Walking sticks are very popular,
they look cool,
and everyone's gonna think you're really cool.
Get a fancy one if you'd like.
Go out in the woods and go for a hike on the trail.
The tranquility and the birds, the trees,
and the fresh air will do more for your mind
than for your balance walking on the trail,
but keep your mind on the trail as well.
Good luck with that.
Okay, and number seven,
the last one is kind of similar to number six,
but it relates more to being in the house.
Times when you have to walk sideways or walk backwards,
they call 'em "perturbations,"
where things happen kind of quickly
and you don't expect it.
Particularly if there's a crowd of people around.
Those little things, sideways and backwards,
can lead to stumbles,
which can lead to falls and it's a real problem.
So we're gonna show you some quick,
little, simple things
you can do to practice on a daily basis.
It only takes a minute a day.
- So the first activity to do, is just sidestepping
and just bring one foot out to the side
and bring the other foot to touch it.
Going sideways like this.
Make sure to do both directions.
The distance will be determined
by the length of your railing or countertop
or whenever you get tired.
- I wanna emphasize, Mike, when you do this,
make sure you're looking straight ahead sometimes too,
because when this happens in real lifetime,
you're not looking at your feet often
and that's when falls happen.
This is a very common reason for falls
with people in the kitchen and the bathroom
is with sidestepping.
We know that from working with a lot of broken hips.
- Yes, the next variation you're going to march forward.
Just lift your legs as high as you comfortably can.
And then once you get to one end, walk backwards.
Take your time, make sure you feel controlled.
If you really feel unsteady doing this,
maybe hold off,
or have someone hold onto you with a gait belt
is a good option as well.
And you're just gonna do this
the length of your countertop or your railing as well.
- So the reason we're doing this,
is the marching forward simulates
when you are going up steps or up an incline.
If you've ever walked up a step and misjudge the steps,
or you didn't lift high enough,
perfect time to catch your toe on the edge of the step,
causing a fall,
walking backwards into the chair
that you're gonna sit down.
Maybe you're farther than you than think and stumbling.
So these are great functional exercises to practice.
- Again, if you feel safe,
try to keep your eyes looking ahead
not down at your feet like this.
Then the next variation you could try,
which is a little more challenging,
is called the grapevine, the karaoke,
it has a bunch of different names.
I don't know why it's called karaoke,
but you're gonna cross one leg in front,
bring the back leg back, and you're gonna go behind.
So right foot front, right foot behind.
The opposite direction,
you're just gonna do the same thing.
Left foot in front, then left foot behind.
You wanna make sure to take your time.
If you start crossing your legs
and feeling like you're falling,
you're not ready for this exercise.
It's a little more advanced.
- That's right.
And this is, I think, Bob and Mike and I can all agree,
when we work with people with this in the clinic,
it's one of those things
that people oftentimes get confused
on which foot goes in front or behind.
If it's a problem, don't worry about it.
You can just forget it and go work with the other ones.
- The last one, another challenging one,
is to try to walk heel-toe like you're on a tight rope.
And so you're gonna put one foot
directly in front of the other,
going forward like this,
you can turn around and go forward-back.
Or if you're feeling advanced
and feeling good and this is easy,
you can do this backwards as well for more of a challenge.
- I always emphasize, make sure,
see if you can feel your toes touch your heel.
Because when that happens, particularly going backwards,
you're working your proprioception.
In other words, you're training your body
to know where your feet are
without visual contact.
Very important to work on your proprioception
and it's gonna make you less resistant to,
or less risk for falls.
Nice job, Mike.
These are, they're something that's really important,
but be careful with them.
Be safe and if you don't feel safe,
do not do them by yourself or you know,
you'll be okay without it.
So I don't know, do we have some more to cover, Mike?
- I think we covered about everything.
Those other two videos, again,
are linked down below in the comment section.
Let us know if these worked for you
or what we forgot about.
'Cause we don't know everything.
- Well, right, you're right, we don't.
I thought maybe we be did.
I don't know.
But be careful and be safe.
(upbeat music)