♪ Bob and Brad, ♪
♪ The two most famous ♪
♪ Physical therapists on the internet. ♪
- Hi folks. I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Brad, today, you wanna talk about
10 best balance exercises that a person
with vestibular or vertigo symptoms could, could perform.
- Sure. Right. If you're having some, some dizziness
with head movement and that kind of thing,
first of all, you should try and get it treated
by, you know, having a, a therapist work the Epley maneuver
or whatever, whatever-
- Whatever's gonna be appropriate for you, yeah.
- But if you're still having some, some of those symptoms,
these are good exercises to help tune it in, you know.
- To follow up with maybe?
- To minimize your, your risk for falls.
And you can do these even if you don't have
vestibular or vertigo symptoms.
They're just plain good exercises.
- Good, good balance exercises
for someone who's having trouble with their balance.
- Exactly.
- By the way, Brad,
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- Say no more, Bob.
- All right. I won't
- Okay. Balance exercise.
We're gonna talk it from, talk about it
from the toes to the eyes.
Okay. So we're gonna start out low down by the ankles.
One thing that, you know, all therapists know,
they call the ankle strategy for staying balanced.
I'm not gonna go into detail about it,
but if you don't have strong ankles and feet muscles,
your balance is not gonna be as good.
So this, the nice thing about this, it's simple.
If you have some balance problems,
you may have a chair, hold onto that.
You're gonna just go up on your toes.
Simple heel ups, I call them.
Some people might call them toe ups, whatever.
You're just gonna go up like this, up with good posture.
And you're gonna go as high as you can.
You're gonna do 10 to 15 of these, okay?
And then you're gonna rest.
You might do three sets of those a day.
Morning, afternoon, and evening.
- Three sets of 10?
- Or 15.
- Or 15, okay.
- Whatever you want.
But along with that, I'm gonna add a bonus on that.
You're gonna go up here.
You might as well go back and lift your toes up
so you're back on your heels, okay?
So you get a rocking motion, okay? Get hold-
- So Brad, you could hold onto a countertop too, right?
You mention that?
- Right, as a matter of fact, yeah, a lot of times
we have people go to the kitchen sink
so they can get their fingers over the top, like here,
and they have something steady so that when you go back,
if you were to happen to lose your balance,
you can catch yourself.
This works to, and to your part.
And this is also good for walking
so that you don't get toe drag
as you swing your foot through and your toe catches.
You can eliminate that potential, therefore resisting,
reducing your risk for fall.
- [Bob] Amazing how much of your balance
comes from your ankles.
- Yeah. Yeah. This is one of those simple things that,
that we can do as therapists, usually with older people.
But if someone had an injury, you'll work these,
get those ankles strengthened up after ankle sprains.
- [Bob] What's nice is you can do it throughout the day,
real easy.
- Exactly. Exactly.
And once those become easy,
then you're gonna go just to the single leg balance.
And again with this, one hand on something solid.
You might want to have two to start with,
and just see how you can balance on one leg.
If that's pretty easy, you know, you might go to one hand,
and this is an amazing thing, Bob.
One of those little things that therapists do.
I know I do this a lot.
If this is not too hard, well, then I say
go just to fingertips.
And then I'll say, if that's easy,
well just go to three fingertips, a thumb and two fingers.
And it's amazing.
- [Bob] What a difference it is. Yeah.
- And how much that helps.
And then I'll say go to one finger,
and things are going like this.
And when that gets easier, then it's like this,
and then time yourself and see if you can go for 30 seconds.
But make sure you do both legs,
because you wanna make sure you're even.
- [Bob] And I've had people brush their teeth that way,
Brad, when they get better.
So that it's a really good reminder every day to work on it.
And it's also, the brushing throws you off a little bit.
- Yeah. You're thinking about something else,
so your vision is on something else.
- Right. And you're shaking, you know, so you're not,
you're trying to have to hold your balance.
- And we're also crossing the midline
which is a big component for vestibular problems.
'Cause when things cross the midline,
it changes your balance.
And we're not gonna get into the details of that.
The next thing is, Bob, can you throw me the foam?
- [Bob] Gotcha.
- If you're at home, if you're doing this,
you need to do it with a partner.
You gotta have a belt on
so your partner can hold you so you don't fall over,
but just get a piece of foam.
If you can get an old piece of furniture
or you can find a piece of foam rubber like this.
- So I'd be behind you holding onto your belt.
- Exactly. Yep.
And this really makes a big difference on your balance.
Well thank you, Bob. Okay.
So you're just gonna, just get a feel for it first.
It's good to time yourself.
Go for 30 seconds is a good place to start,
or even 15 seconds, depending on your level, okay?
And once you feel comfortable here,
the next thing I like to have people do,
and with this again, could you grab me a cane, Bob?
- Sure.
- I'm gonna hold on to this chair here.
You might have a cane.
You could pull a chair up to the other side.
Go ahead, hold me, Bob. I might need some help.
And we're simply gonna start adding some squats.
Now, when I say squats, we're not gonna go way down to here.
Okay. We start out easy.
Once you get so far, if you can't get back up,
then the person behind you has a big job to do.
- Yeah. They'll pull you up.
- Yeah. Okay. So we're just gonna work simple squats.
If this gets too easy,
take the hand off of here and work the cane.
If that gets too easy, we're gonna do 10 at a time.
If you can do 10 with good stability, the cane goes out here
and then we add it, and that makes quite a difference, okay?
All right. Then...
- By the way, I wanna call this foam at home.
- Yeah. Foam at home.
This is even, this is for the advanced level.
Close your eyes. There you go.
And then we start to do the marching, and this is-
- With your eyes closed?
- Wow. Yeah. You definitely need someone here,
and it's good to start here and here again.
You can see this all progresses. Then here.
That gets too easy. Then here. Hands here.
And now if you really are good,
you might go to one legged stance again.
I'm not getting into that. That's pretty high level.
If you're doing that, you're,
you're probably a gymnast or something of that nature.
Okay. Now this last part, you can let go, Bob.
- You wanna do the leg ball toss? Or is that not?
- Well, no, actually I'm gonna get to that, Bob.
- Okay. Sounds good.
- Because I, I want to talk a little more time on,
this is more the vestibular part,
is where you're focusing with your eyes, okay?
People who have vestibular problems and they're walking,
and they'll shift their eyes to look at something,
or they're gonna turn, and that can throw them off.
One thing I want you to practice on is when you're walking,
and you're gonna turn to the right,
the first thing you're gonna do is turn your eyes
to the right, and then turn to the right, okay?
So it's split up and two separate things.
- Sure. Eyes first,
then actually move your neck and body.
- Exactly. And you can, you know,
you could practice zig zagging like this. Over here.
Now you might not be able to see this,
but it's eye shift first and then over.
- So as an actual exercise,
you can practice this, and we've done this with patients.
'Cause it's amazing how that plays
into the vestibular system. The, the eye movement.
- And again, there's, this is a, a real neurological thing.
But when your eyes cross the center line, that makes,
that can make a big difference
on your balance and how you feel.
And this can be good for strokes too.
People that had strokes.
- When Brad talks about the center line,
it's the line that goes right down the center of your body.
- Right.
- So if he, if his eyes, you know,
normally are looking just straight forward.
But now if he looks towards me with his eyes,
this eye has crossed the center line.
- Right. Right. And it's just amazing.
You could take a a whole year class
on the neuro system, and still not-
- Very, very complicated.
- Exactly. Okay, this is a nice test.
Or nice, not a test, but a nice...
- Exercise? - Exercise.
- You don't have to have cones.
You can put anything you want that you can see.
It's nice to use something soft, actually,
like maybe some stuffed dolls,
because if you step on them, you don't break anything,
and you're less chance for falling.
And this one, I just learned the other day.
It's called the infinity or the figure eight test.
- Well couldn't you put this down there?
This is nice and soft.
- Oh, Bob, Bob. Oh, Bob. We're serious here.
Okay. Actually that would be a nice thing. Let's do this.
Take this nice Green Bay Packer,
or brown ball, or whatever you got for me,
and go hold it over there.
'Cause that's something that's attractive.
Okay. Now, even back up a little bit, Bob.
So you're gonna look, pick something.
You're gonna look out in front of you.
- [Bob] So you're looking at the ball.
- I'm looking at the ball, okay?
And I'm gonna make a figure eight first.
I'm just gonna do this.
You'll see the foot pattern, and I'm just gonna walk.
And right now I'm looking down at the floor
so I can see where I'm going.
Once you get that so you feel stable,
then you pick out your, your object.
I'm gonna look at that nice Packer ball,
and I'm gonna keep my eye on it.
And now I'm crossing here, and I'm continuing to look.
- [Bob] Which is a lot more difficult to do,
isn't it Brad?
- Yeah. And right now my head and eyes
are crossing my midline.
And that may be the part where it's really
gonna throw people off.
And plus you need to pay attention to where you're walking.
I'm looking at one point,
and you just do this until you feel stable.
And this may take time to retrain your mind and your body.
This, when you're normal and you have no problems,
it seems like what's the big deal?
But if you've got some vestibular problems,
or after a stroke...
- [Bob] Very difficult to deal.
- Yeah. That can be very challenging.
- [Bob] That's what often throws people off.
That's where they lose their balance.
- Yep. Exactly. All right.
Now you can play with this one, Bob.
This is kind of one of those fun ones,
but it's a nice thing to do.
Take, take a ball, okay?
Face the camera, Bob.
- All right. Face the camera.
- So now we're just gonna work on regular standing balance.
As a matter of fact, I'll, I'll be the advanced person.
I'll stand on my foam and do this
'cause this is a little harder to do.
And just bounce the ball and catch it.
There you go. Bounce the ball and catch it.
- How come I have two balls?
- Now take the other hand, bounce the ball and catch it.
Okay. Bounce the ball and catch it.
Okay. When you can do that, bounce the ball and catch it.
Bounce the ball, trade hands,
and catch it with the other hand.
- Like that?
- Kind of like that. Bounce, trade, and catch.
The thing is, is we're crossing,
not with your eyes, also with your eyes,
but with your hand as well, you crossing the midline, okay?
Now put one ball down.
We're gonna, we're going through this a little quickly but,
'cause these are more advanced.
You bounce the ball, catch it.
- With the opposite hand.
- Yep. And put it behind your back,
and then come over to here.
Bounce the ball, catch it.
Put it behind your back and over to here.
And then you can advance that to two balls.
Bounce, behind the back, and catch.
Bounce, behind the ball, and catch.
- Wow.
- Try it, Bob. It's fun.
- Bounce the ball, behind the back.
- Well you played basketball.
- Well you didn't think I was gonna have trouble.
- Whoa. All right.
So those are the exercises.
You can go from easier to harder,
to more visual and vestibular.
They're a excellent routine to get through.
So what do you say, Bob?
- I say that sounds like a good idea, Brad.
- Okay.
- Thanks for watching.
- Good luck with your balance.