♪ 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.
- What are you talking about, Brad? (laughs)
Okay, today we're gonna talk about
to improve your balance,
you must address this issue.
It's a seven step system,
this is an updated video.
We did it once before,
we're gonna improve upon it,
make it a little bit better for probably the older person.
Am I correct on saying that?
- Well, we found out that 80 to 90%
of the people who watch this were 55 and older.
So we're gonna gear it so it's even more--
- More towards that age group.
- It's gonna be more efficient.
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There we are.
I don't know why Mike's looking up on the air.
(Brad chuckles)
The lighting seems different. - Oh yes.
All right, so Bob, balance.
Big issue , you know?
You start to get a little older, or if you have--
- I've been having trouble with that,
I'm so tall my (mumbles) high arches.
- Right, taller people have more of a balance with it,
if you've had an injury, a sprained ankle,
you'll find out that leg, the balance on it,
is gonna be much worse than the other leg.
- Correct.
- And just the aging process, the proprioception,
which is the key on all of these
is something they have to address.
And typically it's not addressed
unless your physical therapist--
- Are you gonna define that?
What proprioception is?
- Yeah, that's a good point, Bob.
Proprioception is your mind is being aware
of the location of your body parts without looking.
- So I know my hand is off to my right right now.
I know that I'm moving my fingers.
I know I'm touching my thumb to my little finger.
Just by, without looking.
That's proprioception.
- Right, and in this case,
it's where are your feet?
Are they underneath you,
off to the side,
as well as if you're walking on an uneven surface.
- It's got to correct rapidly.
And that proprioception is what allows you to walk
on an uneven surface and your ankles and your hips
are doing all kinds of gyrations that keep you upright
without you being aware of it.
And when that system starts to get broke down,
your balance goes down with it.
So these exercises are gonna queue that in
and really fine tune that to make you more stable.
So should we start? - Here we go, let's start.
- All right.
So the first thing you want to do is find out
how bad is your balance.
Or maybe one leg is better than the other.
And we do the 30 second balance test.
You could have a chair to hold onto, a cupboard.
We're gonna use a booyah stick,
you can use a cane.
- I think we should say first Brad, before any of this,
you know, safety comes first.
- Sure.
- We do not want you to fall
while you're trying to improve your balance.
If you're really bad,
you might wanna put a belt on.
- Have someone hold on to it,
another thing, you could use a booyah stick.
You could be next to a counter top.
You know, so that if you lose your balance,
you can grab onto it.
- Good point, Bob.
Yup, we want you to stay safe.
You're probably wondering what this ball is here
and we're gonna use that, we just didn't have
hanging there.
There's a specific reason.
So just to test your balance on one leg.
Here I'm standing fine.
I've got the booyah stick, or whatever you're holding,
now see if you can do that like this and--
- I'm bad. (laughs)
- And now if you can go for 30 seconds
without having to touch with your foot,
touch the cupboard or the chair, the booyah stick,
that's pretty good.
Then check the other side.
Chances are you're gonna find one leg
is better than the other.
If you have an injury, it's gonna be very clear
how bad the one that's recovering is.
If you're just have problems with your balance
as part of the aging process,
it's still nice to know which leg is worse
or which one's better.
So we're gonna do that 30 seconds balance test,
count how many times you have to touch
to catch your balance in that 30 seconds, write it down.
And then after you practice this for a week,
you can do the same test over.
- And see if you've improved.
- Right, instead of touching the floor 10 times,
it might go down to three times,
which I've done many times with patients.
- Sure. - All right, here we go.
Number one.
With your feet,
you gonna go heel to toe.
So your right heel--
- I'll hold the side.
- Right heel is gonna touch your toe, okay?
And then you're just going to stay on there
and see how that goes.
And look straight ahead.
Don't look down at the floor, look straight ahead.
And I'm gonna use this ball to look at.
Now what I'm gonna do is get this ball moving
'cause when your eyeballs start to moving,
that affects your balance.
So now I'm gonna watch that ball.
And you can see how it's really throwing my balance off
just because I'm watching that ball move.
Now, you don't have to put a ball on a string like this.
What you can do is just pick a spot on the wall
and then move your head right to left.
- Yeah, even in the clinic, I just have even,
when I'm having people walk,
I just have them work on moving their head left to right
because even that's how a lot of elderly people fall
like on holiday events and stuff.
They're getting distracted by their niece or nephew or--
- 'Cause their proprioception's not intact
and the vision goes off and it--
- And they turn, and down they go.
- So after you do this and you feel comfortable doing this
and it's working that way, then you go the next step
and then you're gonna do the single leg balance,
just like we did before.
But again, get your visual practice, practice, practice.
Make sure you do both legs
and you may not want to go 30 seconds.
You could go 10 or 15 seconds to start out with.
Again, get the movement going with your head.
And you can see I'm having much more difficulty
when I'm looking at that ball going right to left.
Make sure you do it with both legs.
When that improves and you go to the next one
and we're going to do just the single leg balance,
same thing,
here
moving back and forth.
Oh.
- You're doing it with your eyes shut?
- Yes. - Yeah.
(Brad chuckles)
Eyes wide shut.
- So we're going to do the same thing here,
instead of the ball movement and any visual,
we're gonna take that out and close your eyes.
And this really throws people off.
I'm not too bad at this,
but I've had a lot of people get this bad
and then make sure you do it with one leg.
- Yeah, I'm bad. (laughs)
- One leg balance, and close your eyes.
You know, if you got your stick or something to hold,
just use it and--
- It helps - Touch it.
And go for that, it's nice to have a timer.
So you don't have a clock to look at,
so you've got something to beep.
Little egg timer, for like cooking.
- Set it at 15 seconds
and see if you can hold it for 15 seconds.
Again, if you're really wildly,
someone should be right next to you to hold you.
- 'Cause you go down, listen again, no falls,
let's be safe.
So that's all the static ones we're gonna do.
Now we're gonna on number six and this is walking.
But we're gonna put a challenge to it,
we're gonna do the heel to toe.
So your heel has to touch your toe on the other foot
and when you do that, you could start out
looking at your feet and see if you can do it
with your cane or your stick.
And once you get that down, try it looking straight ahead.
And that's quite a bit harder,
and this is really proprioceptive because
you're trying to touch your heel with your toe
without looking and you can feel it
when everything is intact.
Okay, if you've had a stroke,
you'll find out that one foot is much more challenging--
- Again, and you can do it along a counter too,
that way you know--
- Good point, Bob.
- You're having something solid
to hold on to the entire time.
- Right. You bet. - That's all.
Okay, so you're gonna do the heel toe walking,
and then you can also go backwards,
which is quite a bit harder.
You know these are getting pretty advanced,
particularly when you've got your eyes closed
when you're doing that.
But wait,
- [Both] There's more.
(Bob laughs)
- We're gonna get a cushion.
Now you can take a cushion off a piece of furniture
if you'd like to.
You can get a cushion from a bench seat
that you use on bleachers, something for hunting.
Something that's squishy and soft.
- Or a boat seat, you said, right?
- Yeah, a boat cushion, a boat seat,
whatever you have that's convenient.
You know, these are kind of expensive,
what we use in therapy,
but they work well,
but you don't need to spend that much money,
these are $50 or so,
but it's squishy.
Your feet go in it and that challenges your proprioception
even more, so we could start right at the beginning.
We can start here and hold heel to toe
and do the same thing.
Look straight ahead, eye movement right to left
and eyes closed.
You can do that with one foot,
and if you look at my ankle--
- Yeah, look how it's working.
- It's really working.
That's really, and then eyes right to left
and I'm using my booyah stick
'cause it's really challenging without.
And then eyes closed.
It makes you tired, Bob.
- Yeah, and you've got actually really pretty good balance
for your elderly years.
(Brad laughs)
I mean, speaking as someone that doesn't,
I don't, but you, you actually,
so, and you look how you're working on that thing.
- Yeah, you may not even get to this point
and that's not necessarily, that's pretty high level,
but if you like, if you're someone that,
if you're golfing, Bob.
- Sure.
- We've got another.
- Little exercise here.
- Exercise that, you know, when you're walking
and you're using your hands with movement or pulling
or pushing--
- Gotta maintain your balance.
- What you can do is you take a band
and you've gotta connect it to the wall one way or another,
we've got our wall anchor, which works out really well.
But you could tie it to a doorknob.
- Sure. - Something solid.
And it's not gonna be very strong.
And you could just work on a pulling motion like this
with both feet.
And if that goes well, make sure you go both directions.
- See, in this is working your core
and this is making your core and balance at the same time.
- Which is all part of balance anyway.
So this is real functional.
If that's too easy, repeat the same steps like this.
I got my heel to toe and you can see
I'm being much more challenged.
Okay, you can do it with one hand,
if you want to do a golf swing, we can go like this.
So you get ready for the golf course
if you happen to be a golfer,
and you can do the one legged,
now this is even more challenging.
Whoa! And if you do it with your eyes closed,
it's really exciting. - There we go.
(both laughing)
- So you see the system, eyes all--
- Yeah. - Eyes straight ahead,
right to left, eyes closed
while you have different challenges with your feet
for that proprioceptive feedback.
- And as we've said ad nauseum, safety.
Safety, safety, safety.
- You're not gonna do this by yourself in your house.
You've got to have somebody with you
and someone that's got good balance.
So you both don't fall over.
- Yeah. That's happened to me before.
( both laughs)
It did, I had a patient, I was showing her
how to perform transfers and she did it beautifully
10 times in a row.
- I had her sister transfer, they both fell down.
- Oh my gosh!
- Oh, I was a young student.
I started crying, I almost told the doctor.
I managed to (mumbles) crying
(Brad laughs)
I got really teary, I tell the doctor, "I'm sorry."
- They didn't get hurt?
- They didn't get hurt.
Oh, good. - I was really lucky.
- Wow, that happens, Bobby.
Even to the best of us.
- Yeah, even to the best of us all.
- All right, well good luck on your balances,
stay upright.
- Yup. Thanks for watching.