Balance, fall prevention, dizziness and more

Dr. Mark De Anda specializes in treating the lower back and sciatica. (Courtesy photo)

By Dr. Mark De Anda

Last week, we opened up a discussion about balance, falling and trying to understand the parts of our body that make up our balance system.

We broke it down into three major components: the first one was the source of sensation that tells us about our body’s position; the second was the brain’s ability to process this information as it comes in from our eyes, ears and body; and finally our muscles strength and coordination of movements required to maintain balance.

In the next few paragraphs, I will go over each one of these components so that you can have a better understanding of your balance.

The source of sensation that tells you about your body’s position relative to your environment or your body’s position in space is called proprioception. Let’s play a game to see how good you are at this ability.

Close your eyes and raise your right arm in front of you.  Open your eyes with the arm still raised.  Pay attention to exactly where that arm is.  Keep your right arm up.  Now close your eyes again, and raise your left arm to exactly where your think your right arm is.  Now, open your eyes.  Are they raised at the same level? Is one higher than the other?

Again, this ability to know where your body is in space is called proprioception.  Some people are just naturally better than others at this.  Or others may have injuries to their joint that negatively affect this ability, and it is difficult to know where their body is with their eyes closed or in the dark.  That is why many elderly fall in the dark.

The second component is our brain’s ability to process all this sensory as it comes in from not just our bodies, but also our ears and eyes.  As we sometimes lose our balance as we walk, we rely on our body’s proprioception, ears and eyes for giving us our balance.  We lose our balance when one of these are weakened. If we begin to lose our sight, we are giving less sensory information to our brain about our environment, and it can really affect confidence when we walk.  It’s kind of like walking in total darkness.

Finally, the condition of our muscle strength and coordination required for keeping our balance plays a huge role.  As we age, we lose strength and we become less active causing decreased coordination and reaction time.

Trauma and surgeries can also affect strength and coordination.  When we have trauma, such as a stroke, it weakens our muscle strength in our legs.  Lifting our legs over a simple step is not so simple anymore and can really set you up for a fall. Not only that, but the coordination of moving one foot in front of the other is also affected and makes it difficult to walk in a normal pattern, which also can lead to falls. Ultimately, a fall can shorten your life span and lead to early death.

So, what do people usually do with balance issues? Most people ignore it!  They do nothing to fix it, and they become more dependent on friends and family.  Maybe they go out less often to avoid falls or just do less activities. People may try to alter their bad balance by using a cane or walker, however, they are dependent to those devices.

So, how do physical therapists treat balance and dizziness problems successfully?  My patients perform balance specific challenges and activities. I also retrain my patients how to walk properly.  Patients may perform strengthening and endurance exercises that include teaching posture so that balance is not offset.  They also perform exercises that involve eye, head and body movements.  Finally, we encourage our patients to continue exercises during and after physical therapy.

My name is Dr. Mark De Anda, and I’m a doctor of physical therapy located in central San Antonio. If you call (210) 314-6725 and schedule and appointment I can confirm exactly what causes of your loss of balance and give you a written plan of exactly what a successful treatment looks like.