Your Health and You
Tips from the providers at Gifford Medical Center
By Eric Medved, MS PT

Our ability to stay active—play sports, perform household chores or go for a walk—is a result of our sense of balance.

The risk of falls increases as one ages, and with falls, comes the greater likelihood of injuries such as ankle sprains, concussions or hip fractures. These injuries can decrease mobility and independence, and lead to a general decline in health.

A decline in balance can be a result of decreased activity, osteoarthritis, poor posture, decreased vision or sensation in the legs. Any of these medical conditions alone may not directly impact balance, but together these multiple factors can make getting around difficult.

While most of these conditions are considered chronic, in that they develop over time, the possibility of an acute balance loss, often caused by a virus in the inner ear, can have an immediate impact on balance and can affect people of almost any age.

Your balance is made up of a triangle of systems working together to keep you from falling. The first point of the triangle is the most obvious—the visual system. Vision is responsible for one’s sense of depth perception, peripheral vision, and simply knowing the environment within which you are moving.

The second point of the triangle is the system known as "proprioception." This is commonly considered to be input from nerve endings in one’s joints and muscles of the feet, legs, pelvis and upper body.

The third and final point of the triangle is the "vestibular system," or the inner ear. The vestibular system enables one to know the orientation of the head in space, assists in visually fixating on a point or scanning the environment. It communicates with postural muscles to maintain standing balance. And it can be considered the top point of the triangle due to its ability to coordinate interactions between all three systems.

The vestibular system assists in visual tracking or fixation while maneuvering through a crowded store to help us find our way. Even activities one takes for granted, such as reaching for items on a shelf, bending to tie one’s shoes, or turning around when someone calls our name, have input from the inner ear to assist in balance.

When this system becomes weakened through head trauma, viral infection or disuse with the aging process, the vestibular system’s ability to relay messages relative to head position to the rest of the body weakens, causing one to feel off balance or dizzy. This diminished ability to help maintain balance can result in a greater risk of falls.

The good news is that, like muscles in the body, this system often can be strengthened. A series of simple exercises related to increasing head movement, improving one’s center of gravity and challenging oneself by walking on uneven surfaces can retrain the communication between the inner ear and the other "points of the triangle" that make up the balance system, thereby reducing the risk of falls and increasing one’s mobility in the community.

(Eric Medved is a physical therapist and Rehabilitation Services manager at Gifford Medical Center. He holds a special certification in vestibular rehabilitation and oversees Gifford’s Balance Center.