Balance

The key to all functional movements, whether walking in the park, running down a soccer field, exercising on a stability ball, is the ability to sustain balance and posture control. In basic terms balance is defined as ‘an even weight distribution that enables you to remain upright and steady’. However, dynamic (when moving) balance is the ability to move and change direction under numerous conditions e.g. walking up steep and uneven steps.

This type of balance is strongly influenced by other components of health and fitness such as speed, endurance, flexibility and strength. To decrease the force at your joints, at the correct time for the direction of movement, should involve dynamic balance and enough muscular output for this to occur with little effort.

Poor balance is linked with an increase in injury risk, such as hip and wrist fractures (1). Therefore, it is vitally important to understand how balance can impact your functional (everyday) fitness and boost your athletic performance. Balance is dependent on both inside (the body/mind) and outside (the environment) factors to sustain the body’s centre of gravity, when in a variety of positions e.g. performing a push up or barbell front squat.

Balance does involve a number of different factors such as:

  1. Having a good length and tension relationship of the muscles.
  2. Being able to recognize and use the correct amount of force at the joints.
  3. Using eye sight and ‘joint inner feeling’ (proprioception) to help with balance.

The Research

Research indsicates that movement imbalances can have a negative impact on your overall balance and the effective use of muscles (1). This is caused by changing the ‘firing’ order of the muscles being activated and is a platform for poor movement patterns.

Unfortunately, this scenario can have a negative impact on your daily movement patterns and the effective use of the major muscle groups. This can lead to the major muscles becoming sluggish and the supporting muscles over compensating to counteract this short-fall. This process is called being ‘synergist dominant’. The combination of poor movement patterns does lead to stress on the joints, which does impact on the structure of the whole body when moving and potentially leads to premature aging of teh joints.

The dysfunction of the body when moving incorrectly contributes to joint pain and may further reduce the effectiveness of the muscles being used. Issues at the joints can block the ‘firing patterns’ of the muscles and swelling blocks sensory inputs.

Blocking the sensory inputs can have a disturbance to the ‘inner feeling’ at the joints, and this can lead to an increase in ankle sprains, lower back pain and ligament injuries to the knee (2). Are we starting to see the bigger picture yet?

Benefits of Balance Training

Balance training programs are used to prevent and reduce the rate of injuries in healthy and active individuals. Research has indicated that balance exercises are used to reduce the incidence rates of ACL (anterior cruciate injuries) in the knee (3). In addition, balance programs do show promising signs of improving the movement of the lower body. This reduces the rate of lower body injuries (4). Here are some main findings of the current research on balance:

  • Home based training with wobble boards can improve ‘movement’ balance (5)
  • Improvements in balance and overall posture of ice skaters when using a balance program versus a flexibility and strength program (6)
  • Improvements in ankle stability and posture after an 8 week balance program (7)
  • Balance training in the warm- up and the use of wobble boards reduced the risk of injuries (8).

Although it is best not to be hoodwinked into believing that balance training on its own is the ‘oracle’ for lower body injury prevention. However, combining balance training with strength and flexibility training is a far more ‘balanced’ approach (excuse the pun) to injury prevention, improving daily fitness and/or athletic performance.

A Balance Regime

Balance training should follow the boundaries of your natural stability. A ‘provisional’ measurement should focus on the distance from the base of your support, without the loss of control of your centre of gravity. This quick test will determine your natural boundaries and the limitations of your balance and it is an excellent starting point!

Daily movements in different directions should be used in an unstable/structured environment, to boost balance when moving and promote the best use of the right major muscles. Regular training programs do tend to leave out and fail to recognise balance as an important part of fitness. Many individuals tend to bolt it on at the end of their training session. More often than not, balance training tends to be used for rehabilitation and recovery purposes. However, if your balance was correct in the first place could the vast amount of lower body injuries be prevented?

Unfortunately, some training regimes do not challenge the ‘inner feeling’ at your joints when moving. The design and use of a balance training program does fill the void left by regular programs. It should be based on daily movements in an ‘unstable’ training situation, and this will improve muscle firing patterns, dynamic balance and the use of the major muscle groups.

Balance Training

Balance exercises are an important of any training regime, as they ensure optimal use of the right major muscle groups. The exercises should always be progressive; the balance program should continually challenge the awareness and limitations of your stability. There should be 3 stages of balance training and these are:

  1. Stabilization
  2. Strength
  3. Power

All 3 of the stages can ultimately be progressed by altering the surface, visual conditions and body position of the exercises. For example move from the floor to a Bosu ball, closing your eyes, moving the opposite limbs and going from two to one leg moves. This makes a simple exercise far more challenging. Bearing this concept in mind, caution should be made and only change one factor at a time, as this will ensure a safe exercise program. Let’s explain the 3 stages of balance training in more detail…

Stage 1: Stabilization Exercises

Stabilization exercises involve minimal joint and whole body movements. They are used to boost reflexive joint movements and this in turn will increase overall joint stability. During this phase of training the body should be in a state of instability, so that it counteracts this by firing the correct muscles at the right time. Essentially, this will help you to maintain a balanced body position and some exercises that help with stabilization are:

  • Single leg balance
  • Single leg reach
  • Single leg hip rotation (internally and externally)
  • Single leg lift and chop

Stage 2: Strength Exercises

Strength exercises involve a dynamic upwards and downwards movements of the balancing leg, through the complete range of movement. These exercises will require control throughout the whole movement. The choice of exercises, speed of application and demand of the muscles, is far more intense during this stage. This is compared to stage 1 and some exercises that are a solid platform for balance-strength are:

  • Single leg pistol squats
  • Single leg deadlifts
  • Step up and balance (moving through different planes)
  • Bodyweight lunges to balance (moving through different planes).

Stage 3: Power Exercises

We move on to stage 3 and this should not be just skipped to, without completing the 2 previous very important balance training stages. Power exercises have been created to develop slowing down skills, when moving the whole body position from moving to a static position. The exercises have also been designed to improve joint stability and the correct use of the major muscle groups. This is why the first two stages are important as they develop these variables to a high level. Power exercises during stage 3 should include:

  • Stabilization (through different planes of movement)
  • Single leg platform hop ups (through different planes of movement)
  • Single leg platform hop downs (through different planes of movement).

Using a Balance Training Program

Using a balance program is relatively simple. The first part of the program is honesty, as this will determine which stage you should start off on. Use the program below to improve your dynamic balance and the effective use of large muscle groups. A top tip if you are unsure what stage you are at; then start off from the beginning of the program. To progress through the3 stages of the balance program following the simple timetable below:

Stages Exercise Sets Reps Tempo Rest Intervals (secs)
1. Stabilization Single leg balance
Single leg reach
Single leg hip rotation
Single leg lift and chop
1-3
1-3
1-3
1-3
12-15
12-15
12-15
12-15
slow
slow
slow
slow
90
90
90
90
1. Strength Single leg pistol squats
Single leg deadlifts
Step- up and balance
Bodyweight lunges to balance
2-3
2-3
2-3
2-3
8-12
8-12
8-12
8-12
Medium
Medium
Medium
Medium
60
60
60
60
1. Power (Move all through the different planes) Stabilisation
Single leg platform hop ups
Single leg platform hop downs
2-3
2-3
2-3
2-3
8-12
8-12
8-12
8-12
Medium
Medium
Medium
Medium
60
60
60
60

 

References

  1. Olsen OE, Myklebust G, Engebretsen L, Holme I, Bahr R. Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial. BMJ 2005; 330(7489):449
  2. Fahrer H, Rentsch HU, Gerber NJ, Beyler C, Hess CW, Grünig B. Knee effusion and reflex inhibition of the quadriceps. A bar to effective retraining. J Bone Joint Surg Br 1988: 70:635–9
  3. Griffi n LY, Agel J, Albohm MJ, et al. Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg 2000; 8(3):141–50.
  4. Tippet S, Voight M. Functional Progressions for Sports Rehabilitation. Champaign, IL: Human Kinetics, 1995.
  5. Emery CA, Cassidy JD, Klassen TP, Rosychuk RJ, Rowe BH. Effectiveness of a home-based balance-training program in reducing sports-related injuries among healthy adolescents: a cluster randomized controlled trial. Can Med Assoc J 2005;172(6):749–54.
  6. Kovacs EJ, Birmingham TB, Forwell L, Litchfi eld RB. Effect of training on postural control in fi gure skaters: a randomized controlled trial of neuromuscular vs. basic off-ice training programs. Clin J Sport Med 2004;14(4):215–24.
  7. Michell TB, Ross SE, Blackburn JT, Hirth CJ, Guskiewicz KM. Functional balance training, with or without exercise sandals, for subjects with stable or unstable ankles. J Athl Train 2006;41(4):393–8.
  8. Soligard T, Myklebust G, Steffen K, et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ 2008;337:a2469.