By Carol Kutik

In 2011, The American College of Sports Medicine (ACSM) announced additions to its 2008 Guidelines to include more comprehensive recommendations for flexibility, balance and neuromotor exercise (commonly referred to as functional training).  Exercise that involves motor skills, such as balance, agility, coordination and gait, as well as any exercise that improves physical function is recommended 2 to 3 days per week. Balance, strength and posture are interwoven as each can have a significant impact on the others. Older adults commonly notice a diminished ability to maintain balance, especially after a fall or near fall.

Many factors can directly affect an individual’s ability to maintain good posture, balance, and walking (gait) mechanics. These include the natural aging process, physical disability, and the symptoms of many chronic medical conditions. The inability to maintain balance can increase the risk of falling, and since falls are the leading cause of injury for people age 60 and above, it is crucial to incorporate balance exercises into your exercise program.

The idea behind balance training is that we are teaching the body to react to changes in its position. For example, when you sway from side to side, or forward and backward, your brain and central nervous system quickly turn on the muscles that will pull you back to center. The more you train your balance systems, the better.

Sometimes, balance will decrease slightly over years and you may not think about it. However, if you have noticed changes in your posture, step width and height while walking, or you feel unsteady getting up and walking, chances are your balance systems are not working as effectively as they could.

No one group of muscles controls balance; to some extent, you use all of your muscles. Depending on the movement, your brain decides what muscles it needs to recruit at the moment to help maintain or re-gain balance. 

Balance training doesn’t have to take a long time. Just minutes a day, added to your current exercise routine, can give results in a short period of time. But first, let’s talk about posture.

Posture is key to being able to safely perform balance exercises; hence, a great place to begin balance training is by analyzing your posture. Here are some tips:  

• Know what good posture is. Most people think that to "stand up straight" means tensing your back to heave your chest 'in and up,' and pulling your head back in to your chest. This is not so. The spine has two natural curves that you need to maintain called the 'double C' or 'S' curves. These are the curves found from the base of your head to your shoulders and the curve from the upper back to the base of the spine. When standing straight up, make sure that your weight is evenly distributed on your feet. You might feel like you are leaning forward, and look off-balanced, but you don't.
• Using a mirror, align your ears, shoulders, and hips. Proper alignment places your ears loosely above your shoulders, above your hips. Again, these points make a straight line, but the spine itself curves in a slight 'S'. You'll find that this doesn't hurt at all. If you do experience pain, look at your side view in a mirror to see if you're forcing your back into an unnatural position. If so, stop it!
• Posture can also be assessed from a seated position. The same alignment of ears, shoulders, and hips applies to good seated posture.

Posture can be changed, but as it likely took a long time to decline, it will take some time to improve. Good postural awareness and habits should be practiced every day, all day – when you’re driving, walking, even relaxing on the couch or brushing your teeth. Eventually, it will become your body’s natural alignment.

Next month’s article will include standing and seated balance exercises. Until then you have homework – yes, homework. Be aware of your posture 24/7 and sit or stand with your best alignment. Be the little birdie on your own shoulder that says “Straighten up.”