- Oh, excuse me. I just wanted to say, as we age, particularly after age 50,
we become more unstable. It happens to everyone,
I noticed at about 55 and I work my stability all the time. The big problem with being unstable is a risk for falls which is a big thing we wanna avoid. - However, if you understand the reasons why you're falling you can help prevent them from happening. And the best part is we're gonna show you how to do that and it doesn't take much time or effort to fix these problems. - That's right. (upbeat music) All right. As therapists
myself, Mike, and Bob, over the last many years have worked with countless
number of individuals with their balance in keeping
them upright and safe. - Falls can occur for
many different reasons, and we're gonna talk about seven
common reasons they happen, seven, and figure out how to prevent them from happening, or what you should do to fix this problem. - We're also gonna discuss some of the other benefits of working on your balance, some things that you
probably aren't aware of. For example, you're gonna
have less joint pain, less muscle pain, and you're gonna actually look and be taller and look better. It'll all be explained very
clear in the next few minutes. - So these seven balance issues are not in any particular order and they may not all pertain to everyone. Just pick which ones pertain to you and hopefully it'll help. - That's right. It's gonna be very clear, and let's go to the first one, Mike. - The first one is vision declining. Obviously if you can't see where you're going, or your surroundings, you're more likely to have a fall. - And this doesn't mean
just blatantly not seeing, but if your vision changes over time and you need new glasses, or you don't have glasses and you do need glasses, you're not aware of it can make a significant
difference on your balance. And once you get your glasses things will change a lot for you. - Yes.
- In many ways. - So the solution is: you have
to go see your eye doctor, because we are not licensed
to give advice on this. - That's for sure. I can hardly see myself! No, I need cheaters, that's all. Anyways, let's go to number two. Alright, number two. Now this one is something
many people are not aware of, but your ear health! What happens in your ear, or not what happens, But what is in your ear
is the vestibular system. It houses kind of like a
little balancing system that talks to your brain and lets you know if you're upright and controls a lot of your balance. So if you've had a history, or recently have had a ear infection; if you had anything related with your ear, even the ear impaction, in other words your ears get plugged up, get that checked out by the doctor, make sure your ears are in good health. It can make a big
difference on your balance. - So a good solution to
this, like Brad said, is to go visit your doctor to make sure that isn't
causing your falls. Typically there's dizziness
associated with this problem. We do have a video, much more in-depth with
another physical therapist, called, "Understanding Causes
of Dizziness and Vertigo: All You Need to Know." and we'll link that down below in the comments section. Just click on it if you wanna find out more information
about this problem. - Right. And that actually, I think that's with Sherry, right? - Yep.
- She is an expert on this and she does an excellent job describing the problem and how to work with it. - Reason number three for falls, is typically poor posture like this when you're standing. Now this happens commonly as we age, leaning forward like this, this will shift the center of gravity and make you more likely to fall over causing imbalances in your muscles and can even cause some back pain. So we want to try to straighten you up. - Right? This is so critical and I want to emphasize
this posture as we age, you notice it with a lot of people. They start walking this way, gravity takes over, everything
starts pulling down. And the muscles in the
back are particularly, can be the joints and
the knees and the hips. That stresses everything, causing pain associated with tippy balance. So we're gonna show you
one quick simple exercise to improve this. - So the solution for this, if you have rounded posture like this, is to do a simple posture
check against the wall. So what you're gonna do, is put your buttock against the wall. If you're forward like this, it might be hard just to try to get your shoulder blades back. The goal is to try to touch the back of your shoulder blades to get better posture. Once you can do this comfortably, try to bring your chin like this, back, and touch your head to the wall. So you want to try to get
nice, flat and upright. Your feet can be out further. They don't have to be touching the wall, that's going to possibly cause you to fall if you have poor balance. So, remember: buttock first, try to bring the shoulder blades back for good posture, and then the head. - Now I'm gonna mention, some people who have been forward-slouched for a long time, may not be able to touch, go ahead and touch the back? Oftentimes I've seen
patients be able to do this, but, touching the head, the neck has become so contracted or tightened up over time. That takes some time. That may take some weeks, actually, you know, a few days, possibly some weeks to get this back. You can take your hand and do some gentle, what
we call "chin tucks." Gently stretch it out to
get that head to come back. Sometimes I've had people make progress all the way to touch. If they're very, if they're older, in the seventies and eighties and had real bad habits, that never comes back; but you still work with it. Alright, number four, we're gonna talk about lack
of sensation in the feet. In other words, numbness, tingling. If you're diabetic and you
have neuropathy in your feet, you know exactly what I'm talking about. I've worked with a lot of
patients who have that; they don't feel or have
sensation in your feet. When that happens, there's no feedback from
your feet to your brain, in the balance centers, and your balance becomes
much more difficult. Now, you can also have similar problems just by the shoes you wear. If you have thick shoes, your feet are not gonna
sense and feel the ground, particularly if it's unsteady ground. If you have shoes, like Mike and I have these
really thin soled shoes, they're called "zero drop" and, - "Barefoot shoes,"
- "Minimalists," that can help. However, we understand
that certain people, these are just not comfortable. Perhaps you have feet problems
and you need the support. So that's okay. We're gonna show you some exercises that you can do very simply to improve your balance
and proprioception. Did I mention proprioception? - You maybe did. - Ah, did I?
- I wasn't listening. - Anyways, that is what
it's called, technically. "Proprioception." And we're gonna get right with that. Okay, we're gonna show you the option to do some exercises. Now, if you have neuropathy, this is something you
definitely want to do if you decide that you don't want to go with these thin shoes to get a more feel of the
ground or proprioception, you're gonna stick with your comfortable, soft soled shoes. That's okay, you're gonna wear those when you do this exercise. You could do it barefoot as well. So the thing that you want to do, is go to a corner like this. Now the reason we're using the corner is because this is gonna
make you a little unstable and we obviously do not want you to fall. So when the corner's there, you have all these directions that you're stabilized by the wall. Going forward, you are not stable. So like Mike has a cane, you could use a walking stick, you could use your stretch-out stick or booya stick, whatever you have. You could actually put
a chair in front of you, so the back of it you can grab onto. - So to work on this in the corner, make sure you have your cane, or if you want a chair like this, just position it in front of you and you can hold onto this
as well for more support. So to start, just stand
with your feet wide apart, as long as you feel safe this way. You can bring your feet closer together, eventually try to touch them. Stand like this for 30 seconds and you can repeat it three times. Once this becomes easy, another progression to do is to stand on one leg. The higher this leg is up, the more it will challenge the balance. Make sure to work both legs three times for 30 seconds as well. Now if all this is too easy for you, you can also take some type of
cushion, pillow, balance pad, whatever you have laying
around, something soft. Put it on the ground and
you can stand on that. Again, start with wide base of support, feet further apart. Then bring your feet closer together for narrow base of support and you can progress to one leg as well. - Now let's look at this
a little bit closer. Let's use a Pete's Choice. This is what we use in the clinic, they work very well. This is from my seat,
my Audubon seat at home. So whatever works for you, there's a lot of things. If you zoom in on this ankle, now watch as he stands on one foot. This ankle is working back and forth and is really focusing a lot
of energy to stabilize Mike. This is a type of thing we wanna work on for that proprioception. That's critical for your balance. This little thing is what you will not get without a cushion to
unstabilize your support. So that's why we use it. If you don't feel comfortable
with it, don't use it. Alright, number five. This happens with a lot
of people as we age, in our fifties and sixties, is simply a decline in
strength in our hips, legs, feet, and ankle. Oftentimes because we become
a little more sedentary, don't get out and exercise as much, so things weaken as a result. Weaker legs, hips, et cetera result in being a little more unsteady. The body just cannot
control itself as well, particularly walking on uneven terrain. - So the solution for this
is to strengthen your legs. You can do this in a variety of ways, but we have a video
we've done in the past. We'll link it down below
in the top comment. And it is called, "Three Best
Beginner Senior Leg Exercises Using A Kitchen Chair,
Improve Balance, and Walking." That is a long title. (laughter) You will need a chair for it, the video explains how
to do the exercises. So if you wanna start
strengthening your legs, just watch that video. - Right, and again I wanna emphasize, if you're not sure where to go, right below the video, it's comments. It's gonna be a first comment always. And there's actually other videos that we are referring to in that location. - Yeah, both videos will be there. - Yep, it's very easy. - So reason number six that
your balance isn't improving, or reasons you can fall, is because you're not
challenging your balance enough. So that means standing up, doing standing activities, going for walks outside; Maybe not just on a sidewalk, but maybe take some hikes
on the grass or gravel or even going for a hike. Challenging your balance
through everyday activities is gonna help improve it. - That's right. And I'm gonna actually recommend you go out of your way to do this. Have good judgment, make sure you're not going on a trail that has rocks and three foot elevations to negotiate over, good judgment. But things that you have to actually think about where you're walking, you're placing your feet
to get around rocks, stumps, uneven terrain like the lawn that is gonna make you think. And when you do this, probably use a walking stick or a cane, something that assures
you're gonna be safe. Walking sticks are very popular, they look cool, and everyone's gonna
think you're really cool. Get a fancy one if you'd like. Go out in the woods and go
for a hike on the trail. The tranquility and the birds, the trees, and the fresh air will
do more for your mind than for your balance
walking on the trail, but keep your mind on the trail as well. Good luck with that. Okay, and number seven, the last one is kind of
similar to number six, but it relates more to being in the house. Times when you have to walk
sideways or walk backwards, they call 'em "perturbations," where things happen kind of quickly and you don't expect it. Particularly if there's
a crowd of people around. Those little things,
sideways and backwards, can lead to stumbles, which can lead to falls
and it's a real problem. So we're gonna show you some quick, little, simple things you can do to practice on a daily basis. It only takes a minute a day. - So the first activity to
do, is just sidestepping and just bring one foot out to the side and bring the other foot to touch it. Going sideways like this. Make sure to do both directions. The distance will be determined by the length of your
railing or countertop or whenever you get tired. - I wanna emphasize,
Mike, when you do this, make sure you're looking
straight ahead sometimes too, because when this
happens in real lifetime, you're not looking at your feet often and that's when falls happen. This is a very common reason for falls with people in the
kitchen and the bathroom is with sidestepping. We know that from working
with a lot of broken hips. - Yes, the next variation
you're going to march forward. Just lift your legs as high
as you comfortably can. And then once you get to
one end, walk backwards. Take your time, make
sure you feel controlled. If you really feel unsteady doing this, maybe hold off, or have someone hold
onto you with a gait belt is a good option as well. And you're just gonna do this the length of your countertop
or your railing as well. - So the reason we're doing this, is the marching forward simulates when you are going up
steps or up an incline. If you've ever walked up a
step and misjudge the steps, or you didn't lift high enough, perfect time to catch your
toe on the edge of the step, causing a fall, walking backwards into the chair that you're gonna sit down. Maybe you're farther than
you than think and stumbling. So these are great functional
exercises to practice. - Again, if you feel safe, try to keep your eyes looking ahead not down at your feet like this. Then the next variation you could try, which is a little more challenging, is called the grapevine, the karaoke, it has a bunch of different names. I don't know why it's called karaoke, but you're gonna cross one leg in front, bring the back leg back,
and you're gonna go behind. So right foot front, right foot behind. The opposite direction, you're just gonna do the same thing. Left foot in front, then left foot behind. You wanna make sure to take your time. If you start crossing your legs and feeling like you're falling, you're not ready for this exercise. It's a little more advanced. - That's right. And this is, I think, Bob
and Mike and I can all agree, when we work with people
with this in the clinic, it's one of those things that people oftentimes get confused on which foot goes in front or behind. If it's a problem, don't worry about it. You can just forget it and
go work with the other ones. - The last one, another challenging one, is to try to walk heel-toe
like you're on a tight rope. And so you're gonna put one foot directly in front of the other, going forward like this, you can turn around and go forward-back. Or if you're feeling advanced and feeling good and this is easy, you can do this backwards as
well for more of a challenge. - I always emphasize, make sure, see if you can feel your
toes touch your heel. Because when that happens,
particularly going backwards, you're working your proprioception. In other words, you're training your body to know where your feet are without visual contact. Very important to work
on your proprioception and it's gonna make you less resistant to, or less risk for falls. Nice job, Mike. These are, they're something
that's really important, but be careful with them. Be safe and if you don't feel safe, do not do them by yourself or you know, you'll be okay without it. So I don't know, do we have
some more to cover, Mike? - I think we covered about everything. Those other two videos, again, are linked down below
in the comment section. Let us know if these worked for you or what we forgot about. 'Cause we don't know everything. - Well, right, you're right, we don't. I thought maybe we be did. I don't know. But be careful and be safe. (upbeat music)
