Balance is a complicated process that is controlled by multiple systems in our body. Our brain takes information from the receptors in our body, our inner ear, and our vision, and consolidates this information to identify where we are in space and keep us upright.
Proprioceptive system: This system consists of our muscles, tendons, joints, and skin in our body. Receptors in these tissues communicate to your brain where your body is positioned in relation to your environment.
Vestibular system: A few different structures in your inner ear help you maintain your balance.
– Semi-circular canals: when you move your head, fluid in these canals moves and sends electrical signals to the brain; and this tells the brain what direction and how fast you are moving your head.
– Utricle and saccule: these organs assist in linear motion – like moving forward in a car or up and down in an elevator. When you tilt your head or are in motion, crystals in these organs cause little hair cells to bend and send a signal to your brain that you are moving.
Visual System: This system consists of your eyes and the muscles that control them. You use your vision to orient yourself in space as well. This system works closely with your vestibular system as head and eye movement need to be coordinated in order to be well balanced.
In order for us to have good balance, our brain has to integrate information from all three systems. If there is a mismatch in information coming from these systems, you might experience imbalance, dizziness, or even vertigo.
Who might benefit from balance training?
1. Aging: Incorporating balance exercises with functional training can help reduce the risk of falls in those over 65 years of age, and may reduce the risk of injury.
2. Vestibular conditions: There are numerous conditions that can impact the inner ear, including BPPV, neuritis, Menieres, PPPD, or vestibular migraine. Balance training can be an important component of retraining the vestibular system to find better balance.
3. Concussion: A concussion is a mild traumatic brain injury that can impact the areas of the brain that control balance, vision, and proprioceptive information. A comprehensive program incorporating balance will help retrain these systems to work together for better stability.
4. Lower body injuries: Rehabilitating lower extremity injuries should include balance training, which can assist in tissue healing and may play a role in future injury prevention after return to sport or activity.
5. Neurological conditions: Parkinson’s, Multiple Sclerosis, and stroke, among other neurological conditions, have shown positive response to balance training in assisting with gait and prevention of falls.
So next time your physiotherapist asks you to stand on one foot, know that there are numerous benefits to focusing on your balance!
References:
Al Attar WSA, Khaledi EH, Bakhsh JM, Faude O, Ghulam H et al. (2022). Injury prevention programs that include balance training exercises reduce ankle injury rates among soccer players: a systematic review. J Physiother, 68 (3). 165-173.
Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, et al. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic reviews, Issue 1, Art no CD012424.
Su W, Wang J, Ying Y, Lu, B, Liu H, et al. (2025). Injury risk reduction programs including balance training reduce the incidence of anterior cruciate ligament injuries in soccer players: a systematic review and meta-analysis. J Orthop Sure Res, 20 (248).
VEDA. https://vestibular.org/article/diagnosis-treatment/vision-hearing/the-connection-between-vision-balance/
Yitayeh A, Teshome A. (2016). The effectiveness of physiotherapy treatment on balance dysfunction and postural instability in persons with Parkinson’s disease: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil, 8 (17).