Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
131: Basic Bitches Talk About Balance
314 Plays5 hours ago
What is balance, really? In this episode of the Movement Logic Podcast, Laurel and Sarah unpack why “balance” is much more than standing on one foot, not falling, or having a strong core.
Using the motor control concept of postural control, they explore balance as a dynamic, emergent process shaped by sensory input, motor responses, cognition, confidence, fear, environment, prior experience, and social context. They discuss center of mass, base of support, stability, perturbations, sensory reweighting, and why balance is deeply context specific.
You’ll learn why steady-state, reactive, and anticipatory balance are different biological problems, why yoga may train some balance skills better than others, why strength and power matter for fall recovery, and why no single “balance exercise” prepares you for every balance challenge life throws at you.
SIGN UP Free Barbell Mini Course
ABOUT Power Play
FOLLOW @TheMovementLogic on Instagram
WATCH Movement Logic on YouTube
LEARN MORE on the Movement Logic website
FOLDABLE HOME BARBELL RACK by Verse, use coupon code MovementLogic10%OFF at checkout
RESOURCES
BOOK: Motor Control: Translating Research into Clinical Practice by Anne Shumway-Cook and Marjorie Woollacott
EPISODES
128: Does 'Balance Training' Prevent Falls, or Just Improve Balance?
129: Sarcopenia Redefined: Loss of Strength and Power Matter More Than Muscle Mass
On motor learning - 29: The Cues We Use Pt. 1, 31: The Cues We Use Pt. 2, 34: The Cues We Use Pt. 3
Our interview on the Capable and Worthy Podcast
Recommended
Transcript
Introduction to Hosts and Their Mission
00:00:00
Speaker
I'm Laurel Biebersdorf, strength and conditioning coach. And I'm Dr. Sarah Court, physical therapist. With over 30 years of combined experience in fitness, movement, and physical therapy, we believe in strong opinions loosely held. Which means we're not here to hype outdated movement concepts.
00:00:15
Speaker
or to gatekeep or fearmonger strength training for women. For too long, women have been sidelined in strength training. Oh, you mean handed pink dumbbells and told to sculpt? Whatever that means, we're here to change that with tools, evidence, and ideas that center women's needs and voices. Let's dive in.
Launch of 'Power Play' Course
00:00:48
Speaker
Hi, hello. Welcome to the Movement Logic Podcast. My name is Laurel Beversdorf, strength and conditioning coach, and I'm here with Dr. Sarah Kord, physical therapist. We just finished Power Play launch, so we are in that post-I-just-launched course similar to I-just-had-a-baby, similar to I-just-graduated-for-college. I just ran a marathon. There you go. Yeah. We are recovering. We're in a state of recovery. I'm excited that it's out there and that people can start doing it and it is still available to buy. It's just no longer longer at a discount anymore at the moment, but there probably will be another sale down the road somewhere.
Exploring Balance Beyond Pathology
00:01:29
Speaker
We are talking about balance today. wo And this is an episode that is coming after two episodes that you may want to go back and listen to if you haven't already.
00:01:41
Speaker
One is about falls and the other is about sarcopenia, which is a loss of muscle mass, but maybe most importantly, a loss of strength and power and how that causes falls, can lead to falls. Today, we're taking a little bit different approach to an episode where we'll typically really identify problem and then we'll provide an episode that sort of offers solutions or knowledge that could lead to solutions, right? yeah Today, we're not talking about a problem. We're talking about a thing, a phenomenon, ah ah an event, a state. We're talking about balance. like i don't even i don't even it's it's It's been hard for me in in researching this and putting this episode together to conceive of like what exactly is it that we're talking about when we talk about balance. Yeah. think it is an extra nerdy episode. I do think that it is going to pull us a little bit into some of the weeds, so to speak. But I think there's going to be a lot of really cool connections made to everyday life and not necessarily to problems as much as to just this this idea that is really all pervasive in terms of how we navigate the world and get around and do things and move, right? So yeah we're talking about balance today.
Dynamic Nature of Balance and Motor Control
00:02:53
Speaker
I want to clarify the scope of this episode is that we're going to talk about balance, but we're not talking about balance in the context of neurologic impairment or any type of pathology, where it is, of course, a major topic of interest. We're not talking about it so much even in the context of aging, even though we do talk about aging quite a bit and we discuss topics as they relate to aging populations quite a bit in this episode. We're not actually getting into balance as it relates to aging as much either, although the topic of being older and balanced will certainly arise a lot in this episode. we're We're going to be a lot more basic today.
00:03:24
Speaker
Basic bitches. yeah Sorry. We are mostly, we're a couple of basic bitches today just talking about balance. Oh, that's the episode title, Basic Bitches. Basic Bitches talking about balance. We're going to be more basic today because we're mostly discussing balance as a thing that happens, how it works and in healthy adults predominantly. And we're really coming at this from the perspective of motor control.
Mindset and Learning Complex Topics
00:03:51
Speaker
How do I know? Because I read a textbook title, Motor Control.
00:03:56
Speaker
And I got mostly information for this episode from that textbook. Nice. So that's how I know. I have a a quick question. Yes, please. Was it a scintillating read? ah Well, here's the thing. You would expect me to say no, right? I sort of like, here's my thing.
00:04:10
Speaker
The nerdiness of it is not beyond you at all. Thank you. But the dryness, but i I just mean like the dryness in terms of like, this is like, I can't even like, process what I'm reading, but the dryness of it is pretty snooze worthy. Yeah, I would say you hit that. Unless somebody wrote a really good textbook. Nobody wrote a really good textbook. ah However, here's what I'll say.
00:04:31
Speaker
i have two things to say. One is I want to talk about mindset and reading. And two, I want to talk about textbooks. So number one, mindset and reading. If I am in the right mindset, as long as something is written reasonably well, and I am interested in the topic, I like it.
00:04:46
Speaker
Definitely. So fantasy novels, not really a big fan lately. I've been reading them so much. Oh my God. I have so many to tell you about them. So much reading of fantasy novels. Yeah. Nathan is a prolific that's right reader of fantasy. And he, i I'm like, I literally will always have a book to read because he is like, ah he's like a walking search engine of fantasy books and he knows me very well. So I, and you do too. So now you're my other search engine. Well, I'm kind of dipping my toes in and and I have to say, i enjoy the break from all of the historical fiction. Reality, yes. Yeah, and the been the nonfiction I've been reading. I have a feeling that Nathan is not recommending these types of books to you.
00:05:30
Speaker
Okay. My friend Alex Ellis turned me on to these, which are the, let's just call them spicy fantasy novels. Oh, are is it, um what do they call it? um Cliterature? Cliterature? Yes. But that also involves- Romanticies? Romanticies? Well, yes. But understanding that involves people who have wings type thing. Oh, yes. So fantasy in my mind means that it is going to be a pretty large departure from reality, right? Yes, yes. So this one I'm reading is called The Fourth Wing.
00:06:00
Speaker
Oh, yes. I love that book. Which is cliterature. Yes. Oh, but it's not as dirty. There's some much dirtier ones. I know. that I've heard. Do you know about a court of thorns and roses? I've heard of it. Or also known as Akitar. That is where you start.
00:06:13
Speaker
I have a friend group up here in Huntsville that reads that reads a lot of books. There's like six books in that series. I read them all like multiple times the first time I went through chemo. So ah yeah, very good. ah Yeah, i i am I am enjoying it. I wouldn't normally go for these types of books, but I really did need a break from what I was reading, which was I was reading a lot of World War II books. Oh my God. Jesus Christ. Which I'm addicted to. I've read a lot about World War II. So um back to textbooks. If I'm in the right mindset, it has to be morning, caffeinated, preferably a kind of peaceful, nice and quiet setting. I have my pen and my pencil and my ah highlighter and my sticky notes. And I'm like, ooh, hands rubbing together. Let's learn. learn.
00:06:59
Speaker
yeah Yes. Yes, I can do it. um Nothing I want to say about textbooks, that's my part too, is um I love textbooks. you know We were like, let's do it an episode about balance. The idea of pulling studies on balance just made me want to ah you know run away from home, basically. Bye, I'm gone. I'm not coming back. right like No, I'd rather live somewhere else. Yeah. um Than in a world where I have to read a lot of studies without any clear what am I reading about? You know, this is where textbooks can be phenomenal because guess what? All the information in this textbook is research supported and it is referenced and cited. So, you know, you know where they're drawing their information from. You see why they make the arguments they do. The terminology is consistent, which really helps because that's not um true for papers, right? It's like,
00:07:46
Speaker
different papers or different words to mean the same thing. So textbooks can actually be a phenomenal way to get started with evidence-based engagement with information and in and actually a far more accessible way. So we're going to link this textbook in the show notes. And then basically any topic you want to learn more about, like strength and conditioning or what have you, if you're new to reading research, start with a textbook. That's, I think, a really good, solid piece of advice that I definitely received several years ago. Nice. Like fully took it on and would like to pass on. Don't kill yourself trying to read a bunch of papers and then be like, what the fuck? Just get a textbook. I like it. and you'll you'll be you'll be reading papers, but you'll be reading papers that have been organized for you. And you will actually have some broader, coherent takeaways. There you go. Cool. So back to our scope here, we are exploring how balance is much more than just standing on one
Emergent Nature of Balance Systems
00:08:43
Speaker
leg. It's much more than just not falling even, interestingly enough. And we'll learn how balance functions as a dynamic and emergent process, one that must account for the cooperation and coordination of many of our body's systems, but that also must take into account the environment we're in, even the clothes we are wearing, as well as the task we are performing. So this word emergent, I think it's a fancy, fun word, a really useful word when talking about any type of phenomenon that arises out of the human body. Emergent means bottom up.
00:09:16
Speaker
versus top down. So a phenomenon emerges from the cooperation of many different parts and pieces. It's not pre-planned. I think ah a good example would be like a traffic jam. No one planned a traffic jam. No one was like, I know what we'll create as a traffic jam and all these cars will come in from here and these cars will come in from here. And then they'll all kind of jam together in the intersection and people honk and get pissed off. No. What happens is that traffic jams emerge, right? They emerge from large scale changes to patterns that are really the result of many different individual choices, right? So balance emerges from large scale body wide patterns that emerge from many different inputs and actions. So the textbook that I enjoyed reading in preparation for this episode is called Motor Control, Translating Research into Clinical Practice. It's the 2017 edition by Anne Shimway-Cook and Marjorie H. Wolicott. And I think these women are prolific researchers in the realms of balance and motor control. So balance is the term that I think is most popular, most commonly used to discuss the many things we're going to be discussing in this episode. But the textbook actually used this this term, which I like a lot, which is postural control. Sarah, what is your mental model of balance as a phenomenon, as a thing? What do what do you think when you hear this word balance? Well, when I think about it, it' it's sort of different things in different circumstances. When I think about it in terms of my work,
00:10:49
Speaker
then I think about it in terms of helping people who are either seniors and are concerned about falling or people that I work with that have various neuromuscular diseases like Parkinson's disease or multiple sclerosis who are also dealing with deficits that impair their balance or that you you know we work on improving certain things like foot speed and stuff like that.
00:11:10
Speaker
But if I'm not talking about my work, Balance to me is now just a word that's been completely hijacked by wellness marketers as something that you need to be trying to achieve. And you probably aren't feeling it because you're tired or you're stressed or you're alive in this day and age. And so there's always something that can be sold to you to help you balance once your life. It's a supplement. It's a book. It's a, I don't know, it's anything, right? Yes, 100%.
00:11:37
Speaker
hundred percent So one thing that became obvious to me while researching this episode is that, yes, that term balance is used in so many different ways, right? Like talking about your clients, your patients, right? The physical considerations of balance.
00:11:53
Speaker
And or if you have done any type of exercise in your life or you've just lived in the world, like there's balancing poses, balancing on one leg, catching yourself from falling, a.k.a. balancing and not falling. But as you allude to, we also use this word a lot metaphorically. Right. We talk about work life balance, balanced nutrition, feeling grounded, centered, stable or emotionally off balance. And what's interesting is that even though these meanings are different and they're used in completely different contexts, they do share a common idea, which is that balance involves ongoing regulation. the ongoing management and adjustment and organization and control of competing demands or forces or priorities or emotions or relationships or resources under constantly changing conditions. Okay. So you mentioned the wellness industry and the grifter approach, which is basically name the problem and then sell a really overly simplified solution, right? I think hormone balancing is It's great example of this, right? People often talk about wanting to, quote, balance their hormones or the person with a program to sell you or a supplement to sell you is going to talk about balancing your hormones as though the goal is this perfectly stable, static hormonal state. But the truth of hormones is that they're constantly fluctuating in response to stress and sleep and food intake and menstrual cycle and exercise and illness. As they should be. yes Their normal state is one of flux and their normal state is to not quite ever be fully balanced. So as it turns out, this thing we call balance is also one of constant change, constant regulation of competing demands, it's one of flux.
Biopsychosocial Perspective on Balance
00:13:35
Speaker
So if we even just um restrict our context and movement rehab spaces, balance can still refer to so many different things, right? Sometimes it's yeah it's a momentary state. Oops, I lost my balance or I regained it.
00:13:48
Speaker
Sometimes it's a specific skill, like I can balance in tree pose. And sometimes people use it more broadly as a general trait or ability, like i have great balance or my balance is not so great. And something I found interesting is that this motor control textbook prefers this term postural control yeah as the act of balance. And it defines postural control as the act of maintaining, achieving, or restoring a state of balance. Balance is now a state or a goal.
00:14:18
Speaker
And this postural control happens during any posture or activity. I like this phrase, postural control. What do you think? Yeah, partly because the word balance has so many potential meanings and definitions for movement and for bodies and for exercise science and physical therapy, using the words postural control gives you a much more accurate phrase that's describing what's actually going on during the act of balancing physically. So it's not only taking the word balance and saying, we're talking about the things that go on while you are attempting to physically balance. Mm-hmm.
00:14:53
Speaker
um And it doesn't hang on on that sort of idea of like there's this one perfect still point, right? Postural control is something that's ongoing. Yeah. Or even that it's directly oppositional to falling, which we'll talk about. You can have postural control while falling. People fall on purpose all the time. Dancers, soccer goalies. Yeah.
00:15:14
Speaker
athletes of various kinds. Even, you know, walking is a series of controlled falls. Postural control can include losing stability, right? Managing stability yeah um and even falling. So researchers often and analyze postural control or balance mechanically. And they do this by looking at the relationship between the body's center of mass, right? Which is that point of where the most of your physical mass, the midpoint of it, right?
00:15:40
Speaker
And it's a base of support, meaning are you on your feet? Are you on your hands? Are you sitting? Like all that kind of stuff. So your center of mass, it's basically the body's average point of weight distribution used interchangeably with center of gravity in human movement. And I think it's slightly different for men and women, isn't it? Because women carry more weight in their lower body, it's slightly lower physically on women, higher on men. In anatomical position, right? Because it yeah changes as you move. But yeah, two people, men and women are in anatomical position, probably.
00:16:08
Speaker
Yeah. Depending on their morphology. I mean, a lot of things depending, but yeah. um And so it also changes as we're moving, right? Because as we're moving, our relationship between where our center of mass is and where our base of support is, is also changing. So whether you're just shifting your weight side to side while you're standing, whether you're walking, whether you're running, all activity then changes this relationship. Mm-hmm. And so then our base of support, it's the area created by the body's point of contact with the environment that helps support it, right? So that's this idea of, are you on your feet? Are you on your hands? Whatever you want. And if you stand with your feet wider, you're going to give yourself obviously a wider base of support.
00:16:45
Speaker
ah which in itself tends to be easier to manage as ah as an area to balance on than if your feet are all the way close together and touching, or even if they are tandem, one in front of the other, right? And that makes sense because you think about it, you've got a bigger physical area within which you can move. Whereas when your feet are together, you have a much smaller physical area where if you start to shift your center of mass over that base of support, you're going to run into the limits of it pretty quickly. So that's why like standing on two feet is easier than standing on one foot, for example, right? Or if you put your hand on the wall, that's also then giving you another contact point of support. So you can think about it like you've got your base of support, whatever size it is, you've got your center of mass, the more your center of mass moves towards the edge of that base of support, the harder postural control becomes. The other thing is center of pressure. So center of pressure is a little different than center of mass or center of gravity. And it refers to where force is being applied against the supporting surface and instantly shifts as we make our postural adjustments. So if you think of standing in tadasana, if you've ever been in a yoga class where the teacher's like, shift your weight into your toes, shift your weight into your heels, to your right foot and your left foot. These are shifting the centers of pressure. right And I think that center of pressure play, maybe that's our new course, center pressure play. Sorry, center of pressure play sounds a little bit too close to cliterature. Just going to say. i don't think we can call any course center of pressure play. that's just my t-shirt Well, maybe that's our next business that we start. This brings us to the concept of stability.
00:18:21
Speaker
Sarah. Yeah. When the word stability is used in exercise, stability. Stability.
00:18:31
Speaker
What is it typically being used to explain or describe from your perspective? Make this more stable, to stabilize, increase stability, blah, blah, blah. Stability, this, stability, that. what What are we talking about usually? Well, stability is always, it's it's sort of like stability, good, instability, bad, right? So that seems to be the sort of overarching thing.
00:18:49
Speaker
model that a lot of people use when talking about stability. um You know, if i kind of niche into into my world of PT, stability is like, am I confident enough that I can leave you standing here, go across the room and get something and come back and you're not going to fall over? Like, that's what I think of as stability. Like, is this person stable enough right now? Or if they're standing and they're not holding onto their walker, are they going to fall down? Yeah, yeah. That's much more of a like sort of rehab way of thinking about it. But stability is sort of like, you know, God, the phrase spinal stability and like horse shit, essentially. It's a lot of like, you know, must be you stable, must stack everything exactly. i feel I feel like stability and posture both became these words that were like, you have to have good posture and you need to be as stable as humanly possible. Wait, I got a question. Why did you have such a strong word for spinal stability? You used the term horseshit? I believe I did. Where's that coming from deep down inside of you, Sarah?
00:19:47
Speaker
Why so much negativity? When I was five years old. No. um Because there's a lot of... fear mongering around what's going on with your spine, number one. Number two, there's a lot of using the the phrase stability, especially in relationship with your spine, where it becomes like the word balance. Like, what do you mean?
00:20:06
Speaker
What are you measuring? When do I have a stable spine? yeah What test is going to say, yep, your spine is stable now. You know what i mean? Like it's it's one of those phrases that's gotten hijacked yeah and and now is just being used so sort of loosely it just like thrown in places and people, you know, like, oh, this workshop is about stability. I guess my core is not strong enough. Maybe I need to be more stable or you know what i mean? It's like a lot of concepts that kind of like get wrapped up in one and then just like shoved down your throat. I feel like people are constantly being noceboed. Yes. In movement spaces, in health spaces, in any type of space where their body is talked about or described or used, there's this nocebo effect. The way certain words are used, and I think stability is a word that is used to nocebo people a lot. Yes, I agree. And like you said, stability, good, instability, bad. But we just discussed how walking is a series of controlled falls.
Stability and Postural Control
00:20:59
Speaker
Right. Instability is something that happens momentarily. we need to actually let go of some stability just to walk and to to move. Right. So right I think the same is true if we just can go back for a second about the word balance. I think balance is often used to nocebo people.
00:21:14
Speaker
Yes. Because the opposite of balance is in people's minds, falls. Yeah. Or imbalance. Imbalance. Which leads to, if we're speaking in a metaphorical term, like hormones that are all out of whack, right? Or, you know, ah terrible work-life balance. right So balance in the realms of falls, right, is good because now I'm not falling. But when we replace balance, maybe with a word that's less... popular, not used as often, but that kind of means the same thing. Postural control.
00:21:43
Speaker
We suddenly get away from this balance-fall dichotomy, this good-bad dichotomy. i think the same thing is true for stability. We have to maybe in this case not replace the word stability with a new word. but actually start to try to understand a little bit more accurately what it means. And it does not mean alignment. Right. Right. Alignment is orientation. And there's two ways to think about orientation. One is the relationship between your body segments to each other.
00:22:11
Speaker
So what is the alignment of Tadasana versus the alignment of triangle pose? Right. Well, Tadasana, you're basically an anatomical position, triangle pose, your torso is tipped horizontally, your legs are abducted, one the thigh is externally rotated, your arms are abducted, right? and And so that's the body in relationship to the body. But then we can also talk about orientation of the body relative to the floor.
00:22:36
Speaker
Okay, so you could do standing with your arms reaching up overhead, and we call that uttita hastasana in Sanskrit. But then you can flip that all the way upside down, and yes, your wrists are in a slightly different position, and now we're in handstand, right? So when we talk about alignment, we're really talking about orientation. Stability is not that.
00:22:52
Speaker
So what is stability? In motor control and biomechanics, stability does not mean posture, right? It doesn't mean any type of ideal, safe, however you want to put it, alignment. Stability refers to how a system responds to a disturbance. Let me say that again. Stability refers to how a system responds to disturbance. Disturbance or perturbance is usually the word used. So if something perturbs the system, does the body successfully regulate and recover or does the perturbance or disturbance continue growing larger or is it neutralized? And the example that's often used in motor control is this example of a ball. So a ball sitting at the bottom of a bowl is considered relatively stable equilibrium, right? Equilibrium and balance mean the same thing. Because if it gets nudged, it's going to tend to roll back to the center of the bowl. It's going to recover its initial state. So if we're asking how a system responds to disturbance, it's stable.
00:23:55
Speaker
if it recovers its initial state. okay A ball balanced on top of an upside down bowl is in an unstable equilibrium because even a small disturbance will cause it to move far away from its starting position and not recover.
00:24:10
Speaker
right It's not going to come like magically roll back up onto the bowl because not how gravity works. And it it moves far away from it. And then this third example, which is interesting, a ball resting on a flat surface is considered neutral equilibrium because if it gets pushed, it it changes position, but it settles into a new position. It doesn't return to the original one, but it doesn't move far away from its original. So I was like, I don't really quite understand the difference between unstable equilibrium and neutral equilibrium. then I was like, let me think of a real life example. So I thought of subway surfing. Sarah, did you ever subway surf? Oh, sure. Actually, when I was in high school in England,
00:24:47
Speaker
I used to play a game with my friends when we'd be riding the underground home where somebody would invent a pretend pole to hold onto. So they would mime that they were holding that pole with two hands and you had to stack your hands on top. And so you get like four or five people all stacking their hands, holding this imaginary pole. And then like as the train shifts and bangs around, you all have to try to maintain where this imaginary pole is. that was our that was our sort of subway surfing game.
00:25:12
Speaker
That's advanced. I was not as advanced. Well, we were children. i would be on the subway with a couple of friends and we probably had a few drinks and I would stand up and be like, I'm going to subway surf you guys. Usually the the subway was mostly empty. So I wasn't that person who was like running into people and stuff. But I'm Yeah. So so if you if you're on a train or any type of moving thing, right, you can stand in the middle of it, not hold on to anything. Of course, this this train is moving down the track. And in New York City, it's rattling along and it's stopping, you know, for no apparent reason. It's accelerating. It's accelerating. It's going around curves. It's very jerky and bumpy and chaotic.
00:25:46
Speaker
And if the train jolts for some reason and I stay upright with my feet planted where they are on the floor, I wasable i was able to respond to that disturbance by returning to my initial state, right? Which is my feet are still planted where they were. My body is still upright.
00:26:02
Speaker
However, if I get jolten and I fall on the ground, right, that's unstable, right? I lost stability. I'm in a completely different state. And then finally, neutral stability. so the way I thought about this was the train jolts me forward. I take some recovery steps. I don't fall on the ground.
00:26:20
Speaker
I'm still upright, but I move to a slightly different part of the floor of the car. So this, when we talk about fall recovery, these are three scenarios we see very, very often, right? Someone experiences a perturbation and there's some postural sway, right? Maybe they increase their base of support by quickly grabbing a railing, but they return to their initial state. That's their response to the disturbance. Sometimes people fall, right? They completely lose their stability. And other times people have to lose their footing a little bit, take some recovery steps, end up somewhere slightly different in the room, but they're still standing upright. Sarah, when we did the falls episode, we
00:27:00
Speaker
We ended up talking about not falling, right? we We were talking about exercise for not falling and why people fall all that good stuff. But then at the end, we talked about falling well. Totally. Learning how to fall well. Yeah. um So how do you think of losing stability? You're going down, but you get better at falling, which is a thing that can happen. How would you think of that in terms of our topics today? Yeah.
00:27:28
Speaker
Our barbell mini course is a totally free set of videos that set you up really well to understand how to do a deadlift, a squat, and a bench press, which are sort of like the big three lifts with a barbell.
00:27:42
Speaker
Now, if you're saying to yourself, well, I don't have a barbell, that's cool. You can do all of it with dumbbells or kettlebells or other types of weights. We just think barbells are so much more efficient. And I find myself, Laurel, I don't know if you find yourself doing this, but when I'm working with new patients or new clients and my goal is for them to improve their strength in my house, I have a 25 pound barbell and I have a 45 pound barbell. My favorite moment is always when I've gotten them away from the dumbbells and onto the barbell. There's almost like a sigh of relief. when we're finally using barbells because it's so much easier. Yeah, it's easier. I know what you mean by, oh what a relief. Now we can just lift this one thing and it will sufficiently challenge your lower body because now I'm not having to talk you through cleaning two dumbbells and then, oh, your upper body got tired before your lower body. And like, yeah, the barbell, it is a problem solver. And many people I think are intimidated by it, but actually it's simplicity can solve a lot of problems. That's part of why we're so pro barbell and we want you to be pro barbell as well. So if you're interested, shoot us your email. It's in the show notes. It's in our Instagram bio. It's literally everywhere.
00:28:50
Speaker
And we will shoot you. that We won't shoot you, but we will send you the barbell mini course. I love that.
00:29:02
Speaker
How do you think of losing stability? You're going down, but you get better at falling, which is
Role of Systems in Balance and Environmental Adaptation
00:29:08
Speaker
a thing that can happen. How would you think of that in terms of our topics today? I think a good catch when you fall, it involves a lot of things, but you know, there's sort of like...
00:29:18
Speaker
I take 10 extra steps and I don't fall on the ground or there's actually like, I make it, I end up on the ground, but everything's okay. So if we're talking about, I end up on the ground, but everything's okay. yeah It still has a lot to do with things like power and and strength because let's say you tripped. You like tripped over a tree root. If you are able to get your hands out in front of you and on the ground first, it's going to suck for your hands, but it's going to suck way less than if your hands weren't fast enough and it was your face that hit the ground first, right? So it's this idea of like,
00:29:51
Speaker
saving yourself. I have a great example. This patient that I work with who does fall occasionally, she's by herself a lot. And she told me about a fall that she had. And what happened was she was walking. I mean, she has a neuromuscular condition, so it's different circumstances, but like she was fine, her legs got weak. So she was starting to kind of fall to the ground, but she was to reach a hand out, put it on a chair as she was going down, which slowed her down, right? Didn't stop her from falling, but it slowed her down. In that sort of slowness of that timing, your body often has enough time to do something smart, like get your butt in position to land first. Because like, that's the best thing to land on is your ass essentially, right? So ah you have the ability to put out a hand or put your butt down or a knee or something that's going to be much more preferential than like your face or your head hitting the ground.
00:30:37
Speaker
Yeah. It's an unstable equilibrium based on what we were talking about. Yeah, it is. But here's where I like the word postural control, right? Like you lost your balance, but you had decent postural control while falling such that you fell well.
00:30:52
Speaker
Right. Right. That's where I really like this term postural control because you know what? Falls are going to happen. So let's not be so afraid of them that we don't move and develop the capacities, which you identified power, strength, mobility, maybe, right? Reaction time to be able to fall well, to have that postural control.
00:31:10
Speaker
Right. So we're going to shift topics a little bit. One of the things that became obvious when we were talking about balance is that even though we don't talk about it as something that is biopsychosocial, it absolutely is. well If you've been a listener for a while, you've probably heard us use the term biopsychosocial. It's usually used as a model in discussions about things like pain and injury and health, right? and And what it means is that a physical experience is not typically biopsychosocial. physical alone. There is the physiology, right? That's the bio part, biopsychosocial. There's all the anatomy, all that kind of stuff. The psycho is the crazy people. No, the psycho is the psychology of it. So things like, where is your attention? What's your fear? What are your expectations? What's your stress level, right? Memory of things, perception of what's happening. Social refers to our community and our environments. And in this circumstance, things like footwear, clothing can affect our movement options and our postural control. How many times have you heard of a woman rolling her ankle or falling because of or the shoes she was wearing. Sure. Right? And the cultural expectations or pressures that women have to wear shoes that look a certain way, that make their legs look a certain way, maybe that they're even supposed to wear at work, right? Right.
00:32:27
Speaker
Yeah. It's also talking about what kind of physical experiences have you had in the environment in which you live and grew up, right? If you grew up in a rural area versus an urban area, you are probably going to have different movement experiences, right? people having access to green spaces, sports, playgrounds, climbing, uneven terrain, unstructured physical play. All of those things influence how comfortable and adaptable we are with instability, variability,
00:32:56
Speaker
relative risk and our ability to to recover. What you were encouraged to do as a child may well shape your confidence in your behavior and your postural control later in life. When we start to sort of look at all of these different factors that go into your postural control or your balanceability, it becomes harder and harder to think about balance in this kind of isolated way or address it in this isolated way. Do you feel like you grew up in a place where you were taking stability risks, we'll call them, within your environment? Like, were there possibly opportunities for you to fall and hurt yourself as a child? Or were you raised in a space that was maybe a little bit, quote unquote, safer? I grew up in London, mostly. And I did a lot of physical activity outside kind of stuff, but it's a concrete environment. So it's like, well, I might be roller skating around the neighborhood.
00:33:43
Speaker
which is absolutely a balanced activity. And then I fall and scrape my knee, right? Or something like that. I wasn't climbing up rocks and cliffs and hills kind of stuff, but that was environment more than anything else. Were your parents pretty much like, bye, come home when it's time for dinner? Come home when it's time for dinner, pretty We had our little neighborhood friends wherever I lived. Or it would be me and my brother, Because it's the two of us. Yeah.
00:34:06
Speaker
and Unstructured physical play. Definitely. Definitely. And also I remember like playgrounds back in the day, woof. Yes. Like they were very unsafe. There were a lot of things that were very high off the ground and the ground was concrete. The ground was concrete. I remember there was a balance beam that we used to walk along that was easily six or eight feet off the ground. concrete yeah and that's fine yeah you know so i did lots of like play know hanging upside down from the monkey bars kind of thing and all of that all that goofy stuff yeah yeah yeah me too and and um and then i noticed when i was in my 20s the playgrounds got really fucking boring and safe for a while but now i think they're coming back from that and making them nice little bit a little bit less safe and i think there's the reason for that is that developmentally um children weren't being challenged enough right
00:34:48
Speaker
On this postural control level, but also on this physical activity level, there there weren't opportunities for them to do as much maybe hanging or climbing. There weren't as many opportunities for for risk assessment, right? Which is an important part of of growing up, like actually learning what the consequences are of making certain choices during unstructured physical play where there isn't an adult telling you what to do all the time, like exercising some agency in that risk assessment. So balance is not your ankles or your core or your posture or a balance center in your brain or your ability to stand on one foot. It's not your strength.
00:35:23
Speaker
It's not your power. Like looking at all these things in isolation help us understand all these individual pieces of postural control, but they don't explain balance individually because postural control is what emerges, right? It's that emergent word again. It's what emerges from the interaction between many of these systems working together under constantly changing conditions, right? If we change any of these conditions, we then change the postural control problem itself. right? Fatigue changes our force production and our coordination. Darkness, meaning is it light out, changes our sensory information, right?
00:35:57
Speaker
Fear changes our behavior. Distraction changes our attentional resources. Uneven terrain changes the demands of the environment. High heel shoes change the mechanics, the constraints of of the task. So postural control is really context specific. You can be very confident in yoga class and still feel unstable carrying something down the stairs, right? You can feel very comfortable walking on pavement, but...
00:36:20
Speaker
be overwhelmed by the idea of going for a hike on some loose gravel trail. One balance exercise or drill does not automatically transfer to every or any other like real world movement situation if it's not exactly the same thing, because it's not a single skill, postural control, and it's not something we can fully prepare for because balance challenges are unexpected a lot of the time and they're novel, right? You may have tripped over something before. i certainly have. I trip all the time. i'm very clumsy. Mm-hmm. But every trip is a little bit different, right? So it is. So you have these kind of like broad capacities that you develop, like power and speed, but bodies are amazing and brains are so amazing. And your reflexes are so amazing. Like some of this postural control doesn't even, isn't even at the level of your brain thinking about it. It's only goes to your spine and back because it has to happen faster. Mm-hmm. But the amount of information that your brain processes in such a short period of time, like during the fall, what decision to make and just doing it is based on all of your multiple experiences and all of your training. But each one is is individual in its own way. We're going to now get into the biology.
00:37:24
Speaker
and the psychology and sociology, but we're going to start with the biology. We're going to talk about sensory systems and the motor systems. So our nervous system, it needs information, right? About where we are in space. So that's sensory information. That's information that we're taking in from the outside world. Assuming we're in the middle of a fall, our movement systems then have to generate a motor response like Hey, get your foot out now. And then through this whole process, you've also got your cognitive systems that are interpreting what's happening, predicting what's happening, allocating attention, changing your behavior, right? It's kind of like the overview of this whole thing that's going on. So if we start with the sensory systems, your nervous system is basically always wanting to answer a very standard question, which is where am I in space right now? Where is this body physically? And it doesn't just have one source of information. It has three subsystems to do it. Your visual system, your somatosensory system, and your vestibular system. And each of them give you very unique information, but also they each play off of the information provided by the other, And when the information does not match, that's when you get messed up stuff happening like vertigo, which we're going to talk about in a second. So major contributor, probably the one we rely on the most is our visual system, right? It helps us figure out things like orientation. Am I upright or am I lying down? Motion. Am I moving or am I still?
00:38:50
Speaker
How far away is something? Is this an obstacle physically in my way? And then whether a system appears to be stable or unstable. Right. So in terms of our anatomy, this is our eyes, right? The optic nerve, the visual pathway, the cortex and the brain and different kinds of vision. We have central vision. We have peripheral vision.
00:39:07
Speaker
Laurel has a story she's going to tell you now. So when we first moved to Huntsville, which is in Alabama, I live right next to lots of trails and there's snakes here. There's like five different species of poisonous snakes. When I first moved here, every time I looked at the ground, I thought a root from a tree that stick up out of the ground, there's also a lot of trees here, was a snake. And so I would go out and like basically be walking around in a veritable hotbed of snakes because every time my eye caught like a particular root that sort of looked like a snake, I would have this moment where I'd stop and look at it and take a closer look at it and be like, okay, that's a route. And the longer I lived there, the better I got at visually interpreting the terrain. It was very treacherous at first. Then I started running across the terrain. So now I have to interpret it much faster and i would trip a lot. I would catch a foot on so many different things all the time.
00:39:58
Speaker
and I consider myself to be pretty sure-footed, but I I actually felt myself being kind of not good at it for for a while. And then eventually I improved my ability to interpret the terrain and navigate the terrain improved. So I got better at seeing and then predicting and then responding to the demands of the trails, scanning very quickly for footholds. adjusting my foot placement. These are sensory and motor things that are going on. But my postural control on the trail relied heavily on my ability to see, right? All enough that was going to potentially trip me up.
00:40:26
Speaker
And this is why running after sundown is a very bad situation. And I have been caught on the trail because I think that I'm faster than I am. And the sun is going down and my pace has to get a lot slower and I even have to walk. ah the last couple of meters because literally can't see enough to run safely. Yeah.
00:40:42
Speaker
Yeah. I mean, similar, but different riding the motorcycle. I've ridden it after dark, but I hate it. And I would never choose to do it because it's not just about, you know, can I see the other cars on the motorcycle? You're much more concerned with the surface of the pavement of this, the ground that you're on. um Because as you can imagine, like a big stone or a big pothole or something that could really screw you up. Yeah.
00:41:06
Speaker
um And so a lot of staying on the bike well involves making a lot of these small movements, small changes to kind of get around these things that you don't want to land in. And so it's it's pretty similar. Like you can still ride after dark and i I've done it, but the vision is so much more limited. What you can see is so much more limited that it it becomes much harder and much more dangerous for them. To be honest with you, I don't even love driving after dark as much as I get.
00:41:31
Speaker
Yeah, no, for sure. There's um there's a time when like you're like, wow, my eyes are not as good in the dark as they used to. Yeah, I start to get a little confused with the headlights coming at me and the lights on the road. I'm like, oh shit, I'm getting old. Yeah. um Yeah, so let's switch now to talk about the somatosensory system, which is another subsystem of the sensory system that we rely on for postural control and balance. So this system includes lots of different receptors all around your body. There's a lot of them in your skin, cutaneous receptors. There's proprioceptive receptors in your muscles, your tendons, your joints, your connective tissues, along with peripheral nerves and spinal sensory pathways carrying this information through the nervous system. And the somatosensory system
00:42:16
Speaker
is giving you continuous information at all times. Touch, pressure, joint position, body sway, muscle length, surface, ah you know characteristics of the surface you're on, and the relationship between your body and those supporting surfaces. And this system, if I go back to my running or hiking story, is especially noticeable when you're when you're walking over uneven terrain, right? So lots of roots, rocks, mud, loose gravel, sloped surfaces, creates this constantly changing sensory information flood coming in through the whole body, but especially through the feet, the ankles. um Shoes matter a lot here because they're going to change how you can interact with the surface you're moving across, and that's going to change the sensory information you receive. And yeah, so for example, right, when I am hiking along or running along and I'm using my visual system to make predictions, sometimes I'm wrong, right? Sometimes I'm going to step on a rock that looks like it's sturdy and fixed and it's going to be loose, right? And then my vision isn't as useful to me anymore. Now I've got to take all the data coming through my nervous system from the movements that have just occurred as a result of this loose rock.
00:43:32
Speaker
And I've got to put all that together and create a motor response, right? To maybe not fall. Same thing occurs with the rock is slick, right? It's very deceptive sometimes whether or not a rock is slick or not. It looks dry, but then you realize it's mud, it's not dirt, and it's very, very slippery. There's a...
00:43:51
Speaker
red clay here that is super slick in certain conditions. Same thing with moss. Like a lot of times you think, well, moss is going to give me some good traction. No, sometimes moss just slides right off the rock. And so these instances, a lot of them, the response, the motor response is actually more reflexive, right? Like I don't even have to think about it. And in a very short period of time, my body has this reflexive response. an automatic muscular response, and this is more on the motor side of it. But that response is coming from the information from my somatosensory system. And and something I thought was interesting in the textbook was they talked about how reactive movements happen in half the time that a voluntary movement does. There's that there's that reflex, and that's really kind of the purpose of reflexes, I think, is they aided in our survival as a species. Oh, yeah. It reacts so much faster. yeah But another thing that was interesting to me is that the time between information coming from your visual system to your motor response versus the time between information coming from your somatosensory system to your motor response, the somatosensory system to motor response time is much shorter.
00:44:57
Speaker
Yes. Which is also really cool. It is really cool. So once you're already in trouble, that somatosensory system is like, wait, here's actually what's happening. And then the motor system's like, quick, respond! Yeah. Yeah, exactly. And that's that spinal reflex versus ah a motor control action that has gone all the way to your brain. And then your brain's made a decision and sent that decision all the way back. Which is a voluntary. Exactly. Exactly.
00:45:22
Speaker
If you're taking a dance class, for example, your footwear becomes really important. And it depends obviously on the class you're taking. But if you're taking the kind of class where you might be barefoot, for example, like a modern dance class, a lot of the time you'll see dancers wearing a sock, but just one sock, which is funny because the sock is on their turning foot. oh So let's say they're going to do a bunch of spins in a row. They don't want the, like the bottom of your foot against the floor is actually pretty grippy. yeah And I've taken classes like that where at the end of it, I'm like, wow, that my feet don't feel like yeah great from that. um Yeah, exactly. Like I may have lost some layers of skin, but the sock, provides you enough slipperiness that you could do three or four turns in a row. I cannot do three or four turns in a row, but if I was someone who could, the sock would would help me do that. Or sometimes you just wear socks because you can still create enough grip, but you need some slide. It's about finding that like sort of exact right relationship between your ability to sense, you know, am I slipping? Am I not slipping? Am I steady, right? Am I stable or am I moving? And then people have like favorite socks and things like there's, it's a very sort of specific what people do. Sometimes people wear these little half socky things. Cause like you kind of just need it for the ball of your foot, yeah but it's, yeah, that sort of relationship of like your footwear to the surface and the feedback that you're getting through your feet, through the footwear to the surface and back again. Yeah, it's going to really affect how you're able to move too. Yeah, yeah, yeah exactly. your Your motor strategies. Yeah. Cool. So then our third system is our vestibular system, which I got to tell you, I hated learning about the vestibular system in school because we had a horrible guest lecturer who came in. I might have told this story already. And he was this short. I don't think so.
00:47:01
Speaker
Like, I mean, nothing against being short, that's nobody's fault. But he was kind of, he he had a bit of the kind of like short man complex is what it felt like. Like he very much felt he he needed to come in and prove that he was the big guy and we were all dumb students. Not a short king. Not a short king. the opposite of a short king. um And so because I hated him so much, I had a real block against all the vertigo stuff in PT. But I'm getting over it. So...
00:47:26
Speaker
Vertibular system, it's this third major sensory contributor. This is when people talk about your inner ear, that's your vestibular system. And it's this whole series of like kind of crazy looking structures. You've got your semicircular canals, you've got the otolith, you've got the vestibular nerve, and then the nuclei in the brainstem. And essentially it does a few different things. It helps you understand the movement of your head and like how fast you're moving. Like if you whip your head around real fast, it's helping you reorient yourself. where if you imagine trying to use the visual information that you're getting as you whip your head around real fast, that's not as helpful, right? So it helps you understand how fast you're going. Are you speeding up or are you slowing down? Are you ah falling down? Are you standing up? Like all kinds of of that kind of stuff. um The issue, like I mentioned before, the issue often with things like this that comes up is that If you have ah an inner ear disease or injury, like vertigo, or it's called BPPV, but benign paroxysmal positional vertigo. Yeah. Something like that. There's an inflammation. There's actually like a disease state going on inside your vestibular system such that the information it's giving you doesn't match up with the visual information that you're getting. Yeah. And as a result, you could be just lying down and then all of a sudden the whole room is spinning and you did nothing. Yeah. um
00:48:47
Speaker
I have had BPPV a couple of times. With that, what happens is the little crystals that are supposed to be in one part of your vestibular system escape into another part of your vestibular system. And so then it starts giving you really wonky information. And the rehab is you have to basically like, it's like those tilt games that have a little ball.
00:49:05
Speaker
Like you got to like tilt your head around a whole bunch of different ways to get the crystal back into the right place. Multiple family members. Yeah. Undergo that type of. Yeah. Yeah. It's really, I mean, when it's really bad, it's horrible because it makes you nauseous yeah to be so dizzy all the time. Sounds awful. Yeah. I felt so bad for my dog when this happened. The first time it happened to me, I didn't really understand what was happening. um And I was in my kitchen and I called for the dog and she came running in. And as she came in, I bent down. i sort of bent over. And I but by basically, I put my head completely upside down. And by doing that, I triggered like a really crazy vertigo moment. I thought I was actually going to fall over. and I yelled, oh, fuck.
00:49:43
Speaker
Oh, no. Like right in her face. Oh, So then I felt really badly. Like I called her in to be like, hey, how are you? And instead I was like, ra all poor baby pearly girl. know. She forgave me eventually. Good.
00:49:56
Speaker
um Have you ever had vertigo? Never. I've never had vertigo. I did read in the book that um people have a hard time distinguishing between a knot of the head and a forward fold. And I was like, holy Jesus, that sounds like a confusion I never want to have. Yeah, it's not fun. It's very disorienting. Yes, it's very disorienting. OK, we've talked about the visual system.
00:50:15
Speaker
The somatosensory system and vert and vertigo, no, and the vestibular system. yeah um Again, to reiterate what Sarah said, none of these sensory systems work alone. The nervous system is continuously combining information from the visual, the somatosensory and vestibular and informing each of those systems from the information from the others. And depending on the task and environment, it may rely more heavily on one system than another. So this has a name and it's called sensory reweighting.
00:50:41
Speaker
And with sensory reweighting, what happens is, for example, when visual information becomes less available in darkness, the nervous system may rely more on your somatosensory and vestibular systems for information. Interestingly, and I think we talked about this in our motor control episodes, which I will link in the show notes because... motor control, motor learning, balance, these are all related. um While learning a new movement or a movement skill, folks will often rely more heavily on visual input at first.
00:51:14
Speaker
And then as the movement becomes more familiar, the nervous system often shifts more toward greater reliance on somatosensory information, which is pretty cool and it kind of points toward like visual demonstrations of the movement for your students are probably a good idea when they're just learning how to do it like demonstrating the yoga pose or demonstrating the exercise um another cool little tidbit is research shows that when healthy adults narrow their base of support their reliance shifts away from the somatosensory to the visual and vestibular systems which i thought was fascinating yeah
00:51:48
Speaker
Do you have anything else to say about sensory reweighting, Sarah? Yeah, well, just that, you know, one of the things that we learned in PT school was that if you want to help someone working on their balance, you might purposefully remove or or minimize how much input you're getting from one or two of the systems to make them have to rely more on the third system. So like you take away the visual system, you close your eyes. Actually, that makes it harder for your vestibular system a little bit to work as Right, right, right, right. But for example, you might have someone close their eyes and then stand and then see if they can still balance. And if that's easy enough, then you might also give them ah a proprioceptive or somatosensory challenge by having them stand with their eyes closed on an unstable surface. So now they're having to rely on a lot of information from those small movements of their feet and their ankles to maintain their balance as well. So there's different ways that you can purposely push how much someone has to use one one of these systems over another. Cool. Yeah. Yeah. And so we're going to talk soon about different broad categories of balance tasks, of which there are three we will discuss. with Steady state balance, reactive balance, and anticipatory balance. So that's coming soon just to wet your whistle. um But the central nervous system selects sensory systems to rely on. And it's very, very dependent on whether or not your balance challenge falls into one of these three categories. So we're going to talk about it. Moving on.
00:53:09
Speaker
Postural control is not just about gathering information,
Motor Responses and Coordination in Instability
00:53:12
Speaker
right? We need more than just our sensory system. It's also about generating movement responses. And this is where our motor responses, our motor systems come into play. Because postural control is not just about sensing when we've become unstable. It's about producing effective responses to that instability and managing that instability. Now, the movement side of postural control depends heavily on both your musculoskeletal system, which I like to think of as the hardware, and the neuromuscular system, which I like to think of as the software, even though it's very oversimplified analogy. All analogies for the body pretty much are. The musculoskeletal system, or the hardware, includes your bones, joints, muscles, connective tissues, the overall biomechanics of your body. And this contributes to things like how much range of motion do your joints have? What's your spinal flexibility? What's the mechanical relationship between your body segments, right? So if someone has limited ankle mobility, that could certainly affect how effectively they can use ankle strategies to recover after a perturbation. Likewise, reduced hip mobility or spinal flexibility will change your movement options and what you have available when trying to recover,
00:54:14
Speaker
your balance. So here's where we can talk about hyperkyphosis, which is when you look at someone from the side, it looks like their upper back is very rounded. Their head is often pitched pretty far forward. Their neck is less upright and more horizontal. And this is something that we associate with age. It's also associated with osteoporosis, right? As the spinal bones fracture, the discs shrink. This causes a ah ah increased flexion of the thoracic spine. And it's an interesting example because it highlights how posture can influence postural control, right? The musculoskeletal system in this case has come into this more permanent relationship, right? A more flex thoracic spine posture does a lot of things. It shifts the center of mass forward.
00:55:04
Speaker
It changes how forces are distributed through the body. It reduces your available spinal motion, especially extension and rotation options. And it's going to seriously alter how someone organizes their movement.
00:55:17
Speaker
It's also possibly going to influence your vision. So if someone's thoracic spine and head position become progressively more flexed forward, their field of vision may become more directed toward the ground. unless they're compensating through like a lot of cervical extension. And this can affect how the nervous system is able to gather visual information, which is also going to change your postural control. Yeah. Let's say you've got this flexed posture and you're mostly looking at the ground. Your field of vision is now much smaller. You're not taking in as much information from the world around you. It has cognitive negative effects for people. Yes. Kind of like loss of hearing.
00:55:51
Speaker
Right. Exactly. Exactly. and The other thing I was going to say about this is that even for people who aren't super kyphotic, a lot of people who are concerned about balance and in particular older people spend a lot of time just looking at the ground kind of right in front of them. because they want to make sure they're not going to so you know misstep or something like that. So without the spinal shape change, a lot of people are just looking down to make sure they don't fall. Yeah. ah Dr. Stu Phillips shared a cool infographic like a week ago or so that I really liked. It was ah a timeline of two women and one of them showed the woman progressively becoming older, right? Like her hair was turning gray and she had more wrinkles and and all that. But Her posture was changing, right? So she's becoming progressively more stooped and shorter, right? Physically shorter. And that the second timeline showed a woman who is progressively getting older, right? All these age-related changes were happening around like skin and hair and things like that. But her posture remained relatively the same. Her muscle mass remained relatively same. Her height remained relatively the same. And guess what the difference was between these two women? One of them worked out straight trade.
00:56:54
Speaker
One of them, one of them, one of one of them strength trained. Yeah. And so we talk about fixing posture. One of points of contention with yoga, you, right. Is how they try to, I think, in my opinion, nocebo people by telling them that if they don't do yoga, they're going to have cut kyphosis or bad balance. Right. And that's going to, you know, cause them to fracture. And so yoga is the solution to fractures. And it also, they also say it builds bone. My problem with that is that actually, if you want to alter your posture, You're to have to challenge your posture beyond probably just body weight because if body weight were enough, no one would have this problem, right? Maybe you should hold a weight and try to stand upright and maybe you should push one overhead and maybe you should do some squats because that's actually create demand for your body to have this biological need to push up against it and maintain that postural strength. brightness, that form of capacity, that strength, right? So anyway, back on track. Let's talk about the neuromuscular system. So we talked about the musculoskeletal system, the changes to the hardware. Now we're talking about the neuromuscular system, the changes to the software, and how your body organizes and coordinates movements. This includes timing of movement, sequencing of muscle engagement, coordinations, muscle synergies, anticipatory adjustments, reactive responses, and just generally... force production, right? And this system is constantly solving questions or problems like, for this particular movement problem or balance problem, can I generate enough force?
00:58:25
Speaker
Can I do it quickly enough? Can I react fast enough? Can I coordinate the right muscles in the right sequence? Can I adapt the movement strategy as conditions are changing? So, you know, again, back to my hiking analogy, imagine tripping on a tree root while hiking. The sensory system first detects that something unexpected happened.
00:58:43
Speaker
systems have to respond extremely quickly. So the body can rapidly generate enough force to recover. Maybe it's a recovery step. Maybe it's repositioning your center of mass over your base of support. Maybe it's grasping a branch or a tree nearby.
00:58:55
Speaker
And so, of course, different movement situations are going to require different motor strategies. Sometimes recovery happens primarily through these small ankle adjustments. Larger perturbations tend to require bigger hip and trunk movements as well. Sometimes you have to step, sometimes you have to grasp, but importantly, many of the capacities that support partial control are not balanced skills so much as they are broader neuromuscular capacities that influence how effectively your body can respond because they affect how prepared you are to respond, right? So this is where strength, just as a capacity, starts to matter. Power, your rate of force development, matter Also, endurance and fatigue matter because, as we discussed, fatigue changes postural control. So endurance is also important. And we discussed earlier already how mobility and joint range of motion are important because you you can't get more motion out of a joint that just doesn't have it. Right. And then, of course, yes, coordination, which kind of plays more to the skill aspect of it. I'm kind of hinting at it a distinction, which we'll talk a little bit more toward the end, between the skill-based side of postural control and the more capacity-based side of postural control. What a skill is versus what a capacity is and how they definitely inform each other. So we'll talk about that soon. But your neuromuscular system is about force production. It's about motor strategies. And broadly speaking, we're going to be interested in looking at what are the capacities you have available to respond to balance disturbances, to anticipate how to successfully navigate an unstable situation in an anticipatory way, how to not fall when you're just standing upright or walking, steady state, right? But then also, what is your exposure to these different types of balance challenges? There are definitely some skills that you can develop broadly
01:00:45
Speaker
within these different categories, steady state, reactive, anticipatory. And a lot of that's going to come down to how much of your time you're spending being active, right? And exposing yourself to these to these broader categories of balance
Cognitive Influences on Balance for Women
01:00:57
Speaker
challenges. Finally, when you talk about the cognitive side of postural control, this is where we start to head away from this purely biological discussion around balance. We start to head into the more psychosocial factors around balance. Okay, so cognitive side of postural control is the part where we're making interpretations about the situation that we're in. We're choosing how much attention to give to it. We're deciding how much of a threat it is. We're trying to pick the next best movement to make. to help get out of this situation. And we're also making choices about taking a risk versus not taking a risk. Like, do I feel so strong enough to leap across this puddle or should I just sort of step around the side of it instead, right? And so that's where a big part of things like fear and self-efficacy and self-confidence work.
01:01:46
Speaker
come into play. And for women in particular, I feel like a broken record talking about this, but but women are so constantly taught to not take risks physically, to stay small physically, to allow the potential risk of a situation to determine their choice not to do it essentially. And so you know this might be part of why women, according to research, fall more than men. Um, it also has to do with our prior experience, right? What did you grow up doing? Were you taking physical risks growing up, which might be related to your environment, but it might not. I mean, you know, we think always about like, oh, you know, kids in the countryside run and play and they're in nature and all this kind of stuff. But have you seen parkour? Because that's certainly people taking an urban environment and making a playground out of it. Right. And, and ah I mean, some of my favorite videos are women, like it's always women just doing these like really small little tiny jumps and then going parkour and like, you know, touching a wall and bouncing off of it and going parkour as if that's really park cool like the real thing is, is wild to watch. Right.
01:02:49
Speaker
You shared those with me. Yeah. Those make me laugh so hard. But ah were you doing that? Were you out skateboarding? Were you out riding your bike on city streets and dodging traffic? And I mean, those that's plenty of risk taking. You know what I mean? it's just a very different kind. Lots of balance challenges. ah Sure, sure.
01:03:04
Speaker
Right. So even though we tend to talk about balance as if it's this, you're good at it or you're bad at it, the reality is there's so many different factors playing into it. It's similar to when people try to describe something as heavy. Or they're like, this is heavy. Heavy weightlifting looks like this, right? But in reality, it's got a lot more to do with your personal experience, your body's capabilities, what heavy means to you specifically, and it's a changing target, right? So you know something like balance has that same kind of amorphous description. It's not one thing to everybody. yeah Yeah. This is a bit of a tangent. There is an entire chapter in this book about aging and postural control, and I did read it.
01:03:42
Speaker
And I was like, yeah, this isn't probably as useful for this particular episode. But what did strike me is they talked about longevity and they talked about factors that contribute to longevity. And they talked about the real changes that happen to us as we age that are definitely biological and unavoidable, which is, you know, largely just DNA damage, right, which accounts for about 20% of longevity, but is modifiable with lifestyle, like diet and exercise to a point, right? I mean, you could have the best diet and exercise routine in the world, you're still going to experience aging, right? But you can greatly reduce the effects of aging just through through lifestyle. Those are the internal factors that contribute to longevity. Then there are external factors, which are really the psychosocial factors that play
01:04:25
Speaker
For my reading, a much bigger role in aging and are much more influential. And these include the environment. Obviously, you know, if you live in a toxic environment, it's not supportive of longevity. But also, and this is the one that I'm trying to get to here is lifestyle. OK, so yes, diet, exercise, stress levels. We talk about this all the time. But the book actually did a pretty thorough job of highlighting the importance of self-efficacy as being a crucial external factor in longevity. And I was like, oh, shit. I think it highlighted it because this book is about it's about motor control. But this section of the book is about postural control or balance. And self-efficacy is very much connected to fear. And fear is a major influencer for people around balance. And so this idea of self-efficacy, this concept of self-efficacy really connects directly to postural control in this in this very immediate way. And so self-efficacy is a person's perception of his or her ability to succeed. Okay, so you have a perception of your ability. Am I going to succeed or not at all these lifestyle factors like exercise, like diet, like postural control slash balance, right? Your belief that you can succeed at these things impacts whether you will engage with them or not.
01:05:41
Speaker
And thus, your life, your lifespan, and your health span. And so then when you think about all the social forces and all the messaging telling people, especially women, that they are broken, that they can't do it, that they shouldn't do it, or they're just noceboed out of doing stuff, this is profoundly important and powerful.
01:06:05
Speaker
It's potentially as important as diet and exercise. Because first, you have to believe that you can do something before you're going to try it and stick with it. Right. And so something the hosts on capable and worthy, the podcast they were recently on, which we will link that in the show notes, they brought up this observation they made about their encounters with people who really truly believe that they were the special few. They counted themselves the special few that just couldn't they couldn't do it.
01:06:31
Speaker
like i I just, I'm not the kind of person who can strength train or I'm just not the kind of person who can be in a calorie deficit or I'm just not the kind of person who can can do this, whatever health promoting behavior. And these people truly believe that fundamentally these lifestyles, behaviors are just not within their capability because they're different.
01:06:51
Speaker
And it really struck me and it's so true. And I think this happens in lots of smaller ways around postural control. And that's why I'm bringing it up. But I just wanted to highlight this importance of self-efficacy.
01:07:02
Speaker
It's probably, and this is a tangent and it's also a shameless plug, but I do think, I do think that it is our number one goal with Lift for Longevity, right, Sarah? Yes. Our number one goal is for people to come into lift for longevity and to change what they think is possible. Yes. And to feel like I can succeed at strength training. I can do this for the rest of my life. Yes. Anyway, just had just had to say that because because it it relates very much so to this cognitive aspect of fear, which is a massive topic in in fall prevention and falls and and and obviously then in balance. So yeah, yeah.
Understanding Balance Tasks and Sensory Input
01:07:37
Speaker
right Balance, we know, is context-specific. Every fall is ah is a unique snowflake or something that Sarah said about every trip is a little different, right? Yeah. Well, balance is context-specific. So we can practice getting good in one balanced scenario and it's not necessarily going to translate to the others. But the good news is that there are some categories to help us understand, like, what is actually going on here? What is the challenge? What am I mostly relying on in terms of my sensory systems? Like, what are my motor responses really going to be drawn from, right? So so let's talk about them We got steady state,
01:08:05
Speaker
reactive and anticipatory. We'll start with steady state. So steady state balance refers to maintaining postural control under relatively predictable and on ongoing unperturbed conditions.
01:08:21
Speaker
So basically as soon as there any type of meaningful perturbation, it is no longer steady state. So it becomes probably reactive, right? So examples of steady state balance include things like standing in line at the store, sitting upright in a chair, brushing your teeth, maybe balancing in a yoga pose if that is a posture you find relatively easy to do. Maybe standing on a paddleboard in calm water, assuming you have paddleboarding experience, standing on a moving bus while holding a rail, skiing downhill if you're a skier, right? Walking on flat pavement or quietly standing while talking to someone, right? And I'm sure, right, because all of this is relevant relative, as Sarah just said, right? Just like heavy is relative. This is all relative. You could probably think of many scenarios in which some individual would not be in a steady state balance in any of these scenarios, right? Right. Yeah, I mean, I haven't skied in probably 35 years. So if you put me in some skis and pointing me downhill, I would not consider that a steady state experience. Yeah, and I volunteered a rehab floor of a hospital when I was getting my credits for PT school and saw that there were some patients where sitting upright in a chair was not steady state balance. Like they had to relearn how to do that, right? Okay, so steady state does not mean stillness because it can happen while you're moving, like walking. Steady state cardio, right? Cyclical cardio. This is an example of steady state balance um as well. Things like biking, running, swimming. i don't know if swimming is a balanced act. It's more of a not drowning act. but um walking, ah doing any type of repetitive motion where you're mostly unperturbed. So it's not stillness. The body is, while engaging in this, always making small adjustments. Some of this is referred to as postural sway, right? So as your center of mass shifts, your nervous system is continuously detecting and correcting these shifts, maybe adjusting the center of pressure, right, Sarah? to keep the body within its stability limits. In steady state balance, these corrections are often relatively small and not so fast, right? Because again, it's an unperturbed state, right? And your nervous system has time and it relies very heavily on feedback. So your nervous system usually has time to rely heavily on feedback, right? Meaning sensory information coming in first and movement corrections made in response. Opposed to feed forward where the nervous system predicts and prepares for movement demands ahead of time, which is maybe not as necessary in a steady state balance scenario. Walking, your body just does it, right? um We'll talk about feed forward control when we talk about anticipatory balance scenarios. Steady state balance is very different from reactive balance. It's very different from anticipatory balance on a nervous system level. So steady state balance relies heavily on vision.
01:11:01
Speaker
and somatosensory input and vestibular information, all three together continuously. Vision helps you estimate orientation, motion through
Yoga Poses and Balance Testing
01:11:10
Speaker
the environment. The somatosensory system detects pressure, sway, support surface information through the feet and body. And then the vestibular system monitors your head position and your movement relative to gravity. but I think yoga is a good example of a dynamic movement or activity where there are moments of steady state balance that are very unique and different. right So yoga poses involve maintaining controlled positions under relatively stable and predictable conditions. If you have done yoga and it's not your first time, right, and there are poses that are relatively easy for you, but you're in different orientations, right? Maybe alignments, right? Orientations of body segments to different body segments or orientations to the floor. right? Yoga becomes less steady state when there are lots of transitions happening between poses, when movements become faster. Think fast vinyasa flow, right? And perturbations, like maybe the floor's just coated in sweat. so for you it's good for like to i took ah I took a workshop with Vinny Marino.
01:12:12
Speaker
oh god ri So he was an LA teacher. He was like this rock star yoga works teacher, came to New York and like taught taught this crazy fast vinyasa flow in a room that was supposed to only hold like 40 people but had 60 people in it and it was like the floor had like an inch of a bottle of sweat like slip and sliding it was so nasty it was fun it was a fun class I don't want to I don't want to you know nothing against many burritos it was a fun class but it was so good like sweaty and hot. it was It was like Alabama after a thunderstorm in July and that room was real bad. ah Yeah. It was close. Yeah, yeah, As my mother might say. It very close. Yeah. So that's steady state balance. Think things like steady state cardio.
01:12:54
Speaker
Yoga poses where you're holding it. You're relatively unperturbed. Quiet sitting, quiet standing. um It's not It's not stillness. There's a lot of postural adjustments constantly happening, but your body's taking in all kinds of information it does to make these minor corrections kind of hold you in this relatively, you know, continuously unperturbed, either static or dynamic state.
Reactive Balance and Stability Strategies
01:13:15
Speaker
That's steady state balance. Sarah, do you want to talk about reactive balance? Sure. So another category of postural control is this thing called reactive balance. And that is your body's ability to recover stability after your balance has already been disturbed, right? You slip, you trip, the train jerks, the dog pulls you, somebody bumps into you, you step on something ah that's loose that you thought was stable. There's something unexpected that has happened. Now your nervous system is having to respond to it. and react quickly in order to prevent an actual fall, right? So this is very different from steady state. Steady state balance relies on this feedback control where your nervous system is making a lot of like tiny, tiny changes based on input about like if your center of mass has shifted slightly to the left or to the right or things like that. But for reactive balance, we're still getting feedback, but the situation has just like jumped up in intensity real real quick, right? Because now the stakes matter a lot more. Now you are...
01:14:12
Speaker
potentially going to fall. So you don't got time for these kind of slow, thoughtful corrections. Yeah. Yeah. Small, small like corrections. This is now like rapidly, you got to understand what happened. And then you've got to generate force, coordinate movement, reorganize your center of mass before your instability, as Laurel wrote here, continues growing larger, meaning before your face is growing closer to the ground. Yeah. So I am i am growing my i my, dear me, my instability is growing larger. i like i like i like just replacing getting with growing for pretty much any any nice linguistic use. Yeah. Fantastic. So your body needs to be able to generate enough force quickly enough, right? It needs to be able to coordinate an effective recovery response quickly enough.
01:14:58
Speaker
And so reactive balance relies heavily on power coordination, rapid force production, fast stepping, things like that. Hmm. Now your recovery strategies might be small or large, right? You might only require a tiny extra step because something just kind of like shifted your foot. You might need to actually like really quickly shift your hips over one way to counterbalance the fact that you're about to fall the other way kind of thing, right? So a bigger movement, a bigger response, or you might need to grab onto something. You might also actually need to take a step to recover your balance, right? What we call like a recovery step.
01:15:34
Speaker
so that by getting your foot out in front of you, we now have a new base of support that's actually underneath that center of mass again. So instead of that center of mass ending up way out in front of your base of support, you've gotten a foot out and now your base of support is underneath your center of mass as well. And these are actually, you know, just as an aside, in PT school, we learn these strategies to teach people. They call it ankle strategy, hip strategy, step strategy. And grasp strategy. Oh, for your arms. Yeah, for your hands. Right. So, um and Interesting, if you need multiple recovery steps after a perturbation, that's associated with increased falls risk. Right, correlates. like more The more recovery steps you need, the more, perhaps, depending on the test, like right of an increased fall risk you are. Right. Or or even if you weren't at a falls risk, how unsavable this particular fall is. Right.
01:16:24
Speaker
Right. Through no fault of anybody. yeah Like there's that video. I don't know if you've seen it of that guy slipping on ice where he's just slipping, slipping. Like he's, he's slipping in spot. He's looks like he's practically running on the ice trying to like catch his balance. He's in a perpetual state of reactive balance. Yes. He is. He's like, he's just living in this reactive fall. And it's kind of amazing because it goes on for so long.
01:16:44
Speaker
And then you're like rooting for him. You're like, yeah, don't fall. And then I think at the end he does actually end up falling, which a bit of bummer. But it's a very funny video where he's like catching himself. You've probably seen it. Yeah. um And then again, you know, if you're dealing with this sort of reactive balance, your environment suddenly is extremely important, right? Do you have something there to grab onto? Yeah. Is there a railing? Is there a piece of furniture? Yeah. Right.
01:17:06
Speaker
um And, you know, a lot of the time, if you're someone who is at a risk for fall, you're scanning all of these potential reactive grabbing places ahead of time before the perturbation even happens. Yeah. so the visual system is is something that you used way ahead of time when you entered the room. Right. And even if you aren't potentially going to fall, like you you take stock of a room when you enter, you get like, even without realizing it, a lay of the land, so to speak. So you yeah you recognize like this staircase has a railing, whether or not you use it or not, you're aware of it. So then when, then when you lose your balance, you're like, really?
01:17:40
Speaker
Right, exactly. but you You got that information well before you lost your balance. Because while you're falling, it's a little too late to be looking around like, what can I use? here Is there something here? No, if you're looking around, if that you're looking around, you' you're on the floor. yeah Yeah, yeah. So what is important, right? What is the sensory system we're going to rely most heavily on for reactive balance? ah Well, yeah queuing me up, reactive violence depends heavily on your somatosensory information. Yeah, because that's fast data, right? Right. That's very fast information about where you are in space, right? So all of this information, these signals are processed really quickly. Once the perturbation is already happening, your visual processing is too slow at that point. You have to rely on this this somatosensory information. Yeah. And you know your overall cognition is also going to shape your reactive balance as well, right? If we're scared, we tend to stiffen up.
01:18:36
Speaker
Yep. So that fear could be anything. That could be sensing that you feel unstable. It could be sensing that the ground is unstable. ah It could be based on nothing at all, like fear of heights. Yeah. Right? If I had to walk along a path that you know, is the size of like a sidewalk on my street, no problem. If I have that same width of ah of a path, but it was a sheer drop on each side, all of a sudden I am i am behaving as if I'm about to fall off the side, right? yeah So that's another issue with cognition in terms of how it it shapes your behavior as well. And if you're physically stiff, it's going to be a lot harder to create these small reactive movements that allow you to manage your balance. And I remember you talking about your patients being shufflers, right? They don't take yeah steps because they're exactly falling. So that the act of shuffling actually creates this additional fall risk for them because they're not picking their feet up. so then they're like more likely to trip over a rug or maybe the carpeting and the linoleum, like that level change or whatever. yeah um But that that small stepping is from this fear of if I take one foot off the ground for too long, right? Right. That's too much of a balance challenge. ah Yeah, exactly.
01:19:46
Speaker
Yeah.
Anticipatory Balance and Predictive Strategies
01:19:47
Speaker
Yeah. Okay, cool. And then finally, anticipatory balance. So this is another and our last broad category of postural control. And it refers to the nervous system's preparing for an expected balance challenge or challenge your postural control. It's expecting instability before the instability actually occurs. so it's very future-oriented. It's very predictive.
01:20:10
Speaker
And it's feed forward. So what we mean by that is reactive is feedback, right? Obviously the disturbance happens and now we respond. Steady state is pretty feedback because you're making all these minor adjustments. Anticipatory is feed forward. This is an entirely different, for lack of a better word, pathway. ah Maybe that's not the right word, but it's an entirely different um way that your nervous system gives you information based on, you know,
01:20:32
Speaker
what it thinks is going to happen. These include bracing before lifting a heavy box, leaning forward slightly before standing up from a chair, slowing down before stepping onto ice, adjusting your posture before the subway starts, shifting your weight before stepping over a curb or jumping across a puddle. Unlike reactive balance, where the body responds after instability has occurred, anticipatory balance relies heavily on that feed-forward control where the nervous system predicts what is about to happen and organizes movement ahead of time rather than basing it on sensory feedback after the fact. So these predictions, this is important, they're not always right.
01:21:11
Speaker
And that's when the task quickly becomes reactive. so so Sometimes you expect a rock to be stable and you have a motor plan for navigating that rock and then it shifts and then you have to create another motor plan very quickly on the fly. Sometimes, is this ever happening? You think a box is actually heavier than it is.
01:21:31
Speaker
and you stand up and you whoa, it's very surprising. Or maybe it's heavier than you think it is. Sometimes you miss the height of a stair. That's never good. Or my least favorite is when I think there's one more step and I'm already on the floor and I go to take that extra step and that just feels so jarring. Oh, yeah. Yeah, where you go to step down and there's no step to step down to. um These prediction errors are incredibly interesting, I think, and important because nervous system is going to need to quickly update your motor plan. Here's where we can talk about stability limits. So stability limits are a point at which a person will need to change the configuration of their base of support to achieve stability. And have you ever done a reaching drill with your patients where you have them put their feet on the ground and then they have to reach for something? And sometimes you see how far they can reach before they have to take a step. I saw um the physical therapists and occupational therapists doing that type of work with yes the neuro patients in the and the rehab clinic that I was volunteering in. And that's also, that's the functional reach test as well. It's also something that can test
01:22:32
Speaker
Test and retest. And so yeah that's something that you would do to to to prove that you've that there's been improvement. To the insurance companies. Yeah. Yeah. yeah yeah um Yeah. And so stability limits are greatly impacted by your fear of falling. Like how far you think you're going to be able to reach, for example, before you need to change your base of support. Is very much impacted by like how fearful of falling you are. And this is this kind of comes down to this idea of your patients taking short, small steps, right? They don't have the confidence to achieve stability with a big step configuration. So they take these smaller, more frequent steps. It's like if you were reaching for a rock that's near the edge of a cliff, how would you estimate your stability limits in that scenario versus if you were reaching for ah an object in your kitchen, right? So stability limits, whether or not you change your base of support, is largely about
01:23:26
Speaker
you predicting whether or not you will have to. Anticipatory balance honestly sounds to me also a lot like movement skills. So when we go to do a movement task, like maybe it's transitioning between a couple of yoga poses or it's lifting a weight in an exercise or it's doing a gymnastics move, right? We we have this idea of what's going to happen because we've done it before or we've seen someone else do it, right? So we are anticipating the challenge and we've got all of these motor strategies for getting ready to do it.
01:23:54
Speaker
Right. It sounds to me a lot like skill, because then as we do the thing more often, we get more skillful at it. We get better at anticipating it. We get better at, you know, doing the movement. Right. Which is largely about knowing what the movement entails and knowing what you need to do to do the movement. Why anticipatory balance feels especially skill based is that it relies on prediction and your ability to interpret.
01:24:15
Speaker
which is going to be enhanced by your practice with that movement. It relies on timing and coordination. It relies on efficiency, right? And and I think that these are all aspects of skilled movement. A skilled mover is better at predicting the movement demands, organizing movement in advance, interpreting the terrain, scaling the force appropriately, preparing the stabilizing muscular activity ahead of time, minimizing unnecessary corrections. And so we can see that in experienced hikers, trail runners, dancers, athletes, right? Movement skill is a broader topic than anticipatory balance. I think that movement skill always incorporates anticipatory balance in in addition to probably reactive balance and steady state balance as well. But movement skill is broader than that because it's also dealing with accuracy, precision, performance metrics that you're trying to meet. Did I score a point? So anticipatory postural control is probably an aspect of skilled movement rather than the skill itself. And it depends heavily on the visual system, which I found very interesting, Because you're basically just appraising the situation. I'm going to do this thing. i'm going to lift this weight. I'm going to do this movement with my body. And then based on that, you put all of these motor strategies in place.
01:25:25
Speaker
Okay, so let's briefly contrast these three broad categories. We know that steady state balance is more reliant on feedback-driven information. The response might be might be smaller and slower from a motor standpoint. It relies heavily on continuous sensory regulation, small ongoing corrections. Reactive balance is faster. It's, again, feedback-driven, but relies on your ability to respond to something that occurred and to make small to big corrections and probably reliant much more so on your somatosensory system, whereas steady state all three, right? And then anticipatory balance is heavily prediction-based, feed-forward driven, strongly shaped by prior experience, skill, your ability to interpret the environment and that environmental interpretation. A lot of that's vision, right? Okay, I just want to end by briefly touching on something we've mentioned frequently in this episode, which is this difference between working on a balanced skill, getting good in certain balanced scenarios, which is very specific to the scenario and the context and the clothes and the person and the, and the, right? Versus working on capacities that will create some general preparedness for a variety of balanced challenges.
Balance as Athletic Training
01:26:41
Speaker
So we've listed so many different balance scenarios in this episode, some of which were steady state, some of which were more reactive in nature, some of which were more anticipatory in nature, right? What are the capacities we've talked about in past episodes, we've maybe mentioned in this episode that support these different skills on a much more foundational level?
01:27:01
Speaker
right like I like to think of it like an athlete lifting weights in the gym so that they have a strong body or a powerful body or a durable body or an injury resistant body. That's the capacity that they then use as the underlying support for the movements that they have to do in their sport.
01:27:20
Speaker
And that skill that they develop for their sport happens predominantly through doing the movements of their sport and playing the sport. Mm-hmm. not by lifting weights in the gym, but the strength, the power, and the durability and injury resistance are supported by lifting weights in the gym, right? You see how they're they're kind of different. and and and And also playing a sport will improve your capacities. And there potentially are some movements you're doing in the gym that translate directly to the sporting movement. I think balance is the same way, right? And balance is kind of like the sport of life, right? It's you versus gravity. Yeah, yeah. ah what are some What are some of the capacities we've discussed in depth and what are some possible other capacities that we haven't discussed as much, Sarah, for for being generally ready for balanced challenges? Well, we've talked about power.
01:28:05
Speaker
We've talked about strength generally. um It seems like something that we haven't talked about, but maybe we should start talking about, is this like belief that you can do it. Self-efficacy.
01:28:16
Speaker
I do think that is a capacity. It is mentally psychological capacity. And it's not one that we've discussed much on this podcast. One that's frequently harmed by society. Yeah. i don' yeah Especially for women. Yeah.
01:28:27
Speaker
Yeah. I think mobility is one that we don't talk about that frequently. It's very, it's a very real, um, capacity that is important, um maybe more so for certain joints in certain circumstances. But like, I do definitely see how foot and ankle mobility. Yeah. Right. As separate from strength, you can improve mobility by strengthening your foot and ankle. Right. For sure. But also like mobility.
01:28:50
Speaker
And the ability for your foot and ankle to adopt positions to multiple different types of surfaces and you know to be able to stay connected to the ground and your body's in yeah positions. Absolutely. What was another one I was thinking about is endurance, right? We don't we don't often associate endurance with a capacity that would keep us from from falling, but it is because as you become more fatigued, you're maybe motor response rates are slower and or, you know, your sensory systems aren't as sharp and your strength maybe isn't as as high as it needs to be to support you or your power. Certainly power is very acutely affected by fatigue. We we get fatigue very quickly when we engage in power exercise. So Fatigue would interfere probably first with your your power production before we interfere with strength. yeah um So it's it's overwhelming to think about working on balance when we understand just how specific balance skill is to the balance challenge. Like it's so specific on such a multi-layered way.
01:29:44
Speaker
yeah It gets easier to think about working on balance. when we understand that there are some underlying capacities that will just better prepare us for lots of different balance scenarios. I think that it's good advice to say, well, work on your strength and power and do full range of motion strength to keep your mobility in good you know range of motion through your
Balance as Life's Integral Sport
01:30:04
Speaker
joints. um Engage in cardiorespiratory exercise your endurance is good. I also think we'd be remiss in not also recommending people to put themselves into situations where they do have their balance challenge. Yeah. and Like actually engage in balance, challenging strength exercises. Do single leg RDLs. Do yoga, right?
01:30:23
Speaker
Go for hikes in the woods. I learned to roller skate, right? Like all of these hobbies, sports, sports, play sports, right? There's a really great balance challenge for you. Play pickleball. um They provide you with the real world in the moment practice time to apply your capacities, but also to get better at, get more reps, get more time, more um practice, you know, solving balance challenges. Honing your postural control. And hopefully some of those challenges are steady state. Some of those challenges are reactive in nature. You know, hopefully you don't, you know, hurt yourself, but you possibly have to put yourself into at least some amount of risk to be able to work on reactive balance, right? Because you can't work on reactive balance when you know what's going to happen. right? You can't like pretend to fall and be like, I'm working on my reactive balance. No, you knew you were going to fall because you made yourself fall, right? You actually have to, oops it you know, fall.
01:31:24
Speaker
And then anticipatory balance, which is probably the easiest one to work on, right? Which is just put yourself in movement scenarios where there is going to be some type of perturbation, some type of challenge to your to your balance, and then use your predictive capacities to solve those problems and see if you can, right And get better at it. yoga iss Yoga is a fantastic example of that. Anyway, um Sarah has left the room. I've been talking for too long. and She's over it. Oh, wait, she's back.
01:31:48
Speaker
Okay. I think I'm done. Okay, cool. That's it. The episode is over. Good job. I know it went much longer than I said, but it didn't go much longer than our typical episodes. It did not. And probably once you edit it, it will be much shorter.
01:32:01
Speaker
Yeah. All right. bye I think you should say something other than bye. Say something. Thank you for listening to this episode. We hope it helped you understand a little bit more about what balance actually is, what it isn't. And instead of taking a bunch of balance classes, you're probably much better off just going out and living your life and taking some movement risks. yeah Jump off the curb. See what happens. Go jump off a curb. See what happens. Yeah.
01:32:23
Speaker
That's going to be my new insult. Oh, jump off a curb. And resistance chain. Yes. Yes. Exercise. What a surprise.
Encouragement to Improve Balance Through Exercise
01:32:30
Speaker
Once again, the answer is exercise. And go live your life. And go live your life in a physical way, in an embodied way. Get out there and go take a dance class. That's right. Start some martial arts. Do something different. um Yeah.
01:32:42
Speaker
Okay. ah So thanks for listening. And sorry, I could just see you starting a new tangent. I was like, I don't got time for this new tangent that she wants to start. So to challenge yourself, go out there, make good choices. And we love you. And ah we'll see you after school. and Make sure you make some new friends. And i I cut the crust off your sandwich. Hey, rate, review, ah subscribe. That's right. And we'll see you in two weeks.
01:33:05
Speaker
Yay! did it!