Balance guru Helena Esmonde is the most senior neurological therapist at Penn Therapy & Fitness in Radnor, Pa. As we explore why mobility matters in honor of Mobility Awareness Month, she explains how balance can significantly influence our quality of life.
Tell us about yourself!
I am a senior therapist II, and I participate in mentoring, teaching and research in addition to quality clinical care. As a neurologic and vestibular (inner ear balance) specialist, my focus is to provide individualized rehabilitation using evidence-based practice to ensure the best possible function and quality of life for my patients.
Why is balance important?
Balance is essentially the ability to keep your center of mass over your base of support, which is your two feet. With a working balance system, we can stand safely, react effectively, avoid falling when engaging in a planned movement, and walk and move without stumbling or falling.
When our balance is impaired, we are more likely to fall and get injured. Falls are the most common cause of traumatic brain injuries. Having the best balance possible minimizes the risks for serious and potentially life-altering injuries.
Which conditions can influence our balance?
Our balance can be impaired because of weakness, age, a neurological disease or injury, vision issues or decreased cognition. However, falling should not be seen as a normal part of aging or something that is inevitable. I often tell my patients, “Your auto-pilot for keeping your balance is not as automatic as you get older,” and that’s why patients train with us and learn how to move more safely.
How can poor balance affect your mind as well as your body?
There are a few different ways that balance can be emotionally and mentally distressing. When a person’s balance is impaired for any reason, that person lives in constant fear of injury and therefore tends to self-limit their activity. This can mean that they avoid exercise because of a fear of tripping on an uneven patch of sidewalk. That person then loses the mental and emotional benefits of regular exercise as well as the physical benefits.
A person with poor balance often also chooses to avoid positive social experiences due to a fear of falling. For example, someone may not visit a friend because the friend does not have a railing next to their staircase, or they may not attend a party because of the fear of losing balance if someone bumps into them accidentally. Poor balance can lead to social isolation as well as physical deconditioning or disability.
How can physical therapy improve balance?
There are numerous advanced physical therapy techniques for training better balance, some of which are tailored to people with specific conditions. The focus of all such physical therapy is to key in on an individual patient’s goals. I am currently training an individual with MS who wants to be able to walk, dance and move safely at her daughter’s wedding in a month. Like most people with MS, she gets fatigued easily and finds that the fatigue negatively affects her balance. Another patient is trying to progress from using a walker to using a cane safely to free a hand for opening doors, carrying items and shaking someone’s hand in greeting. I try to focus on the goals that will bring quality to each unique person’s situation, whatever it may be.
Can physical therapy be expensive?
Physical therapy is not as expensive as some other options, such as surgery, to correct balance issues. However, if a patient has a major injury or illness (including trauma, a stroke or a spinal cord injury) he or she will likely require therapy and rehabilitation for a longer time, including inpatient rehabilitation and home care, before “graduating” to an outpatient therapy setting. The numbers can add up.
Our main goal is helping patients get back to the highest level of functioning. It’s hard to put a price on dancing at your daughter’s wedding or shaking someone’s hand when you meet them. At Penn Therapy & Fitness, we offer a charitable care program for patients who are unable to afford their outpatient therapy. We also work with patients to help identify other resources that may help them afford care. This is one of the many reasons we appreciate partnerships with such wonderful organizations as HelpHOPELive!
Are there any ways to improve your balance at home?
Exercise is a critical element in decreasing your risk for balance issues and falls, but it’s important to understand what sort of exercise has the greatest benefit. Tai Chi, Pilates and yoga can improve balance, but for those who are not up for that level of challenge, strength in the hip muscles and core strength (belly and back muscle) are the most significant factors.
Lie on your side and lift your top leg up and down. You’ll work important hip muscles that keep your pelvis stable for balance. In addition to exercise, have your vision checked at least yearly. Keep your mind sharp with crossword puzzles or other brain games that benefit your eyes and your brain! Taking action to prevent falls becomes more important as you age. Talk to your doctor and make sure you can keep your balance everywhere you want to go!