We all want to be able to walk and move around without falling, or the fear of falling. The balance system in our body helps to keep us upright and oriented with activity, or even with standing in one place. There are times when our balance systems can be disrupted, causing loss of balance or falls. This can particularly increase in frequency as we age. We can, however, have a problem with our balance systems in our younger years as well. This could be from either trauma, disease processes, or unknown onset. In this article I will discuss the balance systems of the body and what to look for to determine if there could be a problem with one of these systems.
The body has 3 balance systems that keep you upright and steady with sitting, standing, or walking and changing directions. These three balance systems are: the vision balance system, somatosensory balance system, and the vestibular balance system. These three balance systems work together in keeping your balance whether you are stationary or moving. Trained professionals, including physical therapists, can determine if you have a deficit or a loss in one or more of these balance systems.
Your eyes make up the first balance system. Your vision gives the brain and body feedback on space relationships and whether you are moving compared to objects around you. It assists on keeping you balanced and keeps you from tripping on objects that may in your path. This also gives feedback to your system to know how far you need to step over or around an obstacle, or how to keep moving objects such as your pets from getting in your way and making you fall over. If you start to have visual impairment, this could affect your ability to prevent loss of balance. It is important to obtain regular checkups with your optometrist to keep your vision keen.
Your Somatosensory system is the second balance system of the body. It includes many sensory receptors located across the body in the skin, bones, joints, muscles, and even internal organs. Your joints give sensory feedback on how much bend and motion it is in at any fixed point in time. The pressure sensors in your foot determine if you are leaning forwards, backwards, or to the side. Your muscles give length tension relationship feedback to determine if you are straining the flexor verses the extensor muscle groups. In many instances, this balance system can start to fail. Numbness in the extremities such as with diabetic neuropathy or nerve impingement can cause this system to have diminished effects. Our body at times start to lose reliability on these systems from injury and age that can cause a need for a “Tune Up” on the system through proprioception balance training. If you start to have reduced feeling in the extremities and start feeling a little less sure footed, this balance system may need to be analyzed and tested for fault.
The third balance system is the vestibular system. This system is located inside the head just next to the hearing organ. It senses directional changes and movement. It recognizes both linear and rotational movements. This system is made up of three semicircular canals coming off a main vestibule, or housing. Inside of the vestibule are otoconia. Many refer to these as rocks. These are calcium crystals that sit in a gelatinous fluid. Through head trauma or through the aging process, one of these calcium crystals can break loose and get entrapped inside of one of the three semicircular canals. When this happens, you have a sense of vertigo, or spinning sensation when head movements. Most people complain of symptoms of vertigo with rolling in bed, getting out of bed, quick direction changes, looking up to the ceiling, or tying their shoes. If one of these crystals have been dislodged and stuck in one of the canals, a trained professional can diagnose whether it is the right or left vestibular system that is the problem, as well as which of the three canals crystal is stuck in. This general condition is referred to as Benign Paroxysmal Positional Vertigo (BPPV). Most of the time, with rolling procedures, we can assist in clearing the floating crystal from the canal and placing it back in the vestibule where it can be broken down by the vestibular system. There are other types of problems that can happen with the vestibular system that can be either central origin, or peripheral origin in nature. A trained professional can determine which of these the balance problem is originating from and further direct care to improve your balance and reduce symptoms of vertigo. Vestibular problems can either be a quick fix or can be a long process depending upon what is happening or what disease process may be occurring.
Our balance systems are vital in helping us to be active and maintain independence in functional mobility. It is extremely important to all of us to be able to perform the activities and hobbies that keep us happy in life. If we are not able to walk and move around and maintain our bodies positioning with these activities and hobbies, our overall feeling of worth and satisfaction in life can be significantly reduced. Maintaining our balance systems in our body is vital for continued independence in mobility and changing our bodies position. If you feel you may be having diminished balance or even falls, it is recommended that you see your healthcare provider to further determine your baseline balance and if there is something wrong with one of the three balance systems.