Balance and Postural Control

Many individuals will access physiotherapy through their lifetime for concerns related to posture or balance. Individuals who spend long hours in a similar posture may experience fatigue of their postural muscles leading to dysfunction, muscular tightness, abnormal movement patterns or pain. It’s important to note that there are no bad postures, it’s the time spent in each position that counts.

Posture is a very broad term identifying the ‘ideal alignment’ between body segments (ie. head to torso), or the body and the environment. The concept of postural control is creating an ‘ideal’ alignment and learning how to maintain stability in this new alignment. The concept of balance fits neatly into postural control, as balance comes from being able to maintain a posture without movement, or while your body is in motion.

Many body systems such as our vestibular system (inner ear), vision, and somatosensory system (touch, pressure, awareness of where the body lives in space) play a large roll in our balance. Individuals experiencing vertigo, neurological changes, joint or muscular restrictions, fear of falling etc. may experience changes in their balance and postural control. Our changes, or decline, in balance will often lead to an increase in falls.

The fear of falling is a vicious cycle which actually increases one’s risk of having a fall. Individuals may become fearful of falling from experiencing a fall themselves, seeing or hearing about others falling, or with talk about injuries related to falls. When an individual becomes fearful of a potential fall they will often alter or limit the activities they choose to participate in (i.e. walking outdoors). This can cause a decrease in physical activity levels, leading to weakness, loss of mobility, and decreased reaction time. All of these changes will increase the risk of having a fall.

There are many ways a physiotherapist is able to work with an individual to identify and correct the underlying cause of their postural changes and decreased balance. Manual therapy, stretching, strengthen muscles, improving motor control & balance reactions are a few ways PTs can help. Exercises for balance are designed to challenge the limits of the individuals current balance, to safely progress and improve dynamic movement and reactive/proactive balance strategies. Frequent, regular and safe balance challenges are key!

Melanie Deneiko, BSc.Kin, MPT