By Paul Chek, HHP, NMT
Founder, C.H.E.K. Institute

Whether you are in the 65 or older crowd today or not, chances are you know someone who is already there. And, as much as you may try to fight it, someday you will be too! Nowadays, "growing old gracefully" means more than it used to, because falling is the leading cause of death among people age 65 or older. ¹ The fact is, balance is something that begins to fail as we grow older. Unless we take steps to improve or maintain our balance, we may end up as one of the unfortunate statistics after a fall.

Though there are numerous exercise programs available for the elderly, many of these utilize fixed-axis machines, which may help with age-related decreases in muscle mass and strength, but offer inadequate loading of the spine and long bones and do almost nothing to improve balance or functional strength on your own feet.

To be successful in any balance-improving training program, people must perform movements that closely approximate their everyday activities and those movements that commonly result in falls. What follows are some exercises to improve your balance and stability as well as reduce your chances of falls.

Gait: The Toe-Touch Drill

Gait or walking deficiencies are most commonly seen in the stance phase while standing firmly on one foot while walking. The most common problem is the inability to resist the pronation (interior rotational) forces of gravity on the body, resulting in the internal rotation of the femur, tibia and foot/ankle complex associated with distension of the abdominal wall. This muscle imbalance often results in flat feet.

The Toe Touch Drill performed on the Total Gym Target Grid (or other similar apparatus) improves the function of the stabilizer system while improving balance and coordination on one leg, providing a high functional carryover to both gait and stepping activities.

To perform this exercise, start by standing on one leg. Pretend you are standing in the middle of a clock face. Then, with your belly button drawn in and standing in good upright posture, slowly bend the leg you're standing on while attempting to reach the opposite leg's toe out as far as possible in front of you.

You must keep your working knee directly over your second toe. Once you cannot keep it in this position, stop the exercise and mark the spot your toe reached. Perform this in all the positions of the clock with one leg, then the other. (Figure 1) After you have every position marked, you should stop just short of the mark for a while, performing 1-3 repetitions of the movement. Retest yourself to see if you've improved every week after performing the exercise every other day. If one leg is stronger, always limit the amount you do on that leg to match the weaker leg until they match and develop from there.

Squatting: The Bench Squat

The Bench Squat affords you the confidence and support that comes with knowing you won't fall on the floor if you can't hold yourself up.

To increase your functional base of support and improve confidence, hold a wooden dowel in one hand to aid balancing as needed. For those with very poor balance, I allow one dowel in each hand, although I have never had an elderly patient -- including those as old as 84 -- who needed a second dowel rod. Straddle the bench as low as is comfortable for you with good form. (Figure 2)

Repeat to fatigue 1-3 times, and repeat 2-3 times a week. As you build your strength, endurance and confidence, you'll be able to remove the dowel rods and bench, and progress into traditional squatting.

Posture: The Supine Lateral Ball Roll

Although it looks hard, the Supine Lateral Ball Roll is only challenging in proportion to how far you deviate laterally on the Swiss Ball. This excellent exercise allows you to integrate the upper and lower extremities via the trunk, improves stability and balance and provides a functional carryover to gait and any pushing or pulling activity that requires integration of the anterior and posterior muscle systems of the body.

Activation of the extensor muscles from shoulder to contralateral hip aids in strengthening the muscles across the apex of the thoracic (middle back) curvature, improving posture. With just a short period of practice, you should become much more confident on the Swiss Ball.

From a seated position, roll down the Swiss Ball so your shoulders rest in the middle of the ball. Keep your palms to activate your shoulder girdle retractor muscles. Extend your hips upward until your knees, hips and shoulders are all in the same horizontal plane. (Figure 3) Draw your belly button inward enough to activate your inner unit and place your tongue on the roof of your mouth.

Move laterally from side-to-side without twisting or tipping. Ensure your hips and arms do not drop and your chin stays tucked in slightly. Hold at the end position and return to the middle of the ball.

Seated Posture Trainer

With a soft 5-pound diver's weight on your head, the Seated Posture Trainer will help you develop an increased sense of proprioception (body awareness) while learning proper seated postural alignment.

To perform the Seated Posture Trainer, sit on a properly sized Swiss ball and, while holding a neutral curve in your lower back, gently draw in your belly button while sitting in good posture. As you become more confident with this exercise, one foot can be lifted off the ground, shifting your center of gravity and increasing the amount of balance you need. (Figure 4)

With this one exercise posture, your balance and confidence should improve ! Eventually, you should be able to sit on the ball with good upright posture for one minute without allowing your feet to touch the ground or allowing the diver's weight to move from the top of your head.

Conclusion

The chart that follows below features a sample workout for those interested in incorporating these exercises into your program. Whether or not you've reached the "Golden Years," these exercises will do wonders toward maintaining a good sense of balance and prevent you from becoming a statistic.

Exercise	Rest	Intensity	Reps	Tempo	Sets
Toe Touch Drill		Body Weight.+/-	1-3 ea.	Medium-Slow	1-3
Squatting		Body Weight.+/-	12-16	Slow	1-4
Supine Lateral Ball Roll		~ 60% Max	6-8 ea.	Hold 1-3 sec.	1-3
Seated Posture Trainer	1:00	Variable	1	Hold 1-3:00	1-3

Suggested reading/viewing and equipment for balance exercises:

1. Scientific Balance Training (Audio)
2. Swiss Ball Training (Correspondence Course)
3. Duraball Swiss Balls (Balance Training Equipment)
4. Functional Testing and Training Grid (Balance Training Equipment)
   

Paul Chek, Holistic Health Practitioner and certified Neuromuscular Therapist, is the founder of the C.H.E.K Institute in Vista, Calif. He is also sought-after consultant to sporting organizations, his services have benefited numerous professional sports teams, athletes and individuals seeking optimal health worldwide.

Paul has produced more than 60 videos, 17 correspondence courses and is the author of several books, audio programs and articles. For more information on Paul's popular "You Are What You Eat" audio/workbook program, or for any of his other health/exercise courses, videos and books, call 800/552-8789, 800/552-8789 (New Zealand or Australia), 44 (0)1273-856-860 (Great Britain) or visit online at the CHEK Institute Web site. Please feel free to request a catalog of CHEK Institute products.

References:

1. Hoyert DL, Kochanek KD, Murphy SL. Deaths: Final Data for 1997. National vital statistics reports; vol. 47 no. 19. Hyattsville, Maryland: National Center for Health Statistics, 1999.

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