“Balance is just imbalance in motion.” - Alan Attwater
Have you ever twisted an ankle and after it healed it just didn’t feel ‘right’ for a while? Maybe you feel like you have to look at the stairs while climbing them now when before the injury you bounded up them without even thinking about it. Maybe you keep ‘mis-stepping’ and feel unbalanced now? While some of the problem could be that you still have a talus or calcaneus (ankle and heel bones) in an improper position, many times your proprioception was damaged in the injury and now needs retraining.
Proprioception is an often forgotten element in the rehabilitation following an injury. Proprioceptive information helps our brain know where our body parts are in space, and helps us to coordinate movement. These specialized nerves are often damaged in an injury and need to be retrained to prevent re-injuring the area - like that pesky rolled ankle that you tend to keep going over on.
Seeing a good physiotherapist, osteopath, chiropractor or massage therapist (click here for recommendations) while you’re recovering from an injury is a great idea and they can help you incorporate the right exercises at the right time of your recovery to help speed it along. They can also recommend personalized exercises to retrain your damaged proprioception. If it’s a fresh injury, I recommend that you go see a professional to get personalized advice so you incorporate the right exercises at the right time to avoid re-injury. Even if it’s an old injury, it’s usually a good starting point to see a rehabilitation specialist to get personalized advice before tackling some of the exercises in this post.
A quick search on Google or Amazon and you’ll find all kinds of devices to help you retrain proprioception - wobble boards, balance boards, stability trainers, Bongo™ Boards and BOSU® Balance Trainers, to name a few. Typically, these devices are useful later on in your training. Jumping on a wobble board right after having your cast removed is a little like trying to start weight training by bench pressing 300 lbs - you’re more likely to hurt yourself instead of getting stronger. All you need to begin retraining your proprioception is a solid, flat surface: the floor.
The progression of proprioceptive exercises is to move from static balance exercises to dynamic balance exercises to coordination and agility training. This post will cover some basic static balance exercises. You can see these posts here and here for dynamic and agility exercises. It’s important to note before you begin any of these exercises that proper body positioning is important during the exercises. If you need to lean to one side to stand on one foot, the exercise is too difficult. You need to go back to exercises standing on both feet for a while before progressing to single leg stances. It’s also important to know that children under the age of 16 and older adults are at a higher risk of injury during proprioceptive activities because their central nervous systems are not fully developed/message transmissions to and from the central nervous system tend to slow with age; information is not transmitted quickly enough to provide the necessary safeguards against excessive body stresses. Both children and seniors are also more prone to injuries during proprioception training because they tend to have less muscular strength than adults. So the key take away is to progress slowly and listen to your body. Again - seeing a rehabilitation specialist while you learn how to do these exercises properly will avoid problems and injuries.
Static Balance Exercises
Tandem stance: The most basic activity you can use to begin training proprioception is the tandem stance balance. Simply stand on a level floor surface with one foot in front of the other, heel to toe. Arms are at sides or raised—whichever is easier. You should be able to stand still in this position for 30 seconds with your eyes open. Once you are able to perform this easily, you can progress to standing still in this position with your eyes closed.
Stork Stance: Once you have mastered the tandem stance with your eyes closed, you can move on to the stork stance. Stand still on one leg for 30 seconds with both eyes open and arms at your sides or raised, without allowing the elevated foot to touch the ground. Once you can accomplish this, close your eyes while maintaining the same position and stand still for another 30 seconds.
When you can easily accomplish the stork stance with eyes closed for 30 seconds, you can progress to increasing the instability of the surface you’re standing on. The easiest and cheapest way to do this is to stand on a pillow, first with both feet with your eyes open, then eyes closed, then one foot with eyes open, then eyes closed.
Once you’ve mastered this, you can move on to static exercises on an unstable surface. Typically this is the point where balance boards come in handy, but again, you can begin by using a pillow and progressing to a balance board. You can check here for recommendations for balance boards and when they’re useful to add into your training regime and here are some great sites with some great exercises to increase your proprioception.
Til next time, folks!