As part of any patient’s rehab, be it a teenage netballer or a tradie in his mid 50s, I always emphasise the importance of practising a variety of balance and proprioception exercises as part of their home programme. This helps them return to their normal daily activities faster, and aids in the prevention of re-injury. However, on many occasions, the response to my exercise prescription tends to be: “Why do I need to do this? What has this got to do with (insert any activity here)?”

So here is my view…

Even when standing “still,” we rely on proprioceptors – or nerve receptors – in the muscles, tendons, ligaments and joints of our feet and ankles to communicate sensory signals to our brain. The brain then responds by sending impulses that fire subtle muscle movements in our lower limbs to keep us balanced. At the same time, we rely on information from our vision as well as our vestibular system (the motion-detecting organs burrowed deep within each ear) to orient us as to where we are in space.

When we get injured, pain inhibits or delays these signals reaching the brain, therefore our body is slower to respond to where our body is in space, which in turn can increase the risk of us tripping, or falling, and hurting ourselves further. Thus, loss of balance may result in the inability to do our everyday activities. After a prolonged period of disuse post-injury the weakness in the muscles and joints can also contribute toward an inability to maintain balance. Hence the need to practice maintaining balance during a variety of tasks, in an attempt to restore the fast and effective communication pathways between our brain and body, is extremely important.

I regularly treat patients who go to the gym or crossfit, who profess to lifting very heavy weights and being very strong, and that they do not need to try balancing on a bosu ball/foam roller/wobble board. It’s as if balance-based exercises are beneath them. But every single one of them has been stunned at their lack of ability to maintain their position on any object for longer than a couple of seconds. It is all about the speed of your body reacting to perturbations, rather than performing pre-planned movements with heavy weights. Combining both forms of training together is what has really helped my patients reach their functional goals faster.

The important message here is that problems balancing do not only affect the elderly; it can affect anyone at any age after an injury. And along with musculoskeletal injuries, vestibular (or inner ear) problems are another common cause for feeling unsteady as you walk or move about (and there are great exercises to help with these issues also!).

So you are having difficulty doing any activities you love, come in to see one of our friendly physiotherapists for their advice, and for targeted exercises best suited to address your specific needs.