Your BRIDGE back to being active at every age and stage

balance control

Functional Balance — What, Why, and …

The theme for this week …

Recently I wrote about bone health and that the real health risk is from falling, not osteoporosis. Balance is essential for fall prevention, and much more. But what is balance? And how do you know if you have an issue? Read on …

Balance basics

When we talk about balance, the image of a person standing on one leg comes to mind. Yes, this is an act of balancing, yet there is so much more!

The definition of physical balance:

It’s the control of your center of gravity while still, or while in motion.

What does balance control mean?

Control is the operative word in the definition. From the time we are tykes, our bodies are progressively fine-tuning our reactions to the effects of gravity. The stages of anti-gravity balance development include:

  • Learning to sit
  • Learning to stand (and fall!)
  • Learning to toddle, walk, run, and jump

The self-centering reactions from each stage develop the inherent control which becomes your present day physical balance.

What are the ways we need to control our balance reactions?

Control develops in various spatial directions, which allows us to safely navigate the world around us. The basic pairs of direction are:

  • Bending forward and extending back
  • Turning right and left
  • Shifting left and right
  • Shifting front and back (to/fro)

Why wouldn’t balance reactions be working?

These intrinsic balance reactions happen without thought, until they don’t. When you feel unsteady or anxious about movement, that is a big clue that the finely-tuned reactions are out of tune.

Life events which can throw off your balance include:

  • Injuries and accidents such as bike falls, auto accidents, concussions, and ankle sprains.
  • Medical procedures, especially involving your core, legs, and neck
  • Illness that has you off your feet for extended periods of time resulting in muscle atrophy.

Was your balance good in the first place?

Assuming good balance reactions have been in place is not always a valid assumption. There are distinct events which can impede balance reaction development, including:

  • Birth complications
  • Early life illness, especially when requiring surgery or NICU/PICU intervention
  • Late developmental progression

So, how can Bridging® help? What else can I do?

To look more in depth at your balance skills there are standardized balance assessments. Part of the Bridging® assessment looks at the body’s balance reactions using the concept of sway(posture) control. We address any concerns in our sessions.

General recommendations also include specific balance training found in dance, martial arts, yoga, or Tai Chi.

Insight of the Week from Cara

Functional Balance

Some clients arrive to their session and exclaim that their balance is bad. To their surprise, I have questions back.

What about their balance?

When is it bad?

  • going to the toilet at night?
  • getting up from sitting?
  • walking?
  • turning?
  • reaching from something?
  • getting out of a car?

As you can see, there are many aspects of functional balance.

Balance Assessments

In the research and clinical world, there are many balance assessments. They involve a standard set of tasks which are timed or counted and scored. The score interpretation confirms good or bad balance.

However, we believe learning which practical aspects of balance work well and how those impact your day-to-day life is more informative than an assessment score.

Bridging® identifies the ‘why’ behind the poor balance.

As part of the Bridging® assessment looking at postural sway control, we also analyze why. What has happened in your life to impact the specific aspects of balance control?

Here are some typical events you minimize, but we find they impact your balance reactions.

  • Chest injuries from auto accidents or sporting impact.
  • Minimally invasive abdominal surgery for appendix, gallbladder, hernia, or hysterectomy.
  • Head injuries wearing a helmet. (The neck gets bounced around.)
  • Vision changes including cataract surgery, Lasik, and updated lens prescriptions.

All of the above impair the reactions between sections of the body needed for quick, accurate balance control. The more you have, the more likely your balance is affected.

How can you tell if something is off?

Wouldn’t it be great to know which aspects of your balance are good, and which need some attention?

I created a series of Functional Self-Assessment videos so you can get a sense of how you’re doing. There is an overview video, then the individual assessments. And, yes, Bridging® can help reset your balance reactions. See below for more details.

Functional Self-Assessment Videos

The Functional Self-Assessment video series allows you to get a sense of how you’re doing related to discrete aspects of functional balance and strength. In each video there is an explanation of why the skill is relevant. There will be five FREE self-assessments in the YouTube video series. The first is discussed in more depth below.

Each assessment is based upon a clinical assessment sub-test which has formal directions, measurement, and interpretation. The usage shown is consistent with, but not as detailed as the clinical assessment. You can use the results for your own insight.

How to use the videos?

Do each test, and periodically repeat. Just like measuring your weight or BP, you will have a record of your normal. You will be able to objectively tell when a change happens.


If you recently tripped and fell, you look fine, but feel unsteady. Having a baseline for comparison is helpful, so you can understand if balance reactions were impacted.

If your results indicate an area of concern, what next?

Depending upon your overall healthcare situation, you may want to ask your physician for a Physical Therapy evaluation and exercises. When balance exercises are impractical or ineffective, Bridging® can provide insights on ‘why’ your balance reactions are off, and address the cause.

Self-Assessment #1 The 30 Second Sit-Stand Test

Although the 30 Second Sit-Stand Assessment is often used related to leg strength, the task requires a significant amout of balance control.

Standing up and balance control?

When you stand-up you have to lean forward to generate the momentum to power upward. Once upright, you must stop the motion, or fall forward. There is a lot of balance involved!

What do the results tell me?

An active person should be able to sit-stand 16-20 times in 30 seconds. At a minimum, you want to be able to stand and sit 10-11 times. Follow the directions in the video to keep things safe.