Friday, 30 November 2012

Balance in the Elderly


Following on from my last blog, in which I discussed the importance of ankle rehabilitation and stability, here I will discuss how important ankle stability is with regards to balance in elderly people. As we age, we tend to move less and less, resulting in our joints and muscles stiffening up, which in turn results in less movement again. This vicious cycle continues until we are barely able to move which in turn affects our ability to perform activities of daily living.

When you see an elderly person, the first thing you notice is the typical stooped posture and shuffled walking pattern, both of which are major contributing factors to the high prevalence of falls in the elderly. I will discuss posture in the elderly in the next blog.

Limited ankle stability and mobility are also major contributing factors to loss of balance and thus falls in the elderly. Hence, I again stress the importance of rehabilitating the ankle following an injury, so that movement and strength of the joint are regained as soon as possible. The longer it is left, the worse it will become.

A common movement that becomes limited is lifting of the toes to allow for a heel strike. The ankle mobility required for this movement is reduced and the muscle in front of the shin becomes weak. The consequence of this is that the toes drag along the floor, hooking on uneven surfaces and thus causing a person to trip and fall. A good exercise to prevent this: sit in front of the TV and tap your toes, making sure to lift them as high off the ground as possible, while keeping the heels down. A simple and highly effective exercise!

Another exercise that will help maintain the mobility of the ankle joint is to write the letters of the alphabet using the ankle, so that it is moving in every direction. Again, this can be done while sitting in front of the TV, but be sure to concentrate on moving the ankles through their full range of motion!

The calves are another muscle group that need to be kept strong in order to assist with walking. While standing in the kitchen waiting for the kettle to boil, hold onto the counter and rise up onto the toes and then lower. Repeat this at least 10 times, 3 times a day.

The next group of muscles to target are the hip flexors – the muscles allow you to lift your knees up. These need to be strong so that you can lift your leg up off the ground to achieve a heel strike. To strengthen these, simply march on the spot, again holding onto the counter while waiting for the kettle to boil.

Finally, balance is required to walk, thus it is vital to practice balancing on one leg so that the ankles stay accustomed to it. Again, while standing at the kitchen counter, stand on one leg, keeping your hands near the counter to catch you if necessary – safety first, as you do not want to fall!



Remember: when you walk, you need to lift your knees to pick your feet up off the ground, strike the ground with your heel and then push off with your toes. Watch where you walk, and if the surface is uneven, exaggerate the movements so that you don’t trip!

If you are struggling with walking and balance, consult a Biokineticist, as it is essential to keep moving as much as possible as you age!

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