Balance

Embracing the Gray Area

Many of us want a definitive answer. We feel there is some “correct” answer to every question. We are either doing things right, or wrong. Considering the gray area can help us change our thinking into more of a spectrum, recognizing there is rarely a right and a wrong, but rather a multitude of options. Some of these options may be better for us at that moment, and some not so much.

This way of thinking might stem from our educational system. We all might remember a time where we raised our hand in class, and were embarrassed that we gave the “wrong” answer. Perhaps we stopped raising our hands so much after this. Or, perhaps we still remember the sinking feeling in our stomach when getting a test back and seeing the red X’s by some of our answers.

Binary thinking gets buried deep into us. And it shows up in how we move, exercise, care for our bodies, and respond to pain and injuries. If we are more concerned about whether we are doing something right or wrong, it blocks our ability to explore, experience, and learn.

Think about a well-known exercise, like a squat. Is there a part of you that feels like there is a “correct” and an “incorrect” way to do a squat? Say someone was taught that the correct way to do a squat was to have the heels 12 inches apart, toes turned out to 30 degrees, to sit down until the bottom is the same height as the knees while keeping the chest pointing forward, and then stand back up. If this person internalizes these instructions as the correct way, any variation from this will be perceived as “wrong”.

What about the variability in anatomy? Everyone has different angles at which their hips naturally turn out or in, which will certainly impact how one might place their feet on the ground while squatting. There are also countless variations in types of squats, and none of them are correct or incorrect! Narrow squats, wide legged squats, single leg squats, sissy squats, goblet squats, front squats, back squats, plié squats, kitchen sink squats… to name a few! There is no right or wrong, only options.

If someone is dealing with pain or an injury, it is far more important for them to listen to their own sensations than someone else telling them how they are supposed to do something. Many people with knee pain say “they cannot squat”, and therefore avoid any type of squatting. This can weaken the body and greatly impact mobility. If instead this person were able to modify the squatting pattern in a way that worked for them, they could gradually improve their squatting and end the cycle of avoidance.

By limiting our construct to a correct and incorrect way to squat, we are denying ourselves the ability to explore variations, as well as to respect that our bodies are all different. What is an efficient squat for one person may be an inefficient pattern for someone else, which could set them up for injury or impair their performance.

A great first step to comfortable squatting is the kitchen sink squat: hold on to the kitchen sink or a counter, and slowly sit the bottom back, as if sitting into a chair. Allow chest to lean forward a bit. Choose how low to go down based on your own ability and comfort. Stand back up by driving hips forward and up towards the counter. Repeat as desired.

At the Wellness Station, we are sure to stay far away from using words like right, wrong, correct, and incorrect. Instead, we teach people to match the intention with the action. In other words, we provide an intention (such as the instructions above), and teach people tools to monitor their own actions while moving. That way, the individual can observe whether their action matches their intention, and make adjustments as necessary.

We aim to empower our clientele by providing movement options, which help people become aware of variables that are in the individual’s control. The variables for a squat might include the following: distance between feet, turn out angle of the toes on each foot, depth of the squat, time taken to go down and to come back up, pauses and rests in between repetitions or sets, pauses within a repetition, reversals (changing direction of the movement), alignment/angles of ankles, knees, hips, and trunk, and much more.

Stay posted for our next blog, in which we will provide video examples exploring three-dimensional variations of squats.

It can feel easy and simple to learn a correct and incorrect way to do something. However, thinking in this way is extremely biased, and takes away one’s agency and ability to trust in one’s own experience. By embracing the gray area, we can open our minds and our bodies to a depth of possibilities.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Balance Part II: Strategies for Improvement

Last month, we discussed factors that control and impact our balance. Consideration of these factors can help us become more aware of what to do to stay safe and prevent falls, as well as targeted exercises to improve our balance that are based on scientific principles.

How do we improve our balance and prevent falling?

If we recognize the influence that the physiological, psychological, and environmental factors have on our balance, we can be strategic in how we improve our balance and decrease our risk of falling.

  • Stay active, making sure you are keeping your muscles strong and healthy for life. Have a movement practice that incorporates functional strengthening and balance challenges.

  • Enhance your somatosensory system by regularly stimulating your feet. Think of your feet like antennas that provide messages to your brain about your balance. Massaging your feet with balance pods are a great way to keep the nerve endings responsive. 

    Consider more time spent barefoot, especially during balance exercises. This will allow your feet to feel the ground and your toes to spread out, creating wider points of contact with the ground. In daily life, consider shoes with a thinner, more flexible sole, and a wide toe box.

  • Ensure you are taking care of your eyes and vision by regularly visiting an ophthalmologist. Make sure you use a nightlight when going to the bathroom at night, and remove any trip hazards from your path.

You could also consider the role of vision to challenge your balance during exercises. Notice that keeping your gaze stable on an object in front of you helps your balance. Moving your eyes around will make balance more challenging. Closing your eyes will make it the most challenging!

Recall in Balance Part I, we discussed how being overly reliant on vision can contribute to a stooped posture, as many people will look down to the ground with their whole body rather than just with their eyes. When walking, practice looking down with just your eyeballs as needed to see the ground in front of you, rather than with your whole self. If you had a light shining from the tip of your nose, and a light from your chest bone, you should be able to maintain these lights at the level of the horizon while walking, rather than keeping the lights cast downwards. 

  • Make sure your vestibular system is healthy, and recognize the impact that vertigo, seasickness, and certain medications can have on your balance.

Likewise, you can progress your balance exercises by introducing changes in your vestibular system. If standing on one leg has become easy, can you do it while slowly turning your head from side to side, or up and down? 

  • Optimize your environment: Make sure your environment is conducive to not falling! If icy sidewalks, crowds, or uneven trails are not for you, make sure you modify appropriately, perhaps bringing an assistive device or a loved one to help you stay steady.

You can also use the environment to improve your balance, by intentionally walking on trails and standing on uneven or “squishy” surfaces.

  • Train your balance… but don’t overshoot it! A mistake many people make while training their balance is going past their edge. If standing on one leg consistently leads to excessive wiggles, wobbles, and you are unable to find your steadiness, then you are simply practicing being unsteady, rather than practicing finding steadiness. You want to be close to your edge, without going over it!

Find an exercise that feels moderately challenging, but you are able to find steadiness and ease with practice. If not, modify the activity to make it more or less challenging. Standing at the kitchen sink, by the counter, in the corner of a room, or in a door frame are excellent places to practice balance, as you have the option of supporting yourself with your arms as needed. 

By finding this edge and achieving success with practice, not only can we improve the physiological components of balance, but we can also improve the confidence we have in ourselves, thereby decreasing our fear of falling and subsequent risk of actually falling!

Follow along with this video, which incorporates seven balance exercises and strategies, “Feldenkrais style”! It instructs in balance challenges including standing and walking with a narrow base of support, closing the eyes, getting up and down from the floor, dynamic weight shifting, and practice with “falling”. Best to do this video near something to hold on to as needed. 

At the Wellness Station, we can help you recognize and make changes in the factors that could be impacting your balance. We will provide you with individualized recommendations and movement lessons to help you improve your balance, your confidence in yourself, and your ability to continue to do what you love.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Balance Part I: The Science Behind our Steadiness

A keen sense of balance is crucial for a full and healthy life. Our balance tends to decline as we age, but we can prevent this decline and even improve our balance over time if we equip ourselves with knowledge and targeted exercises. 

Many people don’t realize that their balance has gotten significantly worse until they are put into a situation that reveals it. Older individuals may realize they are no longer able to get up and down from the floor, especially if they have nothing to hold on to. Or perhaps standing on one leg is no longer an option. Maybe we have become a “furniture walker”, always looking for the next piece of furniture to touch as we walk around. As balance declines, one’s life can get smaller and smaller, as fear of falling begins to impact decision making.

What controls our balance?

Our balance is an extremely complex interaction between many physiological, psychological, and environmental factors. 

  • Physiologically speaking, balance depends on the strength and responsiveness of our neuromuscular system. How quickly, and with how much force are we able to respond to perturbations? Do we have the strength in our legs to balance on one of them, or the reaction time to catch ourselves if we fall?

  • Balance also depends on our somatosensory system, which are sensations that we receive and process from our skin, muscles, and joints. The ability to feel our feet on the ground, as well as the sense of proprioception (sensing the position of our joints in space) help us to stay balanced. This is why individuals with peripheral neuropathy (loss of sensation particularly in feet) have great challenges with their balance, because they can’t feel their feet too well. 

  • Our vestibular system also controls our balance. This is the system in our inner ear that provides information to our brain regarding head position, motion, and orientation in space. We all know the feeling of being dizzy, perhaps due to a medication that affects the vestibular system, an amusement park ride that tosses your head around, or seasickness. When the vestibular system is impaired, balance is impaired.

  • Vision is a prime component of our balance system. This is why it is harder to balance in the dark, or with your eyes closed! However, some people become overly reliant on their vision for balance, and find themselves looking at the ground when they walk, as opposed to appropriately integrating information from the other systems. This is related to posture, as many people will adopt a stooped posture over time if frequently looking at the ground to maintain balance. Training your posture and training your balance can go hand in hand!

  • Psychological factors also greatly impact our balance. Of course, if we are feeling crummy, or perhaps are not well-rested, our balance will be worse. More significantly is the confidence we have in our balance. Any athlete will recognize the negative impact of anxiety/nervousness on performance, particularly in sports that require a keen sense of balance (e.g. gymnastics). Lacking confidence and having a fear of falling is actually the most significant predictor of a fall! Studies have shown that those with a fear of falling have more than twice the risk of falling than those who do not have this fear. With this fear comes diminished activity overtime. With diminished activity, a downwards spiral is set in motion that will negatively impact the functioning of all body systems.

  • Environmental factors also impact balance. What environment are we in, and how are we relative to our environment? Our base of support, and how we are able to keep our center of gravity balanced over our base of support will determine our stability (e.g. standing with your feet wide apart is far more balanced than standing on a tightrope).

    The ground we are on will impact the position of our joints and contribute to perturbations that could throw us off center (e.g. sinking into the sand, walking on uneven rocks and roots, slippery ice, etc.) Additionally, disturbances from our environment (e.g. crowds with people rushing past you and bumping into you, high winds, loud noises) can create disorientation and perturbations that can throw us off center. In general, the less familiar we are with the territory in which we are engaging with, the worse our balance

At the Wellness Station, we can help you recognize and make changes in the factors that could be impacting your balance. We will provide you with individualized recommendations and movement lessons to help you improve your balance, your confidence in yourself, and your ability to continue to do what you love. 

See Part II next month for specific strategies to improve your balance over time.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:

  1. https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-022-03018-2#:~:text=Supporting%20this%20research%2C%20FoF%20is,those%20without%20FoF%20%5B6%5D

Images:

  1. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.vecteezy.com%2Fvideo%2F17553944-animated-strength-training-program-building-muscle-full-body-flat-person-on-white-background-with-alpha-channel-transparency-colorful-cartoon-style-4k-video-footage-of-character-for-animation&psig=AOvVaw2uqpDfUHBMFBkIQ4PKB0BR&ust=1687708894348000&source=images&cd=vfe&ved=0CBAQjRxqFwoTCMCvo9uj3P8CFQAAAAAdAAAAABAJ

  2. https://www.google.com/url?sa=i&url=https%3A%2F%2Fankorpilates.com%2Fwhy-are-your-feet-are-important-in-movement%2F&psig=AOvVaw0jamvwH_vA57wplaDnXLRL&ust=1687708834693000&source=images&cd=vfe&ved=0CBAQjRxqFwoTCLDn976j3P8CFQAAAAAdAAAAABAK

  3. https://premierneurologycenter.com/wp-content/uploads/sites/436/2021/11/shutterstock_2030974061-min-1024x784.jpg.optimal.jpg

  4. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.behance.net%2Fgallery%2F31077731%2FFIELD-OF-VISION-Animation&psig=AOvVaw1lU0R4-RZNel4eGhj1b5EK&ust=1687708970802000&source=images&cd=vfe&ved=0CBAQjRxqFwoTCLjwu_-j3P8CFQAAAAAdAAAAABAE

  5. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.pngwing.com%2Fen%2Ffree-png-muppf&psig=AOvVaw32JCXn74IG9G-4YIiLasLW&ust=1687709020307000&source=images&cd=vfe&ved=0CBAQjRxqFwoTCPChlZek3P8CFQAAAAAdAAAAABAE

  6. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.mtbproject.com%2Fphoto%2F3764918%2Fthe-ultimate-rocks-and-roots-trail&psig=AOvVaw3DuNVVu8W3HBbtlKEfFwV3&ust=1687709068276000&source=images&cd=vfe&ved=0CBAQjRxqFwoTCKDhia6k3P8CFQAAAAAdAAAAABAw

  7. https://www.google.com/url?sa=i&url=https%3A%2F%2Fhealth.clevelandclinic.org%2Fwork-life-balance%2F&psig=AOvVaw183XchyKfQMFvvdcX81Erq&ust=1687709187802000&source=images&cd=vfe&ved=0CBAQjRxqFwoTCIj0geek3P8CFQAAAAAdAAAAABAI

  8. https://cdn.w600.comps.canstockphoto.com/walking-off-cliff-eps-vectors_csp19293038.jpg

  9. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.shutterstock.com%2Fsearch%2Fbalance-exercise-cartoon&psig=AOvVaw0bSfZJyOS8lVuP4o9emqg5&ust=1687709566883000&source=images&cd=vfe&ved=0CBAQjRxqFwoTCJCCiZym3P8CFQAAAAAdAAAAABAE 

Chaos Vs. Rigidity: Finding Your Balance

All of us live our lives on a spectrum between chaos and rigidity. Some of us tend to live more in a state of chaos and constant change, while others tend to live with more rigidity and stagnation. If our life is overly chaotic, we may live in a constant state of fear, anxiety, hyperactivity, and reactivity. On the other hand, if we are too far on the rigid end of the spectrum, we may become inflexible, resistant to helpful changes, and even close-minded. We might have certain contexts within our lives that are towards one extreme or the other- chaos in our work life, rigidity in our home life, or vice versa. Perhaps we subconsciously bring structure and rigidity into one aspect of our lives, such as our fitness routine, in order to balance the chaos and unpredictability within other aspects of our life. 

Daniel Siegel, M.D., described this spectrum in his book Whole-Brain Child. Because living on either end of the spectrum can be problematic, it is important to find integration, or a harmonious place somewhere in between rigidity and chaos. This finding of balance can be described by considering floating down a river in a canoe. On one side of the river, there is no flow, only still stagnant water. This side represents rigidity- it is safe and predictable, but unfulfilling and devoid of energy. On the other side is white rapids, rocks, and dangerous currents. This side represents chaos, overwhelm, constant change and even danger. In this extreme, we can lose our footing and get lost without any sense of control. A good place to be is the center of the river. This area is a system that has flow and energy, while still allowing us to maintain a sense of control. This allows us to explore, experience new things, learn and grow. How can we find this in our lives?

It is important for anyone to practice self-study, which in yogic philosophy is known as “svadhyaya” (sva meaning “own” or “self”, adhyaya meaning “lesson” or “study”). Can you feel when you are moving more towards a state of chaos, or stagnating into rigidity and mindless repetition? Our emotional state can be an excellent barometer of where we are at. In the middle of the two extremes we find a state of flow, in which we experience the most joy, discovery, and creativity. We should all seek to build a resilient self in which we are strong and stable, but also adaptable, flexible, and open to positive change. 

Our self-care and movement practices are excellent strategies to direct ourselves towards this state of balance. The low hanging fruit is… are we taking care of ourselves? Are we sufficient in sleep, nutrition, hydration, movement, relaxation, and social connection? What are we doing a little too much of, and what are we doing not enough of? Within the context of our movement practice, we can find even greater finesse.

Consider the following: 

During many functional movements, we have to find a balance between mobility and stability, which can be likened to chaos and rigidity, respectively. Our hips are essential for providing mobility (ability to move in all directions) and also stability (ability to maintain or control joint position). If our hip has too much mobility and not enough stability, our movement would be out of control (chaos). If we have too much stability and not enough mobility, our movement would be stiff and inefficient (rigidity). The middle of the river is an excellent place to be, which allows us to move with both fluidity and strength. 

Consider the examples of unilateral movements in our previous blog. The single leg stand to reverse lunge is an example of how the weight-bearing leg must stabilize, but also allow for controlled movement to occur. A similar phenomenon happens every time we walk, go up stairs, and even kick a ball. Our weight-bearing leg must provide stability so we do not fall or strain our tissues, while also allowing our pelvis to move relative to our thigh bone, so we can move and participate in life. Consider this “movement snack”. Can you feel how the weight-bearing leg is controlling the movement with a balance between mobility and stability? When the stabilizing leg is well organized for mobility, that is referred to as skilled movement, and is a necessary component for moving with efficiency and ease. 

At the Wellness Station, we will help you become more in tune with your natural rhythms, and provide opportunities to help you find your balance between chaos and rigidity. 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Finding Peace & Balance

Last month, we discussed how “overdoing it” is done far too often at the expense of our mental and physical health.

How can we counteract the tendency to overdo in order to find more peace and balance in our lives?

Can we do this while still getting done what we need to do each day, as well as working towards our greater goals? 

Besides completely changing the values of our culture, we can make micro adjustments in our daily lives. One option is re-prioritizing. How can we fill up our kettle so we start each day at 100%? Think about the sources in your life that are draining your kettle, and the sources that are replenishing you. Are there certain people or activities that may be draining your energy, and is there a way to spend less of your time and your energy in these situations? How about activities or people that recharge you? Laughing with loved ones, taking a warm bubble bath, going for a walk in nature, delicious healthy foods…

On a neurological level, activities that are taxing and draining will be fueled by the sympathetic nervous system (e.g. fight or flight), in which our heart rate increases, stress hormones such as cortisol and adrenaline flood our system, and physical and cognitive resources are expended. On the other hand, restorative activities allow the parasympathetic nervous system to take over, which slows the heart rate through chemicals such as acetylcholine, promotes feelings of well-being, and replenishes our resources. We must find a balance between both of these states of our nervous system in order to achieve our goals without burning out. Think about what you might re-prioritize in your life that may help shift the balance towards parasympathetic activation.

Another option other than re-organizing your daily activities is to consider the overall intensity that you put into each activity. Is there a way to embody a sense of calm and ease while you are doing something that you normally consider stressful and draining? We have it drilled into our heads that we should give 110% to everything, which from an energetic balance standpoint is actually impossible! How can we be more easy in our bodies and minds so we don’t drain our physical and cognitive resources as quickly?

Think about an activity that is taxing, either physically, mentally, or both. How about doing chores, such as washing dishes? Are you rushing, gripping objects too hard, and holding extra tension in your body such as hiking your shoulders up to your ears? See if you are able to wash dishes with less effort, more ease, and overall less intensity. You might find it to be a more enjoyable experience.

Next time that you notice you are feeling anxious, rushed, or uncomfortable, think about “resetting” by taking three long, slow breaths, trying to focus entirely on these breaths and nothing else. Then continue on, perhaps noticing that a subtle shift has occurred in your experience. If we are able to drain less tea from our kettle with everything we do, we will never approach a low kettle. The more we can slow down and be more mindful about what we are doing, the more we will be able to do over the long term. This will allow us to perform better in our daily lives and be more present for our loved ones.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team