Getting Life Back in Balance – Literally

Quite a few people will make comments similar to; “Oh I’ve never had good balance.” Or they say, “I get dizzy, but it goes away eventually. There’s nothing to be done for it."

Kaitlin Eichman, Physical Therapist with Aspirus Therapy and Fitness- Medford, is able to address these statements. She discusses the 3 main systems that affect one’s balance/vestibular well-being, as well as the different services offered at Aspirus and what might be available within your community that are beneficial for your balance, as well as overall wellness.
Getting Life Back in Balance – Literally
Featured Speaker:
Kaitlin Eichman, PT, DPT
A Physical Therapist since 2011, Kaitlin Eichman, PT has experience treating patients with a wide variety of often very complex medical needs. She finds joy in helping people improve their physical skills and return to the activities they love following illness, injury, or surgery.  While getting her undergrad, Kaitlin spent a semester studying abroad in Spain and has basic proficiency in Spanish.   She was born in Alaska, but raised in northern Wisconsin. An outgoing home-body, Kaitlin enjoys the outdoors through gardening, camping, hiking, Nordic skiing and raising chickens. Kaitlin and her husband also have a lively bird-dog that keeps them busy.
Transcription:
Getting Life Back in Balance – Literally

Melanie Cole (Host): Each year, more than one-third of people aged 65 or older can have a fall. Fall and fall related injuries such as a hip fracture can have serious impact on an older person’s life. My guest today is Kaitlin Eichman. She’s a physical therapist at Aspirus Therapy and Fitness Medford. Welcome to the show, Kaitlin. So, let’s start with fall prevention and the importance of balance training. People had never heard much about balance training or functional fitness until very recently. Tell us what it is.

Kaitlin Eichman (Guest): Yes. Well, thank you for having me. It’s a pleasure to be here today. Balance training incorporates the three main systems that are used for the balance in our bodies. So, it can be anywhere from—a lot of people come in and say to me, “I've always had terrible balance, and it’s always been that way.” And, I really, strongly encourage them that, well, it doesn’t have to be that way. There are a lot of things that you can incorporate in your daily routine to make life a lot easier and make you feel a lot steadier on your feet. And then, the great thing about physical therapy is, we can do a full, comprehensive evaluation to try to figure out which system needs to be fine-tuned a little bit for you, and what is specific individualized program that we can make for you to help improve that system that might not be functioning as well as you want it to be, and then you feel the effects of being off-balance throughout your day.

Melanie: People hear that word “proprioception”. They don’t know what it means but they do know that there is that connection between what goes on in your brain, in your head, and what your feet are actually doing. How do you, as a physical therapist, explain to people or teach them how to put that all together.

Kaitlin: Well, the proprioception system has lot to do with the response of your muscles and how they respond to different surfaces, different environmental changes, and stuff like that. So, I explain to people that you have this loop between the muscle in your legs, in your feet, from your hip down to your ankles up to your brain, and when you encounter different surfaces and different angles, that loop is then sending those responses up to your brain to help your body adapt to different changes of center of gravity, and different changes of angles at your joints in your leg to help you stay upright rather than tipping over. So, that proprioception is that loop of signals from your muscles up to your brain to let you know how and where you are moving in space.

Melanie: So, then, how can we teach balance to people whether they’re seniors or not--and it’s important for people who are not necessarily in the senior community to learn good balance as well. So, Kaitlin, give us some exercises that people can take home with them today, and try and start to work on their balance.

Kaitlin: Sure. One of the ones that I really encourage people to try and I also practice myself, is incorporating the different base of support sizes. Meaning, most of us stand with our feet about a hip width apart, so that’s a comfortable safe place, sometimes even wider if you feel like you’re a little more off-balance so you have more space between both feet to make you feel more stable. So, something I will challenge patients to do is when you’re in a safe place at home such as near a counter where you can put a hand for support, in a corner so that you have the walls on either side of you or next to another stable surface that you can use for safety, is to narrow your base of support. So, bring your feet as close as you can touching together. You can also stagger your feet. You can take half step forward with your right foot or your left foot, and then you have a more narrow base of support. And, then, you can also progress to standing on one leg; again, in a safe place so if you do feel like you might lose your balance, you can use your arm or hand or that sensation from the wall to help keep you upright. And hold that for anywhere from 15 to 30 seconds, and you can gradually progress it and time yourself to see if you can hold a little bit longer.

Melanie: Does the body remember?

Kaitlin: It does. Balance is--one of the key things about that is if you don’t use it, you genuinely lose it. And, balance exercise is that such the body responds very well to balance training and balance exercises at any age. Unfortunately, as we do age a little bit, that proprioceptive link that I spoke to tends to slow down a little bit so you don’t get those signals as quickly replayed. And, so, it does benefit all ages to practice balance, but specifically as you get above that 60 years or older, then you get a little bit of that delay. So, to train the body to continue to listen to these signals and to improve the ability to respond is an important health and safety issue.

Melanie: So, give us a few more exercises, Kaitlin.

Kaitlin: To build off of the base of support then, what I encourage people to do is then to incorporate the other systems of your balance, the one big one being your vision. Sometimes, when I have people in these base of support challenges, wide or narrow; then you can add in closing your eyes, you can add in keeping your eyes open but turning your head side to side slowly within a safe range if you have any neck issues, or nodding your head up and down. Those seem kind of silly but we actually really use those in a functional capacity. You have to scan the shelves at the store, you have to turn your head when you’re driving or walking in the community to check for your surroundings, looking up and down when you’re looking up into the cabinets for something at home. That can really throw a person’s balance if it’s not something they’re used to doing. So, adding the visual challenge to the base of support challenge will incorporate two of your systems as well, if not three, because you get a little bit of that inner ear system as well when you’re moving your head.

Melanie: And, you spoke before about in the proprioceptive area about the different surfaces. People tend to worry as they get older about stepping off of curbs and stepping on that last stair. For a minute there, you lose that sense that you’re stepping on that last stair and that’s where they sometimes trip. What do you tell people about training for those changes in gradual progression on the ground, and the changes of levels?

Kaitlin: A good exercise for that is to work on that single leg stance that I spoke to earlier because that’s part of what’s scary about going up and down the stairs is for that split second you’re just on that one leg as you’re moving the other leg. So, to do that single leg stance is a great exercise; to do a marching exercise, a slow marching is also important because you have to shift your weight from side to side and hold that one left in the air like you would if you were raising it onto a step. If a person does have a staircase at home with a safe setup with a railing for the use of the arms for stability, it’s not a bad idea to practice stepping up and down a couple times in a row--five times on the left leg, five times on the right leg, to work on building up that security and stability with stepping up and down.

Melanie: So, wrap it up for us, Kaitlin, and give your best advice for balance training, the importance of it to help prevent falls, and what you really want people to know.

Kaitlin: What I really like people to take away is that it doesn't have to be a case of, “I've always had bad balance, there’s nothing to be done about it.” It’s a mindset that I wish could be done away with. There’s actually quite a bit to be done. I strongly encourage people, if you are worried about your balance, to go in for a comprehensive evaluation. Speak with your primary care provider, see someone like a physical therapist or an exercise specialist to help you develop an individualized program to your needs. But, you could try some of those basic exercises that I shared with you, and incorporate that couple times a week, initially, and I think people will be surprised at how your body does respond to that balance training, and how that carries over into multiple parts of your day feeling more secure just moving about your daily activities.

Melanie: Thank you so much for being with us, today. You’re listening to Aspirus Health Talk. For more information, you can go to www.aspirus.org. That’s www.aspirus.org. This is Melanie Cole. Thanks so much for listening.