Balance Exercises & Fall Prevention

by Brooke Iseler, PT, DPT

Did you know that ~37.3 million falls requiring medical attention occur each year? There are many factors that contribute to fall risk, one of which is physical health. This includes mobility, strength, and balance. All of which, can be improved with regular stretching and exercise.

One of the steps in reducing fall risk due to poor mobility, strength, and balance is performing basic lower extremity stretching and strengthening exercises. These will help to increase neuromuscular control and prevent future falls. Below are several stretches and exercises to get you started and allow you to self-assess your flexibility and balance. Safety is extremely important when performing exercises! Do not try advanced techniques until you are confident you have mastered lower level techniques!

If you feel you are at risk of falling or have had falls in the past, you may benefit from a formal assessment of your strength and balance. Please, schedule an appointment with us if you feel you need a more personal, individualized plan!

Hamstring Stretch

Sitting or standing at edge of bed, leg straight out in front of body, lean forward until stretch is felt in back of leg, rotate leg back and forth (like a windshield wiper), do this 20 times, then switch legs and repeat, perform 2-3 times on each leg. This will actively stretch your hamstring muscles. Do not progress to standing stretch until confident balance is adequate to maintain position without falling.

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Hip Flexor Stretch

With chair pushed up to wall or counter top, put foot onto edge of chair, drive hips forward and back, keeping arms straight the whole time, repeat 20 times, switch legs and repeat, perform 2-3 times on each leg. Put your hands up on wall or on counter top for balance. Progress to hands on knee as balance improves. This will help stretch the front of the hip and improve mobility and balance in lower extremities.

Standing at edge of counter top, reach foot out to the side and tap your toe, return to starting positioning, repeat 10-20 times, then switch sides. Perform 2-3 sets on each leg. Put hands on counter top for balance when beginning exercise, progress to hands overhead as balance improves. This exercise will help strengthen your legs and improve single leg balance.

Standing at edge of counter top, reach foot across your body and tap your toe, sticking your hip out to the side as you do so, return to starting position, repeat 10-20 times, then switch sides. Perform 2-3 sets on each leg. Put hands on counter top for balance when beginning exercise, progress to hands overhead as balance improves. This exercise will help improve hip mobility, strengthen your legs, and improve single leg balance.

Rehabilitating Shoulder Injuries

The shoulder is one of the most commonly injured areas of the body. Rotator cuff injuries, shoulder impingements, and adhesive capsulitis (frozen shoulder) are just a few of the many injuries that can occur at this complex joint. The shoulder joint consists of several bones, many muscles and their associated tendons, multiple ligaments, bursa, and a joint capsule. Injury to any one of these structures can cause significant pain and subsequent dysfunction of the shoulder. Over time, this can lead to chronic pain and limited use of the arm.

Whether you’ve had a shoulder injury in the past, or you’ve recently endured a shoulder injury, there are things you can do to help improve functioning of your arm and prevent permanent damage to the joint. It is very important to maintain the range of motion of the shoulder complex. This includes the shoulder joint and the shoulder blade. It is vital to include stretches and exercises that involve increasing the mobility and strength of the shoulder blade muscles, as well as the shoulder joint, to maximize function. The shoulder blade provides 1/3 of the total motion of the shoulder joint. Failure to address shoulder blade range of motion and strength can result in prolonged pain and activity limitations.

Listed below are several basic stretches and exercises to increase the range of motion and strength of the entire shoulder complex. If you are currently suffering from shoulder pain or dysfunction, come see a therapist at Functional Performance Center today (call us to schedule), for a full examination and personalized exercise program! Shoulder pain does not have to be permanent!

Forward Flexion with a Stick

Start with your thumb on the end of the stick, with the same foot forward. Shift your weight onto the front foot and use your bottom arm to push the forward arm up to your ear, keeping your elbow straight. Return to starting position, repeat 15-20 times, then switch sides. Perform 2-3 sets per side. This will help to improve shoulder mobility and shoulder blade rhythm.

Doorway Stretch

Standing in doorway, put arm on frame at shoulder height, with same foot forward. Shift weight forward, driving chest straight ahead, until you feel a stretch through the front of the shoulder and chest. Return to starting position, repeat 15-20 times, then switch to other side. Perform 2-3 sets per side. This will help to improve muscle length in the front of the arm and allow more mobility for the shoulder and shoulder blade.

Scapular Retraction with Resistance Band

Start with arm fully forward, with your thumb facing down and the opposite foot forward. Shift your weight back, pulling the band back to armpit, your thumb should end facing up. Return to starting position, repeat 15-20 times, then switch sides. Perform 2-3 sets per side. Make sure to let arm go fully forward and fully back to maximize benefits of exercise. This will help strengthen the shoulder and shoulder blade muscles.

Solving the Pain Puzzle

Where is the pain really coming from?

It can be very frustrating trying to figure out the cause of your back pain or knee pain or ankle pain when you are suffering from multiple different issues? So, you go see a foot doctor for your foot/ankle problem, then you see an orthopedic surgeon for your knee pain and then a back doctor for your low back issue. You often come away confused about which one of your problems is the root cause or if you have multiple causes. You get frustrated that all your doctors don’t seem to communicate or that nobody is actually helping YOU to solve YOUR pain puzzle.

Seeking medical opinions is always a good start and seeing specialists is a good way to get answers, but often times you need to see a physical therapist that can help you put YOUR body puzzle together. Most of the patients that we see have or have had multiple issues. An old ankle surgery from 10 years ago may not necessarily still be directly bothering you, but since then, you have had a knee surgery and now are suffering from recurring bouts of low back pain. So, perhaps the ankle range of motion is limited and is partially causing compensations to occur that are limiting how your leg muscles are working and you have functional weakness on that leg. That then leads to excessive forces to your pelvis and low back. As physical therapists, we will develop individualized exercise prescriptions that are unique to your complete functional situation.

Since we have the experience of dealing with a variety of patients with multiple issues, we consistently identify common trends in joint immobility and muscle weakness. So, we have listed a few lower body stretching and strengthening exercises that can be helpful in getting you functioning again. Please note that it is best to actually have a therapist evaluate you prior to starting them and get clearance from your physician. All exercises should be pain-free. Give FPC a call to see if we can help solve your “pain puzzle”!

Calf Stretch

Begin with most of your weight on the back leg with your foot facing the wall, heel on the ground and hands on the wall.

Step your front leg to the right (shifting your hips to the right), toe touching the ground.

Step your front leg to the left (shifting your hips to the left). Repeat 10-15 times and switch legs.

Hip Flexor Stretch

Begin standing in a wide stance with both feet facing the stable step that is approximately knee height (bathtubs work great).

Then, keeping a wide base, put one foot on the tub/step, still facing that foot forward.

Put you hands on the front knee and drive that knee forward, keeping the back knee straight, until you feel tightness in the front of the hip on that grounded leg. Hold 1-2 seconds and return to the starting position. Repeat 10-15 times, then switch legs.

Single-Leg Mini-Squat Strengthening

Begin standing on one leg and resting your hands on a counter-top, or something stable.

Bend into a shallow single-leg knee bend (pain-free). Repeat 10-20 times, adjusting the pressure with your hands on the counter, then switch to the other leg.

If you have advanced strength, move away from using your hands on the counter for support.

Perform the single leg squat into a deeper angle and progress to reaching your hands to the floor, and then potentially using hand weights. It’s OK to tap your opposite toe on the ground to help with your balance.

Movement Screen (Movement Physical Exam)

Three Dimensional Movement Analysis and Performance System (3DMAPS)

Most people are familiar with, and consult their physician for a yearly physical. These physicals performed by physicians, PA’s, or nurse practitioners will often be preformed in the absence of the patient being sick or injured. They will often yield results that help to direct the patient’s health and well-being. As physical therapists, we are highly trained to perform movement screens or a “movement physical exam”. This helps us obtain information about a patient’s functional imbalances, as well as, serve as a foundation of revealing where a patient’s successful movement patterns already exist.

The Screen

3DMAPS (Three Dimensional Movement Analysis and Performance System), established by the Gray Institute, is an innovative, effective, and comprehensive approach that enables the therapist to gain invaluable information on a patient’s ability to move or where they are most limited. Our bodies function as a complex interaction of multiple joints, bones, and muscles moving in multiple planes of motion. This movement screen gives the therapist the data/information needed to advise the patient on the specific body regions that need attention. The movement screen will help show specific limitations in the hips, ankles, spine, or shoulder blades that can often lead to overuse injuries in golfers, runners, or fitness enthusiasts. Once these successful and problem areas are identified, an individual exercise prescription will be provided. The therapist will use this data, in conjunction with the person’s past medical history and specific goals, to provide a road map to success. These prescribed exercises can also help prevent issues like patella tendinitis, low back pain, hip pain, Achilles tendinitis, shoulder pain/impingement, etc.

Call FPC

All three of the physical therapists here at the Functional Performance Center (FPC) are certified through the Gray Institute, in 3DMAPS. Give us a call now to schedule your movement screen (movement physical exam). You will benefit from this screen, even if you are not currently having any problems.