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Balance & Fall Prevention: How We Helped Susan Improve Her Balance & Mobility

If you’ve been following our balance/falls and osteoporosis series over the last 5 weeks, hopefully you have been trying to tie all the information together. However, I know it can be difficult so my goal for today’s article to help guide you! And I think the best way to go about it is sharing a story from a patient we’ve recently seen in the clinic; I’ll refer to the patient as Susan. We will be discussing how we assessed Susan’s 3 balance systems, factors that contributed to her balance, and what information we used to design a successful treatment plan for her.

As a quick summary of Susan’s story, she initially came into the clinic after a fall that occurred 6 months ago while walking to her car in a gravel parking lot. She ended up with a couple bumps and bruises, but otherwise was uninjured. However, over the next several months, she became more and more worried about having another fall, so she started limiting her activity level, and she specifically avoided things like walking on uneven surfaces (since walking on the gravel was part of why she fell). So, she decided to come in for physical therapy because she had been feeling even more unsteady on her feet, and she had several near falls where she had to catch herself on a piece of furniture or a wall inside her home. (Side note; if you’ve had a few falls where you caught yourself or just a few bumps and bruises you may not realize what weaknesses may be contributing to these little mishaps! Hopefully this story will make you think about what might be contributing to your lack of steadiness.)

After talking with Susan and assessing her various balance systems, her PT came up with some key findings. With special balance testing we found she lost her balance quickly when she closes her eyes, especially when standing on a foam balance pad (unstable surface). This indicated weakness in her inner ear (vestibular system). She also had limited strength in her ankles, hips, and core.  This is important because when you don’t have adequate strength in your hips, ankles, or core you can’t react as quickly when you lose your balance. As a result, you may start dragging a foot as you walk or even start shuffling (not picking your foot completely up off the ground).

She had normal sensation with no signs of neuropathy and no signs of vertigo (which we touched on a couple weeks ago!). Susan also had a sore left hip, which makes it hard to put weight on her left leg at times which caused her to shift her weight towards her right side when standing and walking. As you may have noticed by now, there were several factors contributing to Susan’s poor balance including: inner ear weakness, limited strength, altered walking (due to fear) and left hip pain. To design a successful treatment approach for Susan, it’s important all of these impairments are addressed (likely not all at once though!). And here’s what a successful treatment plan looked like;

  1. Balance exercises in the clinic to improve her inner ear function.
  2. Specific strengthening exercises for her ankles, hips, and core.
  3. Hands-on treatment of her hip pain, as well as specific stretches.
  4. Gait training (working on walking mechanics with feedback from therapists).

And the result? 6 weeks later, Susan made improvements in all areas.

Her performance with balance testing was significantly better as she was able to maintain all testing positions for up to 30 seconds without losing her balance. She also improved her walking mechanics to be able to take longer steps and without looking at the ground. And since her hip stopped bothering her, she was able to put equal weight on both legs, which also improved her balance. (Plus, if you don’t put equal weight on each leg you can end up with another problem like knee pain, back pain etc.). And most importantly: Susan has regained her confidence and is no longer afraid that she’s going to fall when doing her daily activities. She’s back to taking long walks with her friends, even if there are hills and uneven terrain at times. She knows that she’ll have to keep working hard to keep herself in top shape, but she has all the tools she needs to keep her balance sharp and her muscles strong.

I hope Susan’s story helps you understand 2 things. First, if you’re worried about your balance, you’re not alone. And second, it’s very likely that you don’t have to just put up with it. With the right treatment approach, it’s very likely that you can make significant improvements to your balance and get back to enjoying those activities you thought you had to give up.

 If you have any questions about balance and falls, you can call (360) 456-1444 or by email at info@penrosept.com.

AUTHOR

Jennifer Penrose

Penrose Physical Therapy

"Leading Experts Helping People Become More Active and Mobile, Reduce Stress and Achieve Longevity… So They Can Enjoy Great Health For Years to Come!"
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