Improve your balance by strengthening your core

Your abdominal, back, and hip muscles can help you avoid falls.

Are you walking a bit more carefully lately, or feeling unsteady on your feet?  You may be struggling with a balance problem. That puts you at risk for falls, one of the top causes of injury among older adults. But strengthening your core muscles-in your abdomen, back, and hips – can help. “Core strength is intimately related to balance, because you need good stability at your core to have safe and effective movement at the hip, knee, and ankle,” says Kailin Collins, a physical therapist at Harvard-affiliated Massachusetts General Hospital.

The Core muscles

You can think of the core as your foundation. It’s made up of several muscle groups: The rectus abdominis (“abs”) at the front of your abdomen; the internal and external obliques, in the front and side of the abdomen; the tranversus muscles that run horizontally across your lower abdomen; the erector spinae, the large muscles on either side of your spinal cord; the muscles surrounding your scapulae (shoulder blades); the gluteus muscles in your hips and the buttocks; and the iliopsoas and quadrates lumborum muscles in your pelvis.

            These muscles provide stability to your trunk. They link your upper and lower body and enable you to move in any direction or stand in one spot without losing your balance. “If your core isn’t strong or stable, it will be impossible for the arms and the legs to move well,” says Collins. A weak core can undermine the motions that are part of your everyday life, such as walking bending, turning, dressing, and bathing, let alone the larger movements of sports activities.

Strengthening

Core strengthening is a popular trend in health clubs because of the many benefits that result. In addition to stabilizing your balance, a strong core improves your posture; reduces stress and pain in your lower back; and improves athletic performance, such as swinging a golf club. Strengthening usually includes strenuous exercises such as planks, sit-ups, push-ups, and crunches. Equipment such as balance boards, stability balls, and Bosu balls may also be used.

            For older adults, that type of activity can be dangerous, especially if your balance is unstable. But core strengthening can be as simple as small, repetitive movements, such as front and side standing leg lifts to strengthen your absl, shoulder blade squeezes to strengthen your scapulae, and a pelvic tilt to strengthen your abs. In that exercise, you lie on the floor with your knees bent and then gently roll your pelvis into the air.

Where to start

If you’re feeling unstable, you’ll need to see a doctor before beginning an exercise routine. Instability may be related to problems with your inner ear organs, vision, muscles, or joints. They all send signals to the brain, which processes the information and sends signals back to your muscles to make the movements necessary to maintain balance. Imbalance puts you at risk for falls. “As we get older, falls can become much more traumatic, and are often the reason for hip fractures, rib fractures, and head injuries. These can all lead to significant health problems among older adults,” says Collins.

            If your doctor recommends physical therapy to strengthen your core, you’ll go through an evaluation to determine and prescribe the right exercise routine. Once you’ve been assessed, your PT will likely guide you through a series of gently stretches and strengthening exercises.

            Don’t wait for balance problems before you start working on your core. You can prevent balance problems, as well as back pain, by maintaining a strong core at all times. Just make sure that initially you work with a physical therapist or personal trainer, who can tailor a core-strengthening program to your specific needs. We list some typical exercises that can help strengthen your core above. You can also pick up a copy of the Harvard Special Health Report Core Exercises. Go to www.health.harvard.edu/core for more information.

Alternatives

Strengthening exercises are a great way to tighten your core and improve your balance, but so are other forms of exercise that give your core a real workout. Yoga involves postures, concentration, and controlled breathing that can strengthen our core and increase your flexibility. Tai chi is another effective core strengthener. It’s a form of Chinese martial arts that includes deep breathing and slow movements and postures. Both of these exercises are helpful to improving your balance and are safe for people who may have health issues that prevent more aggressive or energetic activities.

Harvard Health Letter – February 2014