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- Proprioception, Balance and Stability
Lets start with some statistics:
Approximately 28-35% of people aged over 65 fall each year increasing to 32-42% for those over 70 years of age - World Health Organisation (WHO)
Falls are the most common cause of injury-related deaths in people over 75 years old in the UK - National Institute for Health and Care Excellence (NICE)
In 2019, falls were responsible for 95% of hip fractures in the UK. The Royal Society for the Prevention of Accidents (RoSPA)
1 in 3 people over the age of 65 fall each year in the UK, and this figure rises to 1 in 2 for people over the age of 80 - Age UK
The NHS reports that falls account for over 4 million hospital bed days each year in England alone, and in 2017/18, the estimated cost of falls to the NHS in England was £2.3 billion.
Apologies for that bleak opening. But, it’s clear to see that through statistics alone, falls among elderly individuals are a significant problem in the UK. Also, this fails to take into account the personal, family and societal impact of fall-related injuries. So preventing them is crucial for improving the health and well-being of older adults and reducing the burden on healthcare systems across the world.
Proprioception, balance, and stability are all important components of movement and posture. Proprioception is the body's ability to sense its position, movement, and orientation in space. Mechanoreceptors in the muscles, tendons, and joints that provide feedback to the central nervous system about the position and movement of the body.
Balance refers to the physical ability to maintain stability and control of the body's position in space. It involves the integration of sensory information from the eyes, inner ear, and receptors in the muscles and joints, as well as motor responses from the nervous system to make adjustments in posture and movement.
Stability is the ability to maintain control and stability of the body's joints during movement. It involves the coordination of muscles and joints to produce and control movement, as well as the ability to resist external forces that may cause loss of balance or joint instability. These can be trained in isolation or together in order to improve overall movement efficiency and control, which can help to reduce the risk of falls.
The video below perfectly shows what can be achieved if you train these elements alongside strength.
I’m definitely not recommending you set up this obstacle course and get practicing. It's important to start with exercises that are appropriate for your current level of ability and to progress gradually as your skills improve. A qualified fitness or health practitioner can help you design a safe and effective training program that addresses your individual needs and goals.
But I’ve included some examples below of how you may be able to alter training you’re likely already doing to challenge your proprioception, balance and stability and hopefully further reduce your chance for injury in the future.
Basic
Split Squat
Switching up your back squat to a split squat occasionally will train your ability to maintain stability during the movement.
Equipment: Dumbbells or Barbell if used
Split Squat
Start with feet hip-width apart with one foot 2-3 feet in front of your other.
Keep your torso upright and engage your core to maintain stability. Your front knee should be directly above your ankle, with a slight bend in your back knee.
Lower your body down towards the floor, keeping your weight evenly distributed and your torso and front shin parallel with each other.
Ensure knee doesn’t cave inwards or outwards.
Pause briefly at the bottom of the movement, then push through your front heel to return to the starting position.
Perform prescribed reps each side.
Intermediate
Single Leg Pallof Press
The single-leg pallof press is a core exercise that challenges stability and improves core strength. Here are the steps to performing a single-leg pallof press.
Equipment: Resistance Band
Single-Leg Pallof Press
Stand with your feet shoulder-width apart and hold a resistance band or cable with both hands at chest height. Raise one foot off the ground.
Engage your core muscles and maintain a neutral spine. Keep your shoulders down and avoid shrugging them up.
Maintaining your balance on one leg, press the resistance band away from your body by extending your arms.
Hold for a second or two at the end of the movement, then slowly bring the band back towards your chest.
Complete on both legs with band pulling from both directions.
Advanced
TRX Bulgarian Split Squat
The TRX Bulgarian split squat is a challenging lower body exercise that targets the glutes, hamstrings, and quadriceps, while also improving balance and stability. Here are the steps to performing a TRX Bulgarian split squat
Equipment: TRX and weights if using.
TRX Bulgarian Split Squat
Start by adjusting the TRX suspension to just below knee height, and stand facing away from the anchor point.
Place one foot in the cradle, with the top of your foot facing down towards the ground.
Take a step forward, and position your foot so that your knee is directly above your ankle. Keep your torso upright and engage your core to maintain stability.
Lower your body straight down towards the floor, bending both knees and keeping your weight evenly distributed between your front and back foot.
Avoid letting your front knee cave inwards or outwards.
Pause briefly at the bottom of the movement, then push through your front heel to return to the starting position.
Complete on both sides for prescribed reps/sets.
Important Considerations
Be sure to warm up properly and consult with a qualified fitness or healthcare professional if you have any concerns about your form or technique.
These are just a selection of thousands of different potential exercises. Seek advice if unsure where to start. Its also important to incorporate other components of fitness to further reduce injury risk.
Keep your core, glutes, and back engaged throughout to maintain the correct posture.
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