Physical Therapy Guide to Balance Problems

Balance problems make it hard for people to maintain stable posture and stay upright when standing, walking, and even sitting. Balance problems are more common in older adults and are the most common reason they seek help from a doctor. If balance problems go untreated, they can lead to falls. Physical therapists can help people of all ages improve their balance. They perform balance testing and develop treatment plans that include physical activity to help improve the strength, stability, and movement of people with balance problems.

Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation act Zenergy. 

What Are Balance Problems?

A balance problem exists when a person has difficulty keeping a stable and upright body position, whether moving or staying still. There are many causes of balance problems, including:

• Muscle weakness.
• Joint stiffness and decreased movement.
• Inner ear problems.
• Certain medicines (such as those prescribed for depression and high blood pressure).
• Lack of physical activity or too much sitting.
• Simple aging.

Balance problems also can be caused by medical conditions, such as:

• Stroke.
• Parkinson disease.
• Multiple sclerosis.
• Traumatic brain injury.
• Arthritis.
• Spinal cord injury.
• Cognitive diseases (conditions that affect learning or thinking).
• Diabetes.

Balance problems occur when one or more of these five systems in the body do not function properly:

• Vision. Poor vision can result from age, eye tracking problems, or eye diseases.
• Inner ear. The part of the inner ear responsible for balance is the vestibular system. Hence, inner ear problems that affect a person’s balance are also called vestibular problems. Inner ear problems can develop from trauma, aging, poor nutrition, or disease.
• Muscular system. Muscle strength and flexibility can decline due to lack of exercise, too much sitting, or disease.
• Proprioception (the awareness of one's own body position). Body-position sense can become abnormal due to trauma or a disease, such as diabetes.
• Circulation. A sudden drop in blood pressure when a person sits or stands up, called orthostatic hypotension, can make a person feel dizzy or lightheaded. This may cause a person to faint and fall. Circulation problems can be caused by heart problems, dehydration, and some diseases.

The brain receives and combines information from the eye, inner ear, and body-position senses for balance control. It then sends signals to muscles to move or adjust to stay balanced. A person may not be able to maintain or correct their balance if:

• One or more of the senses is not sending correct signals to the brain.
• The muscles cannot carry out the movements.

How Does It Feel?

A person with balance problems may experience:

• Teetering when trying to stand up, or staggering, tripping, swaying, or stumbling when walking.
• Dizziness or vertigo (a spinning feeling).
• Falling or feeling as if you are going to fall.
• Lightheadedness, faintness, or a floating sensation.
• Blurred vision.

Some people’s balance may be fine when sitting or standing still. This is called static balance. Balance also may be fine when only doing one thing at a time. Problems occur more often with dynamic balance, when a person moves about or tries to do more than one thing at a time. Dynamic balance problems also occur when information from the eye, inner ear, and body-position senses is altered. Examples include:

• Walking while turning the head to talk to another person.
• Bending and reaching for an object.
• Walking in poorly-lit places (at night, or in a darkened room).

If a person’s static or dynamic balance is abnormal, they can easily fall, and have a higher risk for injury.
Balance problems can make people fear doing simple daily activities. As a result, they may avoid movements they deem hard or that challenge their muscles. This will cause them to sit too much. This lack of movement leads to weakness that makes balance problems worse. A person who has balance problems also may feel frustration about their condition and become depressed.

​How Is It Diagnosed?

If you see a physical therapist first, they will conduct a full evaluation that includes taking your health history. Your physical therapist also will ask you detailed questions about your condition, such as:

• How often do you have problems with your balance?
• What are you doing when you experience balance problems?
• Is your balance worse at night or in dark rooms?
• Does the room spin, or do you feel off-balance?
• How many times have you fallen in the past year?
• Has falling caused an injury or a visit to the doctor or hospital?
• Have you changed or limited any activities because of your balance problems?
• What medications do you take?
• Have you had a vision or ear checkup recently?
• Do you ever feel lightheaded, or as if you might faint?
• Do you have trouble doing any daily activities?
• How much, and what kind of, daily exercise do you get?
• Do you have any other medical conditions or problems?
• Are you under the care of a doctor?
• What are your goals?

Your physical therapist at Zenergy will perform tests to check your overall physical ability in areas such as:

• Movement.
• Strength.
• Coordination.
• Visual tracking.
• Balance.

Your physical therapist at Zenergy may team with your doctor or other health care providers, who may order further tests to rule out other conditions.