To understand how the body works to balance efficiently, think about how it feels to transfer weight from one foot to the other while walking. As one leg extends forward, feel how the center of mass (hips) moves over that leg and foot to balance momentarily. While walking might seem too simple an example, it's not simple for those who experience pain with movement.

It's not yet known how much practice is necessary for substantial balance improvement. According to a study conducted by Fitter International, Stack says that, "exposures [to balance] in smaller time increments may be more beneficial than longer balance sessions which are less frequent."

Add balance to programs

Few facilities were found that offered specific balance conditioning for deconditioned markets, however some do implement balance segments into usual training and group classes. Mary E. Sanders, director of WaterFit/Wave Aerobics at the University of Nevada, Reno, says that water is the ideal place to accommodate those who require gentler exercise. "Water provides an effective and safe environment for balance training for a wide variety of fitness levels." She says that training in the pool can also lead to improved balance on land. "Water's resistance can be used to challenge balance to promote balance recovery. Water's support provides a safe opportunity for students to make movement errors. [They can] extend away from the center of balance [to] practice and train for recovery back to their center of balance."

The ideal type of program is one that challenges both static and dynamic balance. By displacing the center of mass in as many controlled actions as possible, mobility and performance improve. Static balance tasks take place while stationary in a standing or seated posture. Dynamic balance translates to balance while moving. If the body is trained to be more reactive to imbalance, it will perform more precisely.

Paul Chek, founder of the C.H.E.K. Institute in Southern California, is a corrective and high-performance exercise kinesiologist. He has dedicated much of his practice to spreading the word about the importance of balance training. He says that unless clients and students are made aware of posture first, balance will be less effective. "Always instruct your clients to maintain perfect postural alignment at all times. Stop any exercise at the first sign of stabilizer fatigue."

Stack agrees and adds, "Without stabilization of the spine and trunk during balance conditioning, agility will be limited. If you haven't trained the body to stand on one foot by itself, how can you move quickly to the other?"

Following are some exercises for both static and dynamic balance that can be performed anywhere, although it's helpful for clients to try them in front of a mirror to ensure proper form. Add these exercises to usual cardiovascular, strength and flexibility routines. Have clients practice them three times a week in the order they are listed. Some balance tasks make great warm-ups and cool-downs, depending on the intensity of training and goals. If a task calls for work on one leg, make sure clients perform it on the other leg as well. Make a physical note of head and neck position when balance is best and recall this position to improve posture, sports performance and reactive balancing abilities. Take note of how long it is before the client actually regains a feeling of balance. For most, it will take a second or two. Remember that the quicker balance is recovered, the more effective the program. The goal is to train the client to challenge balance, sense imbalance, react quickly and recover from imbalance via subtle physical adjustments. (Even those in great shape will find these tasks to be challenging until the body becomes efficient at making balancing adjustments.)

Balance exercises

* Stand on one leg, ankle and knee relaxed. Shift focus in all directions, then into the horizon. Where is the client looking when balance is best? Try to balance on one leg with eyes closed.

* Progress to balancing on one leg and swinging the other in progressively larger motions. When this can be done well on either side, progress to standing on tippy toes and performing the same tasks.

* Lunge to all numbers on the clock from the position representing the center of the clock. Work half of the clock with the right leg and then the other half with the left leg. Start with small lunge steps and progressively enlarge them as strength and flexibility improve.

* Sitting and standing are natural actions often taken for granted. From a standing position, close the eyes and sit in a chair, stand up and sit down again.

* How many steps can the client take in a straight line, one foot in front of the other with a book on his or her head? Again, note head and neck position when balance is best.

* Walk up a small flight of stairs with eyes closed. Then slowly walk down backward with eyes open.

* Stand with feet locked together and eyes closed. Try to become aware of the body's amount of sway. Then open up the stance to a walking position. Notice the decrease in sway and an improvement in balance.

* Reaction drill: Throw a brightly colored ball from various angles while the client is balancing on one foot.

Water balance tasks

Sanders urges instructors and trainers to have a good understanding of how to use buoyancy, resistance and water currents to create the most effective water program.

* Static balance "statues": Stand on both feet in navel- to nipple-depth water, with a partner running around to create water currents pushing toward the trunk of the body.

* Static balance "freeze frame": Walk forward and backward in water of navel to nipple depth, using hands for assistance. After about eight steps, stop and "freeze frame" maintaining balance on one foot for five seconds. Next try it with hands just above the surface of the water or extended overhead. Last, close the eyes and try it.

* Dynamic balance: Working in pairs, use a 5-foot band and leash it to a partner. The lead person walks a straight line forward, while the back "tugger" follows and provides "surprise" tugs to the body, working from side to side. Progress by taking larger strides, having the walker raise arms overhead, having the tugger be more aggressive and walking with eyes closed (tugger is the guide).

Sports training for balance

Fit individuals have better balance, respond to training and learn sport skills more quickly. There is a strong link between reaction time, movement time and balancing ability. The more quickly the body is able to react to imbalancing forces, the more quickly balance is recovered.

In sports, balance happens during constantly changing postures. This motor performance allows the best athletes to react freely and quickly in any impulsive direction, adapting to the constantly changing demands of their sports.

Participating in activities which require coordination, agility or quick footwork, and movements that challenge normal range of motion are great ways to cross train for proprioception and dynamic balance. Basketball, racquet sports, jump rope, soccer, hacky-sac, aerobics or other balance sports such as hockey, sail-boarding, in-line skating or mountain-bike riding are options for balance-specific training. Skip over stones or do a hop scotch with the kids. For the more adventurous, try running slalom through trees and down steep embankments in a low position, or even do an occasional cartwheel.

Everyone can benefit

Perhaps the fitness industry has been thinking too hard, building a bridge to the deconditioned market that's too high to climb, too structured and scientific, causing confusion instead of participation. While science is good, practicality is better with these populations. Everyone can benefit from balance conditioning. It is the most innate human function for creating and maintaining movement patterns. The results of a balance program represent a fountain of youth for the millennium. Mobility, vitality, enhanced nervous system function (which operates all other functions in the body), confidence -- who doesn't need these qualities?

RESOURCES

ACSM's Health & Fitness Journal, Aquatic Exercise for Better Living on Land. May/June, 1998. www.wwilkins.com/FIT.

Fitter International, 800 FITTER1, or www.fitter1.com.

Paul Chek, Founder, C.H.E.K Institute, Encinitas, Calif., 800 552-8789, www.paulchekseminars.com.

Personaltraining.com.au, a membership Web page for personal trainers that includes information about balance training.

The Bongo Board: Balance Training Systems, KZT Sports, 888 226-7431.

The Golden Waves Program, Functional Water Training for Health. Presents 50 progressions for functional training, with 15 exercises targeting balance specifically. 800 873-6759.

Sports Energy, Balance Conditioning, A collection of articles by Suzanne Nottingham. 760 934-5245, or send $14 to Sports Energy, P.O. Box 710, Mammoth Lakes, CA 93546.

Properties Affecting Balance

Posture: pinnacle of balance

* Efficient standing posture is the prerequisite to cultivating perception of balance and body position while static or moving.
* Legs should be slightly flexed or relaxed at the ankles and knees
* Shoulders should follow a relatively straight line to the tail bone allowing for the natural curve of the spine
* Arms comfortably down to sides
* Abdominals pulled in
* Head up, ears over shoulders, eyes focusing ahead

Unbalanced weight

* Poor balance can be caused by:
* Feet not aligned under hips
* Too much forward flexion at the shoulders or waist
* Head down reducing field of vision
* Stiffness in the joints
* Spastic rhythm during walking, uncoordinated arm movements
* Holding breath
* No reference for pressure control along sole of foot
* Lack of endurance
* Not strong enough to stand for any length of time on one foot independent of the other
* Abrupt movements

Internal factors affect balance

* Physiological and psychological conditions can affect balance.
Physiological:
* Physical fitness -- endurance, strength, flexibility, agility, coordination
* Kinesthetic awareness (the body's sensory system)
* Visual perception
* Vestibular system (inner ear)
* Existing motor skills, reflexes
* Posture
* Stance
* Improper warm-up/training that is too strenuous
Psychological:
* Self-confidence
* Courage
* Adaptability
* Mental control
* Commitment
* Anxiety
* Fear
* Expectations
* Peer pressure

External factors affect balance

* Improperly fitted equipment: Shoes and other sports equipment
* Forces of gravity
* Friction
* Speed
* Obstacles
* Terrain irregularities

By Suzanne Nottingham