Strength and Balance

This past spring, I spoke at a TBI conference and met an elderly gentleman who confided in me that his biggest challenge was dizziness and balance. Oddly enough, I had recently heard about a condition called benign paroxysmal positional vertigo (BPPV). I only knew about this because my husband’s 90-year-old father was being treated for it after he had fallen a few times. I have since learned this is one of the most common causes of vertigo.

A fact sheet from the Model Systems Knowledge Translation Center explains why:

“With trauma, the crystals in the inner ear can be moved out of place, making you sensitive to changes in gravity. BPPV is characterized by brief episodes of mild to intense vertigo. Symptoms are triggered by specific changes in head position, such as tipping your head up or down, and by lying down, turning over, or sitting up in bed. You may also feel out of balance when standing or walking.”¹

And the cure? A few physical therapy sessions that relocate the crystals in the inner ear! A doctor had never once told the gentleman I spoke to at the conference that his balance problems might be caused by his inner ear. He left the conference eager to make an appointment with an ear, nose, and throat specialist. I crossed my fingers for him, hoping this would prove to be the cause of his problems and he would have a solution. One of the guiding principles of my life as a wife of a husband with TBI is to “explore everything.”

In my husband’s case, we did not know the exact cause of Hugh’s balance problems, but his balance was so severely impaired after his TBI that I had to help him walk with a gait belt. He could not walk independently for a several months after his crash.

As time went on, his balance stabilized, but it wasn’t until after a full year that we saw the most dramatic improvements, and they happened after we incorporated strength training to his exercise routine. Not only did a cross-training program help Hugh’s balance, it strengthened his cognitive abilities: his attention, concentration, and memory — and it allowed him to get back on his bike and back into the ocean surfing, two sports that require good balance.

I’m not a doctor, but I believe that physical exercise is the magic bullet for everyone, including people with brain injury, and exercise is particularly important as we age. Improving physical fitness can be life changing for persons with brain injury — and for their caregivers. Exercises that help us maintain our strength and balance may reap benefits later in life by allowing us to do the activities we love, and by preventing falls.

A few years back, I found a National Institutes of Health study focused on people in their upper 80s that concluded:

“Our findings reinforce the recommendation that structured strength and balance training should be implemented in long-term care facilities. Besides the well-known benefits of physical training, our findings showed that an improvement in cognitive function may also be possible.”²

This particular study gives me great hope that all of us can improve our physical and cognitive abilities throughout our life span by improving our strength and balance.

It’s been 12 years since Hugh’s TBI, but we still both work on our strength and balance. We practice yoga poses together and we recently started paddle boarding. Hugh even set up a slackline between two trees to practice his balance. And now, the man who could not walk without tripping can walk the length of a two-inch slackline without falling off.

Like everything else in life, building strength and balance requires discipline, practice, and implementing safety measures when necessary. Deciding what particular routine should be done to achieve the results you want should be determined by each individual with his or her doctor.

It’s fitting that the words strength and balance can be applied to both the body and mind. May you find the mental strength to do what it takes to strengthen your body, and may you create enough balance in your life to maintain your balance well into old age.