Introduction/ To the top
The human body is a rather tall assembly of bones and soft tissue that stands erect and tall on a relatively small base. Gravity and the environment are consistently pulling the erect body downwards and in all sorts of other directions yet our bodies manage to stay upright. Despite the fact that standing on our own two feet can be “simple” there has been an influx of all sorts of balance training methodologies that can be useless at their best, or dangerous at their worst. It is my opinion that balance training, in one form or another, should be part of everyone’s program – particularly those that prefer bodyweight-only training (or misguidedly favor machines as opposed to free weights). This article will address why balance training is important (both upright and inverted), how our bodies balance themselves, and some tips on how to train balance effectively.
Benefits of Balance Training/ To the top
Since few people aside from gymnasts and traceurs incorporate regular balance training into their program, there should probably be a major case that is made for why people should even bother.
There are loads of studies that explore balance training and most of them are in the elderly. Why? Because the elderly are highly likely to experience a fall that will break a hip. The danger is that about 24% of people over 50 years of age die within 12 months after a hip fracture. This should be particularly alarming to women who are more likely to break a hip due to post-menopausal dips in estrogens that cause osteoporosis. In fact, post-menopausal women have about a 15% chance of breaking their hip in their life time. That risk is easily mitigated by spending short periods of time performing balancing training – even if you don’t start until you are over 70, do simple drills and only balance train for 9 weeks. Other studies show similar results – in fact one can balance like other adults who are 3-10 years younger with Tai Chi training. If you found this site, it is more likely that you are an athlete looking for ways to avoid injury or improve performance as opposed to an elderly woman in an assisted living home. So, while these studies are interesting and highlight the need for good balance – we would likely want to shift our focus to those studies that show the relationship between balance, training, prehab and longevity (aside from avoiding a hip fracture).
If you have been through rehab for a lower limb you may have been subjected to balance training. The rehabilitation environment is one where balance training was first introduced because of studies like this one. This study, along with several others, suggests balance training to be an effective means of improving proprioception in those with an impaired joint (in this case the ankle). But what if you haven’t suffered a lower limb injury? Are there still benefits to balance training? The research suggests that this may be the case.
When it comes to injury prevention, there are some compelling studies that suggest balance training can ward off injury. Most of the work in this area has been done on the lower limb. For example, one study shows that healthy young soccer players can improve their proprioception and prevent lower limb injuries by incorporating specific lower limb balance training into their program. Another study on soccer players looks specifically at the incidence of ACL injuries. The findings show that proprioceptive/balance training using wobble-boards can significantly reduce the incidence of ACL injuries in soccer players. Another wobble board study showed similar results where adolescents added balance training into their program for only 6 weeks. Another study included balance training with plyometic training and it showed an overall reduction in the extremity of valgus measures on the knee joint. If you have read our article by Steve Low on the drawbacks of shoes and sitting regularly, then you would know that increased valgus stress should be avoided to minimize injury and maximize performance. If you haven’t read that article, then you may want to click onto it here: Shoes, Sitting and Lower Body Dysfunctions..
There is also data to suggest that balance training will reduce the chance of relapse in addition to reducing the chance of an initial injury. For example, in this study researchers were examining the ankle. From these results, there is a lesser incidence of recurring ankle sprains if the athlete (soccer or basketball, in this case) undergoes a balance training program.
Finally, there are also some studies that suggest that balance training is an effective means of making strength gains. While I am sure these strength gains are mostly limited to novices, I am still sure that balance training is worthwhile for maintenance programs. This study and this study both show that strength and performance gains have been made by participants using programs that take advantage of balance training. Considering that higher level and novice athletes should utilize lighter days in their programs, making balance training a key part of these “light days” may actually help to accelerate strength gains.
Something to notice is that none of the aforementioned studies look at inverted balance (i.e. handstands) at all. These studies are extremely hard to come by and I am assuming that is because hand balancing is just regaining steam among performance athletes. I am confident that similar studies that examine rehabilitation rates and injury prevention in those that take part in hand balancing would yield similar results since the same mechanisms are at work – just on a different set of joints (the wrist, elbows and shoulders as opposed to hips, knees and ankles).
One side note that I would like to make is that there are LOADS of studies that go into how balance training on a Bosu Ball, wobble board, etc. lead to increased muscle activation. That is, muscle activation increases during some movement when you do it on an uneven surface. These studies gave way to the hoards of trainees standing on Bosu and Swiss balls while doing things like squats and curls. For the performance athlete, it’s not really necessary to worry about muscle activation at all. Doing focused training for increased activation will not benefit too much in terms of performance and will likely take time away from other more useful applications of balance and strength training. With that said, muscle activation isn’t really the focus of this article and it shouldn’t be the focus of a balance training program since it really doesn’t matter all that much in the context of performance gains. The only exception to this would be when some muscle has been identified as a “weak link” and increased muscle activation is required to overcome a plateau or correct pathologies.
In summary, the main proven benefits of balance training, aside from actually being able to balance on narrow objects and unstable surfaces, include injury prevention, rehabilitation, strength increases and increased muscle activation. The fact that we can achieve these ends while working on the functional task of traversing narrow/unstable surfaces and on standing on our hands is compelling enough to include regular balance training into one’s routine for GPP and performance gains. Aside from that, balance training is just plain fun.
How Balance Works/ To the top
Human balance is actually a pretty remarkable feat. The average male stands about 70 inches tall whilst standing on a base that averages out to be about 10-12 inches long and 3-4 inches wide. Balancing objects to stand that tall while on that small of a base is incredibly difficult. As our bodies move through space, muscles up and down the entirety of the kinetic chain are constant reacting to hold our body upright – and most of the time this is a completely involuntary process. So, how do our bodies make it all happen?
There is a popular text on the subject written by Dr. Nashner called Pracitcal biomechanics and physiology of balance taken from his book, Handbook of Balance Function and Testing. If you are interested in the full text from the book, you can find a digital copy here. The gist of it is that our bodies sense the position of the body in relation to gravity and the surroundings. To do this, the body utilizes three sensory inputs:
- Visual input – optical input from the eyes.
- Vestibular input – input from the vestibules in the inner ear caused by fluid moving around.
- Somatosensory input – input from the sense organs on muscles and tendons.
Visual input contains information from about the overall state of our surroundings. Vestibular input contains information about where and how our bodies (actually, our heads) are moving in space. Somatosensory input contains information about how our muscles are reacting to our environment.
Without getting too boring here, these three inputs are the basis of all balance and we balance the best when all three of these are working well together. However, we can rely on any one of these inputs and our balance will remain intact – just diminished. The real trouble with poor balance is when we inappropriately depend on a sense that is “fooling” us as opposed to a sense that is more reliable. This intersensory conflict can cause sickness or balance loss. For example, when you are sea sick you are relying on your sense on vision for balance when you should be relying on your somatosensory perception – that is why staring at a fixed image in the horizon will reduce the sea/motion sickness symptoms. Similarly, when you are having a tough time balancing on a narrow ledge, fixing your eyes on a fixed object in space will stabilize the rest of the system as it forces the somatosensory or vestibular systems to controlling balance for us. So, if you take nothing else from this article, just remember that poor balance can be acutely cured by fixing your vision on a stationary object so that the other two systems can do their job.
So, in short, balance works by taking these three systems and integrates their information to bring the center of gravity (COG) back to a stable or balanced position when balance is disturbed. Training our balance allows the body’s automatic responses to learn how to adjust to these disturbances. Beginning slackliners, for example, have a major shake on the line but that goes away as the brain learns to integrate new somatosensory information from the lower limbs. The adjustment is specific to the stimulus (training on rings is different than a slackline is different than a solid rail is different than a bosu ball) so we need to train balance in the most applicable of ways. (This means that the BOSU ball is useless, by the way, since we rarely balance in a static place on an unstable semispherical surface).
With that said, if we want to improve our balance and get all of the benefits that were stated in the first section, then we typically want to train all three of these systems in harmony as well as independently. For example, you may be balancing on a narrow ledge and are having difficulty – so you fix your eyes in place and keep your head in a static position. This will reduce vestibular processing and visual processing and will train your somatosensory mechanisms to respond adequately to control balance. As your somatosensory system becomes proficient at balance (that is, you balance easily with a fixed head and fixed eyes) then you may want to try balancing with a fixed head and moving gaze. This will introduce more intense visual processing into the mix which will train the visual and somatosensory systems to work in harmony. As this gets easier, you may close your eyes so that the two remaining systems have to pick up the slack or you can start moving your head/neck/body position so that you are training all three systems in concert. These are all respected mechanisms for increasing the difficulty of balancing.
Here are some other tidbits/factoids on balance and how it works that you may want to spout out at your next dinner party:
- Males demonstrated greater sway (difficulty balancing) than females
- One leg increases postural sway (difficulty balancing) by roughly 800%
- Blindfolding increases postural sway up to 300%
- Age tends to degrade balance
- This is due to degradations in feedback from all three systems.
- Broken hips in the elderly lead to increased incidence of death and are caused by balance degradation.
- Significant correlations were found between age and length of sway path for one-leg standing (larger sway indicates degraded balance).
- Youngest groups in studies demonstrate the largest area of stability over which weight could be shifted and controlled. The oldest group demonstrated the smallest area. That means you can’t deal with disturbances better in old age!
- One-leg balance scores are an important predictor of injurious falls in older persons.
- Vision plays a small/non-existant roll in balance control in children up until the age of 7.
- This is possibly useful if you plan on coaching children.
Balance training and the Athlete/ To the top
Now, as athletes we usually have enough on our plates. In addition to our S&C program of choice as well as sport specific training, what exactly is the benefit on balance training? Well, for the older folks it’s clear that balancing and redeveloping proper balance can add years onto lifespan just because once you break a hip the recovery alone can be fatal. However, for people who are training in sport, there are stark benefits to training balance aside from strengthening our sense for old age.
Firstly, at any age, poor balance leaves us prone to injury. Recognizing this, recent trends in the diagnosis and rehabilitation of athletic injuries have been placing more and more weight on balance deficiencies. Among other things, studies are indicating that balance training can enhance dynamic balance ability for up to one year after training with minimal maintenance training. Other studies, such as this one, are showing that cohorts are using balance measurements to predict injury susceptibility. For those who have had previous injuries, this is proving worthwhiles – for others, its proving not to work so well. The point is that clinicians are starting to look at balance as a method for predicting and controlling injuries in athletes and in some cases its working very well. Aside from injury prevention, some early studies in the matter are also showing that mixing balance with other methods of training can be effective at improving measures of neuromuscular power and control. To put it more simply, this study shows that a combination of plyometrics and balance training may maximize the effectiveness of training in a group of female athletes.
What Balance Training will NOT Do/ To the top
Up until this point, I have been pushing balance training and its benefits pretty hard. It is worthwhile to take a minute, step back, and look at what balance training will NOT do just so that we can avoid any confusion.
Firstly, balance training may alleviate symptoms or reduce risks but it won’t fix underlying problems in some cases. For example, if your mother is suffering from osteoporosis she is very susceptible to breaking a hip. Balance training will help her to avoid the fall but it won’t magically make her bone density increase. On the plus side, for certain balance deficiencies, specific balance training can be worthwhile as a therapy that does act on the root of the problem
Secondly, studies suggest that balance training may fix some of the balance deficiencies that correlate well with injury rates. This does NOT imply that balance training will actually avoid injury – it just fixes the markers that are currently being used as correlates. Compare this to cholesterol. Cholesterol is NOT the cause of cardiovascular disease but it is used as a correlate for disease. Fixing the cholesterol problem does not fix the underlying problems such as high stress, high inflammation and inactivity.
Also, certain balance problems originate from problems in the nerve signals such as those from the optic nerve, vestibular systems and muscles. Balance training may help to increase balance to compensate for these problems (as the two other systems may be able to compensate for the deficiency) but the actual nervous system problems themselves will not be fixed by balance training.
The last point in this vein that I would like to mention relates to Mile Head Injury (MHI). A few studies point to the fact that MHI can impair balance for a day or two and balance training will not fix these problems during that time. Additionally, it can be dangerous to engage in balance training in the two days following a mild head injury. After a hit to the head, it is best to stay off the slackline and high ledges. Balance will be impaired and it is best to steer clear of balance training at that time.
Training Methods/ To the top
There is no shortage of training methods to improve balance. For some reason though, very few of these methods have been well represented in peer reviewed studies. In peer reviewed journals, the most represented forms of balance training include the BOSU ball and the balance board – both of which are suboptimal balance training methodologies. Why are they suboptimal? The first rule of S&C for any sort of skill enhancement is that the movement should be as close as possible to the target skill. For general preparedness and sport’s sake, the BOSU ball and balance board are novel and dissimilar to most practical movements. Other methods of training are rarely inspected for balance work but there is more than enough reason to believe that training in these less-researched methods will be just as beneficial (if not more beneficial due to their similarity to real world and sport related movements). Below is a short list on the different types of training methods that exist for balance training and even though they aren’t studied directly, there are some interesting studies that are quite relevant when we think about them with respect to balance training.
Slacklining is my preferred method of balance training. Anecdotally, I have seen a lot of people improve greatly in balance on rails, balance beams, ledges and slacklines in as little as 1 week of consistent practice. After 4-5 one hour sessions with a partner, it is not uncommon to be able to walk on the slackline which, in my experience, has a very solid translation to all other situations in which balance is needed. Slacklining is not only easy to learn with a partner, but it is also a lot of fun. Setting up the line takes only a few minutes but it draws a lot of attention. In the park when I would train slacklining alone in Colorado, I would often convince a passer-by to get on the line with my assistance which would make for an interesting afternoon.
The basis of slacklining is to set up a strong nylon webbing between two trees or posts. The webbing is held onto the endposts/trees by either a ratchet or carabineer setup. I prefer ratchet setups when I am alone since they are quicker and easier to set up – though carabineers don’t require much re-tightening and readjusting. Once the line is established, you either step up onto the line (or jump on if you are a bit more advanced) and train various skill. The line is an unstable surface which requires the somatosensory portion of the brain to adjust substantially. The initial adjustment can take as little as 5 minutes or as much as a week of consistent practice depending on the individual. Some drills that can be performed on the slackline include walking backwards, forwards, sideways, kneeling, pistols, squats, turning, pivoting, jumping, line surfing, line bouncing. Each of these can be done with a moving head, moving gaze, closed eyes or eyes behind the back which will cause conflicting signals from the vestibular, somatosensory and visual components of balance. In short, these modifications will make balancing harder and will make you a better at balance.
If you were only able to choose one type of balance training, then I would certainly go with slacklining for an hour a week, or so, since it has a high degree of translation to other balance applications and the real world. It also fun and makes for a fun activity to do in leisure time with friends and family.
Rail balance is very similar to slacklining. The only difference is that rail balancing does not require you to purchase a line and the balancing surface generally doesn’t move. Rail balance is one of the most practical methods of training balance since finding a rail to stand on is relatively easy (so long as there are buildings around). The techniques that can be trained on rail balancing are the exact same as slacklining so reread that section if you need some ideas. A good balance program would mix rail balancing with slacklining – but performing rail balance does not have a great translation over to slacklining, in my experience.
Weightlifting doesn’t really get enough credit for aiding in balance. It doesn’t get enough credit for anything, really. In general, even if you only do isolation exercises, strength correlates to balance in at least some populations (like this study that examined strength-trained women or the study linked earlier in this sentence). That means, even if you only do isolation exercises on the major muscles of the lower limb, you may see an increase in your balance. Just for good measure, this link points to another study where back extensor isolations helped with balance – but in a different way than direct balance training. Strength training through isolations helped to increase postural control by increasing the fast compensatory responses that are necessary to maintain balance after it has been disturbed. Standard balance training increased balanced by reducing variance (or sway) overall. This is important evidence that suggests that strength training is a great compliment to standard balance training. And these studies just looked at isolations! I speculate that the highly coordinated and variable nature of the core lifts (squat and deadlift) along with the Olympic lifts (Snatch, Clean, Jerk) all provide a much better means of increasing balance through strength training. If you are reading this site it is likely you already incorporate at least some or all of these lifts into your program and these studies really drive home that there is no replacement for these exercises – but they should be done in conjunction with standard balance work on a slackline, beam or rail. Standard balance training cannot replace the benefits of strength training. The converse is also true.
If you know anything about me at all it’s that I love handstands. Handstands all the time, everywhere. Personally, I feel like doing a handstand is one of the most fun acts that I can do anywhere, anytime. Most balance training targets mostly the lower body and few people aside from gymnasts, crossfitters and traceurs even touch on handstands anymore. That may be the reason why handstands are understudied and basically ignored by most peer reviewed journals.
Luckily, I managed to dig up some studies that have some good implications regarding upper body balance training and their effects on health and performance. To put it into perspective, lower body balance surely helps with walking and avoiding a fall but upper body balance should have similar benefits. The bad news is that performing upper body balance training (in my experience and this study) has little to no translation to balance performance. The same is true that lower body balance training has little to no translation to inverted balance (that is, handstands). However, postural regulation when inverted appears to be regulated in the same way as when we are standing on our feet – all three systems play a part. So, what does this mean? If we want to have the most stability and control over our bodies, we need to train balance on our feet and on our hands (handstands and rings).
When it comes to handstands, I am not going to go over the basics of how to get started and learn how to balance. You can find some great resources on how to work on handstands either at BeastSkills, Drills and Skills or Gymnastics Bodies. Rather, I want to delve deeper into the intricacies of handstands and some things that are overlooked by beginners that relate back to the topics in this article.
Balance, overall, is a closed kinetic chain movement. For people who are unfamiliar with this term, it basically means that you are performing the movement with your body in contact with the ground such that you act on the ground to move a weight rather than acting on the weight itself. A deadlift is a closed kinetic chain movement whereas a leg extension is not, for example. In closed kinetic chain movements, each segment of the chain transmits forces to every other segment along the chain. Each segment’s motions are influenced by forces transmitted from other segments. In plain English, each part of your body will influence another part of your body so it is important that form is perfect. Most new handstanders ignore most of their chain and this is why you see lots of beginners flailing their legs and/or getting a “banana back”. This leads to balance impairments due to a lack of consciousness of the entire chain. Recall that balance contains three components which include somatosensory input. By forcing the muscles to learn how to balance while receiving this wacked out input from the muscles while legs are flailing in the air is entrenching horrible habits and the benefits of balance training may not be as great. This was just a very longwinded way of saying to train your handstands with good form or your brain may not be able to be reprogrammed so easily!
Another point goes to head position. For some reason, some people still think that your head should be in a neutral position while doing handstands. As we know from the previous sections of this article, vision and head position are a main component of balance – so head position is much more important than most people will lead you to believe. This study shows that having the head tilted WAY far back or in a slightly bent-back position was far more stable than keeping the head neutral or ventroflexed (looking at the feet). With this in mind, beginners should keep head position very slightly tilted with the goal of progressing to competence with ALL head positions, noting that looking at the feet is the most unstable of all positions that have been studied.
One final point for coaches – touch your trainee’s thighs! As we saw in our previous sections, the three systems that control balance don’t necessarily need to work in concert – they just happen to work in concert better than when they work alone. Touching the thighs enhances the somatosensory perception of inverted trainees. This also means that it can compensate for losses of vision such as closed eyes or for altered head positions. If there is a novice struggling with handstands or an advanced student struggling with a new handstand variation, touching the thighs will help in getting new skills more quickly.
Aside from handstands, most of these facts apply directly to other upper body gymnastics skills. The elbow levers and planche progression are also phenomenal tools to work on upper limb balance techniques. Additionally, any sort of rings training in a support position such as dips, support, L-sits, iron cross, etc. will contribute to the stability in the shoulder girdle that will help drastically with upper body balancing skills.
As stated earlier, the balance board is a classic in peer reviewed articles. Why? I don’t really know. Balance boarding has no significant translation to any sort of practical movement that I can discern. Balance boarding, practically, is extremely boring. The only thing worth mentioning on the balance board is that people who snowboard tend to pick up balance boarding very easily…though I have yet to see someone proficient on a balance board translate that to snowboarding skill. The balance board still provides a lot of researchers with a tool to work with and some data that is compelling regarding balance. Personally, though, I think you can save your money on a balance board and start walking on rails and slacklines.
When people mention balance training, the BOSU Ball is typically the first thing that comes to mind. This is probably because the BOSU ball has been a great tool for researchers performing studies. Researchers can easily get a BOSU ball to use in their studies as they are cheap and readily available. The BOSU balls provide an unstable surface that is highly controlled. People on the BOSU ball appear to be consciously balancing for long periods of time which lends itself to easy data collection. This is one of the main reasons EMG (muscle activity) studies are done on the BOSU ball…it’s easy as hell to do!
Studies that have been conducted using BOSU balls appear to be very compelling until we look a bit deeper. One study, for example, shows that performing exercises such as pushups on a BOSU or swiss ball increases EMG activity. That sounds great, right? Well, as performance athletes, we don’t really care about muscle activating muscles in this way. The instability of the BOSU ball is making muscles work harder to control themselves under the BOSU ball. When you remove the BOSU ball, the muscles still act with increased activity that is not necessary because they have been conditioned to do so. This might sound good, but it ingrains motor patters that are not desirable. In fact, BOSU ball training may decrease sport applicable performance due to improper activation and conditioning – the increased EMG activity may actually hurt performance!
That aside, this is all a moot point since studies indicates that advanced athletes benefit very little from BOSU ball training. That means if you train hard with heavy weights, then the BOSU balls won’t do much for you once you pass the novice phase – so why do two things instead of just one?! Stick to heavy weights and leave the BOSU ball on the shelf.
I know what some of you may be thinking. Why not do the heavy weights ON the BOSU ball, just to cover all of your bases! Well, firstly, that’s idiotic. No one should have any significantly stressful amount of weight loaded onto the body or in their hands when they are performing on an unstable surface. That is a great way to get yourself or someone else hurt or killed. Secondly, if you read the first part of this section, you would see that increasing muscle activity while weighted can actually hurt your performance. Just to make sure I say it again – keep the BOSU ball on the shelf.
Summary/ To the top
Well, in summary, balance training is often ignored when it should be an integral part of a trainees program. Most of the people reading this article should already recognize the benefits of the core lifts and lifting heavy and this actually covers most of your bases in terms of bringing balancing skills up to par – at least the clinical par. For performance, I believe that specific balance training (of at least 1 hour a week, in a casual setting) should be implemented to make the most progress in balance training. If you are a traceur, this training is absolutely necessary for your sport. If you are looking for general preparedness, then it is necessary for your active lifestyle where you may need to balance across a river or narrow ledge sometime during one of your misadventures. If you are a competitive athlete then it is probably less necessary to go out of your way to balance train for your sport even though there is some evidence supporting that it will maximize performance. Rather, as an athlete, it may be worthwhile to investigate balancing as a hobby that way you get the training in on your “off time” out of the gym. Keeping training fun is half the battle of being competitive and sticking with it – and balance training can be a blast.
Note: Most of the studies cited in this article are linked as they are cited. However, many studies were cited based off of the terrific article on balance titled Research and Clinical Applications of Assessing Balance. If you would like further reading then this article is a great place to start.