My name is Dr. Hannah Leatherman, and I work with Dr. Laura Wazen at Equinox Physical Therapy in Sarasota, Florida during the winter months. I am a trained vestibular therapist, which is a physical therapist who specializes in treating patients with dizziness and balance problems. Balance is very important to me, because I am also a professional athlete in the sport of disc golf. I am required to have exceptional balance to have success competing on the professional disc golf tour. The sport of disc golf is similar to golf in that you must drive, approach, and putt towards a hole. Instead of hitting a ball with a club, you are throwing a small frisbee or disc. When I throw a shot with my dominant hand, my follow through forces me to stand on my right leg while maintaining good balance.
In sports and in life, we frequently use one side of our body more than the other. It is natural to have imbalances between our left and right sides, as most of us have a dominant arm and leg. If the imbalance becomes too great, it will lead to problems. Repetitive movements, habits, postures, or even injuries and surgeries can lead to abnormal imbalances on your left and right sides. As you age this can lead to serious balance problems. You may begin noticing that you are having trouble walking a straight line, are bumping into things more than you used to, or even losing your balance and falling.
As a physical therapist who specializes in treating balance problems, I have come to understand the importance of using both sides of my body when I am training in order to improve symmetry in my body. Part of my offseason training involves throwing with my non-dominant hand, which allows my left leg to balance me during the same movements I am constantly using for disc golf on my right leg. Strengthening and balance training of my left leg and core are also key elements to my program.
At Equinox Physical Therapy one of the things that we screen for is asymmetry. In addition to other tests, we analyze our patient’s walking pattern and posture, and assess their strength in both legs in order to find out if asymmetry of the body could be contributing to the patient feeling off balance. This allows us to educate our patient regarding these results as well as treatments which will create improved symmetry in the body, improved balance, and decrease risk for falls.
Whether you have been involved with sports, have had an injury or surgery on one side that has thrown off your balance, or just think that you might have asymmetry from any other activities that you have been doing for years, I encourage you to find a trained vestibular therapist and get evaluated. You might be surprised what they will find. Your body will thank you!
Image from PDGA Disc Golf
This is the time of year when one can reflect on our lives and the things we want to improve on for the upcoming year. Why not make it your goal to improve your balance? One way to decide if your balance needs improving is by having your balance tested. Balance testing can be high tech, or low tech. The low tech testing is something that you could do at home, without fancy equipment, and it is based on a physical performance test. In other words, we ask a patient to perform a balance skill, and then see if they can do it or not. A person with good balance, and no history of inner ear pathology or neurological problems should be able to do the test.
One such test is called the Rhomberg Test. When I do this test with my balance therapy patients in Sarasota, Florida, I have the patient stand in a corner about 2 inches away from the wall, with a chair in front for safety. Then, I am standing by just in case. If you decide to try this test, have a friend or family member stand by to make sure you do not fall and get hurt.
The test is this- the person must stand with their feet together, with no space in between the feet. (If you are knock-kneed and cannot get your feet together, then put your knees as close together as you can). Next, you stand as still as you can, trying not to sway. The goal is to be able to do this for 30 seconds without falling, needing to open your eyes, take a step, or touch the wall or chair for support.
When standing with the eyes open, the person is using their vision, their inner ear system, and their somatosensory system to help them balance. Somatosensation is the sensation that allows your joints and muscles to send information to the brain to tell you if you are steady, or swaying. If a person cannot perform this test for 30 seconds, then they are at high risk for falling.
The second part of the Rhomberg Test is performed with the eyes closed. Again, the goal is to stand for 30 seconds. When the eyes are closed, the brain must rely on information from the inner ear, and feeling the ground in order to maintain balance. If a person falls in this test, they are reliant on their vision to maintain balance. This means that they would be at increased risk of falling if walking in a darkened setting, or on a complaint surface such as grass in the back yard when the sun is setting, for example.
How did you do with the testing? If the answer is “not so good”, make it your 2015 New Year’s Resolution to do something about it before you fall and get hurt. What should you do? Talk to your doctor about your balance, and find a physical therapist who specializes in treating inner ear balance problems. You could find a balance specialist in your area if you go to the Vestibular Disorders Association website. They allow you to search for a physical therapist in your area by entering your zip code. I believe you can achieve the goal of better balance in 2015! Happy New Year!
Painting: Planting the New Year’s Pine by Keisai Eisen, 1830s.
Hi, everyone. I just wanted to let you know that if you live in Sarasota or Manatee County in Florida, there is a great event going on this weekend. It is the called the 3rd Annual Hearing Tech Expo, held on Saturday, March 8, 2014 from 9am-4pm.
Over 50 vendors who help people with hearing loss will be present. There will also be 14 seminars taking place. I will be giving one of the seminars, and the title of my talk is “Understanding Balance Problems, and what to do about them”. My talk is at 1:30 pm in the main auditorium of the Manatee Technical Institute (located on State Route 70, just west of I-75, and east of route 301).
This is a super event, and I hope you can make it. It is sponsored by the Hearing Loss Association, whose purpose is to educated, support, and advocate for the over 135,000 people who live in Sarasota and Manatee counties. Hope to see you there!
We know that people use information from other senses to help them balance. For instance, we use our vision to help us balance. When we walk outside today, and see that the sidewalk is sloping, we will automatically adjust our steps and our balance based on this information.
But how does one’s hearing affect their balance? A study appeared in the Archives of Internal Medicine Feb 28, 2012 about research out of Johns Hopkins Medical Institution. They studied 2,000 people between the ages of 40 to 69. The people had their hearing tested and were asked questions about if they had fallen in the past year.
(Pictured: an antique ear trumpet for the hard of hearing.)
The results confirmed the contribution that hearing makes to balance. In this study, the researchers found that even people with a mild hearing loss (25 decibels) were nearly 3 times more likely to have a history of falls than those without a hearing loss! They were also able to measure how as the hearing decreased, the risk of falls increased. For instance with every 10 decibels of hearing loss, the risk of falling increased by 1.4 fold!
Many people don’t want to wear their hearing aids, for many various reasons. But when they understand that wearing the hearing aids will decrease their risk of falls and injury, they are usually much more willing to put them on…
Do you need inspiration to improve your balance? Then check this out:
So many times we want to make positive changes, but they seem impossible. This is true when working on improving one’s balance too. When I was in Miami for the Triologic Meeting in January 2013, I was walking down the street, and there on the corner of Lincoln Avenue was balance inspiration at it’s best. What these guys were doing seemed impossible, but they made it possible! I hope watching this video encourages you to never give up, and to keep doing your balance exercises!