Many of us know someone who seems to be a little more clumsy. Maybe they trip a lot, stumble often and sometimes even fall. Maybe I am describing you.

Occasionally losing your balance or stumbling here or there is not a balance problem.

Vertigo is a true balance disorder. Issues that involve the vestibular system (which is a fascinating system) are true balance disorders. These can be triggered by head, neck and eye movements and are often associated with nausea, dizziness and true loss of balance (LOB) which often results in a fall.

Balance is a difficult thing to quantify since it involves many systems and many variables. Your balance is maintained by a dynamic interplay between three systems in the body. In the ideal world, all three systems would work harmoniously together.

The three systems that need to work together are:

  1. Your vision

  2. Your vestibular system (inner ear)

  3. Somatosensory input from your feet and ankles

How does balance become unbalanced?

As you get into your 30’s and beyond, it is harder to maintain the same activity level you did when you were younger. Not there yet? Trust me. It will happen.

You may become a bit more sedentary because you have a desk job or kids or maybe an injury or surgery has knocked you back a bit.

Our movements become the same each day with little variation. These movements are done through a small portion of our available ability to move.

As a result, your vestibular system is challenged less and ultimately functions at a lower level. The threshold for overwhelming it is lowered. Your body now relies more on the other two systems.

But, as a result of the more sedentary lifestyle, and awful footwear choices, your ankle mobility is poor, your lower body is weak and as a result, the sensory input from your feet and ankles is diminished. It can be less overall or the input just takes longer to get to your brain where it integrates with the other systems.

You are now left to rely primarily on your vision for balance. If you are dealing with any issues with your vision, you can see how your balance might be off a little bit.

There is a huge strength component to balance.

Although not directly connected to balance, strength is a big-time player when it comes to balancing yourself. Especially the strength of your hips and glutes.

Having a hard time balancing on one leg is not usually a balance issue. It is a weakness and stability issue.

I know it will look like a balance issue, but things are often not what them seem. Let’s go down the rabbit hole, shall we?

down the rabbit hole.jpg

If your hip(s) cannot stabilize properly, it will manifest as poor balance. You could spend a lot of time and effort chasing your “bad balance” and never make any noticeable progress.

When the hip lacks stability, the hip kicks out, the knee collapses in and the foot/arch often flatten.

This is not a good knee position but a very common one.

This is not a good knee position but a very common one.

There is a lot going on here and none of it is any good.

There is a lot going on here and none of it is any good.

Here’s the kicker. When the hip cannot stabilize properly, this lack of stability shows up EVERY TIME YOU HAVE ALL OF YOUR WEIGHT ON ONE LEG!

This is not just when you try to balance on one leg. It is also when you:

  • walk

  • run

  • dance

  • perform certain yoga poses

  • climb stairs

  • perform any single-leg exercise

Simply repeating these movements over and over again WILL NOT fix the hip stability issue. You will have to change HOW you do things to improve stability.

Part of the issue is that the “abnormal” position will feel completely normal to you. You will not feel the need to change how you are moving.

There is one other piece of information that is crucial when navigating this landscape. You can have good overall lower body strength, perform complex lifts and even run races with your poor ability to stabilize the hip.

In this scenario, balance may not be the primary complaint. Pain is usually what gets this problem noticed in the first place.

Your brain cannot be trusted.

Changing an exercise or your daily activities to correct the abnormal movement will actually feel wrong when you first try. This is a dirty trick your brain is playing on you. Since these “abnormal” movements have been learned over time, they are your default movement pattern. To the brain, the are “normal”.

Anything that deviates from this pattern feels off. The changed movement pattern feels weird and your brain will encourage you to continue to do it the wrong way because it feels right. Stupid brain.

How can you fix it?

The ways to fix it are simple. They just are not easy.

First, you must be made aware you are moving this way in the first place. Like I said, your hip will do this and you will not feel like it is wrong. Once it is showed to you and you can see it with your own eyes, awareness is happening.

You will start to pay attention to it during the day and when you train. This is a huge step in correcting the underlying issue. Remember. You CANNOT just do more of the same. And if you are not aware of how you are moving then the brain will just keep doing its thing. And its thing is doing you a disservice.

Second, you must alter your training. If you cannot stabilize your hip properly when walking or climbing stairs, how can you possibly do it during dynamic exercises when you are fatigued? Think about it. I’ll wait.

Give up?

You basically have a zero percent chance during more challenging movements to appropriately stabilize the hip. Quick side bar here. This faulty movement pattern is a common source of knee pain when your knee pain has not trauma to speak of and seems to come out of nowhere.

To correct this, you will need some combination of deloading of lower body movements, lower weights (in some cases, going back to body weight movements) and possibly have some manual assistance when performing lower body movements.

I will often help clients stabilize the knee and hip while they work on steps ups, step downs, lunges or split squats. Manual assistance with some form of a deload allows you to get used to the position you should be in. It will help you override the brain which will continue to pull you back to the troublesome position.

The third thing you should consider is managing, not inducing fatigue. You are working on improving motor control and this is best improved with shorter, more frequent sets.

You will find this situation easier to manage if you keep the reps brief (no more than 6 in a row) with sets being more frequent. It is not uncommon for me to prescribe a set of 6 reps done as mini sets of 1 rep, which allows for fatigue management and an intense focus on technique, since you only have to focus on 1 rep at a time.

If you are working on rehabbing an injury or trying to improve some movement pattern, I strongly encourage you to invert your rep scheme.

3 sets of 10 is common but has no place early on in this process.

10 sets of 3 (or some variation of) makes more sense. The volume is the same, but the quality of the movements will be markedly different.

Take home message

If you feel like your balance is a bit off, do not just chalk it up as something that is what it is. And do not just spend a bunch of time adding in a bunch of balancing movements (unless they have a specific purpose).

Make sure you get yourself a thorough assessment by a qualified clinician to see if balance is truly the issue or if you need to improve your hip stability and dynamic lower extremity positioning.

If this is something you want help correcting or you are just looking for a safer way to train, click below so we can schedule a call and get you back on track.


Do not forget to subscribe to EBM’s YouTube channel which has (at the time this was written) over 500 exercise videos and tutorials.

Until next time,

Dr. Tom

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