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Balance Training – A Wobbly Concept

by Fred Hahn on September 17, 2010

balance

I saw this article in the NY Times yesterday on balance training for the elderly. I braced myself for the fallout.

As per usual when these sorts of articles come out, clients phone in wanting to know the skinny on the issues. One of my long standing senior clients (of almost 10 years), Phyllis, called me and ever so politely asked if we could incorporate the balance training she read about in the article into her routine. (She’s such a sweetheart!)

I thought – “Oy vey. How do I say this to her?”

I explained that for one, there really is no such thing as “a balance” when it comes to the human body. (I’m not talking chakras or spirituality here). Unless you have an inner ear, visual or other equilibrioception problem, the main cause of loss of balance, such as falling when a bike messenger whizzes by or when stepping off a high step, is muscular weakness.

According to Dr. Richard Schmidt, author of the book Motor Control and Learning (my additions are in parens):

A common misconception is that fundamental abilities (running, gymnastics, etc.) can be trained through various drills or other activities. The thinking is that, with some stronger ability, the athlete will see gains in performance for tasks with this underlying ability.

For example, athletes are often given various “quickening” exercises, with the hope that these exercises would train some fundamental ability to be quick, allowing quicker response in their particular sports.

Coaches (as well as physical therapists) often use various balancing drills to increase general balancing ability, eye movement exercises to improve vision, and many others. Such attempts to train fundamental abilities may sound fine, but usually they simply do not work. Time, and often money, would be better spent practicing the eventual goal skills. (Meaning, if you want to get better at running the bases in baseball for example, run the actual bases. Don’t run around traffic cones, over care tires, ropes or anything else.)

There are two correct ways to think of these principles. First, there is no general ability to be quick, to balance, or to use vision. Rather, quickness, balance, and vision are each based on many diverse abilities, so there is no single quickness or balance ability, for example, that can be trained.

Second, even if there were such general abilities, these are, by definition, genetic and not subject to modification through practice. Therefore, attempts to modify an ability with a nonspecific drill are ineffective. A learner may acquire additional skill at the drill which is, after all, a skill itself, but this learning does not transfer to the main skill of interest.

The bottom line here is, though the trainer in the picture is clearly well meaning, he is making that woman sit on that ball with one leg out for nothing. He is not improving her balance – save for the balance required to sit on a ball with one leg out. What these balancing tasks can do for people is make them a smidge stronger but in a very inefficient and unproductive manner. This is the real reason why some people improve their balance from doing these tasks. Sadly, many people are very, very weak especially the elderly. This country would save millions perhaps billions of dollars if we’d strength train our seniors. I have seen what I think are real life miracles in my gym over the years in many older folks. It is most rewarding to experience.

In the time spent doing balance training, the same time would be better spent doing a full body strength training workout (with weights, machines, etc.) to improve and increase a person’s lean mass.

So yes, all those BAPS boards, wobbly boards, Bosu discs and other balance training devices you hear abour or have seen (or perhaps used!) are just glorified Romper Room toys. Use them for fun if you like, but don’t think they are doing anything for your “balance.”

I've been involved in exercise ever since I became a member of The Charles Atlas Club when I was 10 years old. In 1998, I founded and established Serious Strength on the Upper West Side of NYC. My clients include kids, seniors (and everyone in between), top CEOs, celebrities, bestselling authors, journalists and TV personalities.
my book. my Gym.

in Current Affairs,Health/Fitness,personal training,Sports,strength training · 14 comments

{ 14 comments… read them below or add one }

Jake September 17, 2010 at 9:08 AM

I certainly agree with you.

I used to have poor balance. Then i started leg strength training. The stronger my legs became, the better my balance. I can now leg press 380 lbs and my balance is excellent.

I am 68.

Joe September 17, 2010 at 9:38 AM

Agreed. It is crazy that seemingly intelligent individuals think that learning to sit balanced on a stability ball would transfer to other situations. Any one who has ever had to stand, walk, walk carrying groceries, walk up stairs, ride a bicycle and anything else knows each has unique requirements in order to balance. And like you correctly point out, it is usually a muscular issue.

The one value I can see for the wobbly toys, is demonstrating (in a somewhat controlled scenario) the musculature involved in correcting posture in an unstable environment. When a person begins to lose their balance, knowing and then controlling the muscles in their hips, abs, thighs, obliques, etc. can help them recover in order to prevent the fall. If you put a person on a wobble board, they will quickly gain an understanding of which muscles need to be strong, which muscles need to be engaged and how to intentionally activate them. Again, I just mean for demonstration purposes. Then you go strength train and get as strong as possible.

Beyong strength, I think the elderly (everyone frankly) should practice defensive moving (i.e. anticipating being bumped in large crowds). The more aware and vivgilant a person is, the more likely they can prevent the scenarios that lead to falls in the first place.

Additionally, learning how to fall should be required learning at a young age. Fred, you were in martial arts, so I’m guessing you know what I’m referring to? anyway, learning how to minimize injury through manipualting the manding and avoiding mistakes like breaking wrists tring to catch yourself, etc.

Jonathan September 17, 2010 at 10:00 AM

What? Riding golf carts doesn’t improve balance?

joe September 17, 2010 at 10:10 AM

“Riding golf carts doesn’t improve balance?”

I don’t know, the way my brother-in-law drives . . .

Guy September 17, 2010 at 8:52 PM

Fred
You are a candle in the dark!!! Thanks!

Paul September 17, 2010 at 9:16 PM

I’ve gotta respectfully disagree. Obviously I’ll concede that a guy with really weak legs will be wobbly. That’s a given. But you sound like you’ve only seen poor balance training. Obviously no one is going to get huge arms solely from destabilization training, which is what I prefer to call it, but hoping for massive size gains from a bosu ball is missing the point. There are many different ways to benefit from destabilization training. I rehabed my ankle beautifully with a dynadisk. There’s a lot to be said for these exercises, when done right, and with realistic goals.

I have not read the NYT piece. I rarely agree with them (though my mom was an editor there), and am more responding to what I’m reading here. It seems what we should really be talking about is stability, which is not precisely the same thing as balance. Stability would include balance (being less likely to fall) but also an ankle being less likely to roll, a shoulder being less likely to dislocate, etc.

The more our equipment stabilizes our bodies, the less our bodies are asked to stabilize themselves. People who run in these wide-soled anti-roll NewBalance shoes have purchased stability in their shoes which will be counterbalanced by diminishing strength in their actual ankles. There’s a similar effect when people strengthen their legs only on machines that guide and support their bodies while making stabilizer muscles irrelevant. I’m not just talking about muscle mass here. I’m talking about the ability of the athlete (or the octogenarian), when unexpectedly pushed from the side, to recruit just the right synergy of muscles to balance himself in the split second before he even consciously realizes he’s been pushed. That has little to do with muscle mass, and much to do with the nervous system acting as the musculo-skeletal system’s internet. And that ability to respond with lightning speed to an unforeseen impetus before you know it — that is often what people will refer to as balance. Arguably a misnomer, sure. But whatever you call it, you ain’t getting it doing leg extensions.

Joe September 17, 2010 at 10:04 PM

Paul,

You said, ” . . . making stabilizer muscles irrelevant.”
What muscles, specifically, are you referring to as stabilizer muscles???

“I’m talking about the ability of the athlete (or the octogenarian), when unexpectedly pushed from the side, to recruit just the right synergy of muscles to balance himself in the split second before he even consciously realizes he’s been pushed . . . you ain’t getting it doing leg extensions.”

What makes you think you are getting it from a BOSU or VersaDisc??? Or that it’s trainable at all??

Brandon Schultz, D.C. September 18, 2010 at 2:28 PM

Paul,
I must disagree with you statements, as they are chock full of rhetoric from the “functional” training movement.

Stabilizer recruitment is movement specific. Doing any type of horizontal pressing will recruit the muscles the CNS deems necessary to stabilize all relevant joints specific to the movement, no matter on a bench press, MedX Chest press, DB press or Stabilty ball pushup. All specific to load of the weight and line of load through the wrist, elbow, shoulder joint and shoulder girdle.

Recovery from being shoved would also be specific. Are we now going to have “Shove A Senior” fitness class? Don’t think so. Some may fall, some not.The ability to recruit muscle fibers to control a fall, stop a fall or provide cushion for a fall has far too many factors than if they are “functionally trained”. I occasionally fall while on slippery surfaces, but don’t sustain serious injury due to my ability to “catch” myself and decrease the impact and I do not “functionally” train. I still may fall when something unexpected occurs of the coefficient of friction of the surface I am walking on changes to less than optimal. This has nothing to do my training. Everyone is neurologically wired differently giving them more or less athletic ability. This is not a result of a guru’s training program. What you see in highly talented (skilled physical activity) athletes is a unique combination of neuromusclar coordination, activity specific muscle fiber type, visual acuity, joint structure (flexibility) and others. These are inborn and must be coordinated by specific training in a specific sport.

On the Body By Science blog, Greg Anderson has a hilarious example of how an American semi-pro football team crushed a visiting Russian team, who employed plyometric drills and were STRONG, but not good football players and were subsequently crushed by the American team.

I don’t care how people train – free weights or machines. They all strengthen skeletal muscles if done properly and within the appropriate energy systems. Where I draw the line in the sand is the “mystification” terms and use of catch phrases like functional, stability, stabilizers, etc. The above text book on motor learning and many others just like it will back this up. Even the uber-mystical “core strength” has been clearly bedunked by science by direct emg studies on muscle recruitment patterns during various activities and other sources.

I am all for and highly encourage resistance training to build and maintain skeletal muscle which assists with increased insulin sensitivity and for mitochondrial density for improved energy production. Beyond that, training for a sport or activity should be as precise as possible.

Your rehab of your ankle was just that, rehab. The wobble board provides a huge amount of mechanoreception to the joints of the ankle as you retrain the brain to decrease nociceptive activity while restructuring the soft tissues of the ankle post-injury. A healthy dose of old-fashioned calf raises seated and standing and resisted ankle dorsiflexion would have helped tremendously as well post-acute phase. Again this was neurological/soft-tissue rehab, not a miraculous way to train all the time, which unfortunately it has become.

Be well.

Brandon

mrfreddy September 18, 2010 at 2:47 PM

Brandon,

do you have any links for the debunking of core strength you mentioned? I’d love to forward them to my pilates crazed sisters, nieces, girlfriends, wife…

Fred Hahn September 18, 2010 at 3:28 PM

Well said Brandon. You saved me the work of responding to Paul who clearly means well but is, like so many, not up on ML principles. I studied this at LIU when going for my AT degree. It is a fascinating area of ex phys.

joe September 18, 2010 at 7:03 PM

mrfreddy:

This is a good paper by Professor Lederman:
http://baye.com/the-myth-of-core-stability/

Additionally, I’d recommend the book Fred quoted above by Dr. Richard Schmidt. Fascinating indeed!

Dana September 19, 2010 at 12:31 PM

First thing I thought was “what about the use of balance balls to strengthen core muscles” but my brain immediately came back with “duh, there are regular exercises you can do to strengthen core muscles, no ball needed.” And I felt silly.

Fred Hahn September 19, 2010 at 12:34 PM

Dana – Right. The entire concept is based on a flawed understanding of ML principles. Strengthening is the key concept.

Brandon Schultz, D.C. September 19, 2010 at 5:11 PM

Mr. Freddy,

Tha link posted by Joe is the one I was referring to. Great information!

Strengthen the muscles in the most efficient and effective method that is available to you and take the strength and apply it to life however you choose to live it. Nothing is more simple than that.

Great stuff everyone. Fred, thank you for the great blog.

In health,
Brandon

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