Tuesday, July 10, 2018

"Is Your Balance Holding You Back"

Is Your Balance Holding You Back?

Originally published in the Summer 2011 edition of "The Blind Californian".

I work for a 112-acre community college. As a guide dog handler of thirty years, I was used to confidently zipping off to meetings and negotiating the ongoing campus construction with relative ease. As the resident geek for disability services, I often had to drop what I was doing and hustle off to a lab twenty minutes away to figure out why a student's midterm wouldn't print. As a fifty-something, I didn't pay much attention to studies proving we lose our sense of balance as we age.

Then one Sunday while washing my bathroom floor, I slipped in a wet puddle.

Suddenly I was in extreme pain, unable to stand. It took months to heal, though luckily I did not need surgery. Because I worked with computers, I could continue to do most of my job. My guide dog quickly learned to serve as a furry grab-bar enabling us to visit even the least accessible bathrooms. Our transportation for students who depend on crutches or wheelchairs helped me get to my meetings, and though my independence was somewhat diminished, I assumed I'd be back to my old fit self in a few months.

But even after I could walk well again, I developed a terrible fear of falling. Though perhaps common for seniors losing their vision, I had been a confident blind traveler since high school. Medical professionals suggested it was a psychological thing; I had, after all experienced a bad fall, even if only in my own bathroom. Using a knee brace because my leg was now weaker, was a suggestion I was reluctant to follow. And I've never been prone to big psychological issues before. I wondered if I was getting menopausal or there was a deeper cause. I requested tests and to see a physical therapist.

It turned out I was right; it wasn't all in my head. The physical therapist saw immediately that my sense of balance was compromised and my left leg's muscles were weak. The medical tests showed I had a vitamin D deficiency, because while recovering, I'd spent less time walking around in the sun. (A lack of Vitamin D compromises our sense of balance.) Vitamin pills quickly fixed the deficiency, and simple physical therapy moved me forward on the road to better balance, but Internet research showed me some scary trends. Falls are the number one cause of injury for seniors, and millions of seniors with unimpaired vision experience serious injuries caused by falling every year. The problem is that their sense of balance has declined.

The sense of balance, I also read was dependent on vision. Even physical therapists use visual clues to assist clients with relearning balance. I tried for example to take a fall prevention for senior class at our local HMO, and they refused me because they insisted that good balance required vision. I encountered this strong prejudice everywhere I turned for help.

It would have been easy at that point to simply get a knee brace and permanently ride the campus shuttle for the physically limited. How could I prove to the professionals that I believed I could regain my balance again? Despite the danger of falls, there is little advice for the senior who wants to prevent them. They can remove slippery scatter rugs and take Tai Chi, but by far the most common piece of advice is to improve lighting in the home. Nobody with severe vision loss wants to have good lighting as the only insurance policy to prevent falling! I decided I needed to banish my fear of falling before I could zip around campus safely again. Luckily we have a program to teach students how to become personal trainers. I asked C.J., the trainer, if I could become her guinea pig. C.J. was delighted. She is an open-minded teacher with advanced certifications in many aspects of exercise science. Personal trainers find athletes easy to work with, but it's hard to get experience with people who are older, stiffer, or kinesthetically challenged. C.J. taught me a mixture of exercises I could do at home and in the gym.

Under her careful tutelage, student trainers worked with me. They learned how to coach someone who is blind, overweight, creaky and injured, and such experience will broaden their resumes. I was able to benefit from the variety of these young people's teaching styles. Some of my helpers were the students with learning differences I serve in my job. They loved being able to assist me in return. And until the recent budget cuts, I was paying absolutely nothing for this amazing service.

The coolest piece of gym equipment I recommend for balance is the bosu, whose website is www.bosu.com. This is a springy rubber ball, with a flat side that sits on the ground. The exerciser stands on the ball and balances while bending, stretching, or lifting weights. The first time I was introduced to the Bosu, I burst in to tears. I couldn't imagine myself balancing on it while even holding on to the wall. At first we practiced just that. I'd stand, holding firmly to a nearby wall.

Eventually, I could stand just touching the wall with a single finger. Then I had to make it harder by bouncing up and down, flinging my arms in to the air and from side to side. I also practiced stepping on and off it and even doing slight knee bends. Due to my injury, it is dangerous for me to do deep squats or some of the other routines athletes practice with the Bosu. But stepping on and off simulated stepping down from a high train platform, and bouncing up and down helped me strengthen the leg muscles that keep my knee safe. Flinging my arms around throws off balance, simulating what might happen if I stumble on an unexpected curb. I eventually graduated to a larger Bosu which stands at the height of my thighs.

In mastering the Bosu, I discovered athletes and even their coaches were terrified to try it with their eyes closed. Today C.J. who also coaches the cheerleaders, requires they do some simple Bosu work blindfolded. Some of my students have been inspired to work harder at overcoming their dyslexia after seeing me struggle with and master balance on the Bosu.

I work out at the gym twice a week now and always do a stint on the Bosu. Even though I've tripped on many pieces of broken concrete and those evil cement blocks in parking lots, I have lost the fear of falling. My balance is undoubtedly much better than it was before I had my fall. I also suspect, after talking to many older students who both do and do not have vision issues, that a lack of confidence might be directly related to a lack of balance. If you are afraid to ride an unfamiliar bus or visit a store across town, consider that maybe compromised balance is your body's wisdom.

Your body might be telling you that you aren't safe.

C.J. and I offer this advice for blind people improving balance: start simply at home first. Use duct tape to hold two old phone books together so it makes a solid cube. Add more phone books as you advance but be sure to create a secure platform. You want it to be a bit springy but not slippery. Practice stepping on and off your phone book edifice in a clear, carpeted area, or if you feel unsure, near a strong heavy table you can hold on to while stepping. Step in different patterns, on, off, sideways, backwards. Move slowly; breathe deeply and pretend that a string runs from the top of your head to your toes.

Practice every day, but don't push yourself beyond your own comfort zone.

Sit in a chair, feet flat on the floor, knees slightly bent. Your feet should be in the position you normally assume when standing. Place your hands in front of you in any way that seems comfortable but positioned so you cannot use your arms to assist you when standing. I like to hold my palms together, touching my chin with my fingertips. This presses my elbows close to my sides, preventing them from assisting me to stand. Now stand up slowly, using only the strength in your legs. Once you are upright, lower yourself to the chair, again not using your hands to assist. Just as your rear touches the chair, but before you settle your weight on to it, stand again slowly. My physical therapist made me repeat this 25 times nonstop every morning. It gave me amazingly strong legs. Of course if you have any concerns that your legs aren't healthy, you should check with a doctor first before performing this or any other exercise.

Stand near a solid chair or counter, and holding on to it with one hand, balance for as long as you can on one foot. Track your progress by counting "One Mississippi", "Two Mississippi" etc. Log how many Mississippis you can go standing on the single foot. You will see improvement each week. Remember to do this with each foot.

Investigate local fitness centers, YMCA, senior centers and college gyms. If you are on fixed income, get creative and ask about scholarships or if you can be part of an experiment or (as I did) other people's training. If an exercise class looks challenging or inaccessible, don't give up, but try something else. I unsuccessfully tried several exercise classes before I found C.J. Don't let injuries, age, arthritis or your weight be a barrier. Not every exercise opportunity works for morbidly obese, or arthritic people, but many exercises need to simply be done more slowly and gently. Make sure the instructor or trainer has experience working with people who have your physical limitations. You can show them how to work with your visual impairment, but they need to be trained properly to deal with physical disabilities or medical conditions. Instructors should not push a client in to doing workouts that aren't safe.

Remember to do a variety of exercises and not just focus on balance. We need stretching for flexibility, aerobics for cardiovascular health and the often neglected strength training to keep the muscles supporting our joints strong. I use a treadmill at home to keep up with aerobics. I also use free weights at home, to improve my strength and keep osteoporosis at bay. When I travel, I use exercise bands. In the gym, I work out on machines and use the time to learn new floor exercises I can do at home. I always ask students to teach me new stretches.

Don't let little issues prevent you from keeping yourself healthy. I love to swim but can't fit it in to my schedule. I am ashamed I cannot walk around the gym independently, but right now I always have a student guiding me because there are too many people and obstacles to navigate. More important, I can independently walk everywhere on campus again. Neither of these little annoyances have prevented me from getting what I need to keep my health and balance strong.

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