I incorporate balance training into clients’ workouts in one of two ways.
Some clients—usually athletes, individuals who are in postrehabilitation and the elderly—understand that they need balance training. With them it’s acceptable to block out 15–20 minutes of each workout to specifically train balance. With athletes we will probably work on the beam and wobble boards doing sport-specific drills and a lot of single-leg exercises. For clients in postrehabilitation for low-back injury, we might spend that time working on foam rollers, stability balls or other unstable apparatus to train posture and stabilization. With seniors I like to do a lot of dual adjustable pulley work from standing. We add steps to their pushing and pulling exercises. We also do multidirectional mini lunges and walk through drills on the agility ladder.
For other clients the workout goal is to look better. They need balance training as well, but they aren’t really interested in it. So I sneak balance work into the program. We might warm up for 3–4 minutes by walking and moving on the beam. The clients’ focus is on carrying themselves with their best-looking posture, but my focus is on making sure they get in some balance work. Then, before we do squats, we might do one warm-up set without weights on the balance board. We might do abdominal work on the stability ball that day as well. While their focus is on the “fashion” gains from these exercises, I’ve slipped in some “function” in terms of balance.
John A. Blievernicht, MA
President, Institute for Sports, Health & Fitness
At the Athlete Conditioning Center in North Vancouver, British Columbia, balance work is part of the programming for a variety of clients. Balance drills help the youngest kids develop coordination and “smart muscles” during peak neural-maturation phases, while pubertal kids use similar balance challenges to adjust during awkward growth periods. Kids assuming an athletic-ready stance atop a BOSU® Balance Trainer pass and bounce tennis or lacrosse balls back and forth. The activity requires hand-eye coordination, whole-body coordination and athletic posture, with the challenge of an unstable surface.
During young clients’ peak growth phases, I reteach stopping, landing and transitional mechanics for safe direction change. Peak-growth clients complete one- and two-legged lateral bounds, landing on the inside convex surface of the BOSU ball. This is to force them to land and brake with good mechanics, loading up into a deep knee flexion position.
Balance is a big part of training programs for our flagship pro athletes and also a part of each functional-fitness class for adults. Injured clients with return-to-play objectives use balance exercises to recondition joints. Aging clients use similar exercises to keep them out of the disability zone and stay reactive and mobile.
We implement balance training with all of our clients as part of a complete program that includes strength, anaerobic and aerobic conditioning, core power, agility, quickness and flexibility. Balance is used during various parts of each workout. In early-morning sessions, we begin with simple balance challenges to wake up, warm up and activate the body and mind. At this time of day I choose a low-impact, interesting challenge to activate a lot of muscle groups and force the mind to focus, preparing the client for a well-executed workout.
I integrate balance into whole-body strength exercises, to enhance recruitment and involve another method of overload. We always increase loads throughout a program with various tempos—initially using slower movements emphasizing time under tension for hypertrophy and stabilization phases, and later focusing more on coupling and explosive power to shift the force-velocity curve and teach the brain to command high-speed movements under heavy load. Integrating balance increases muscle activation because the client is at a mechanical disadvantage, but it also adds neural complexity to the overload variables. We are stimulating great closed-kinetic-chain strength gains with balance and neural complexity as training variables.
In the strength workout, integrated balance exercises are often supersetted with traditional strength exercises. A balance-traditional order is used to potentiate the muscle before a heavy lift, and a traditional-balance order is used to rehearse coordination and eccentric loading under fatigue after a heavy lift.
We sometimes use integrated balance in strength moves to teach complex to simple, such as when teaching squat technique. Once a move is perfected with body weight only on an Extreme Balance Board, the client is moved to floor-based squats, and I can begin to increase the load. Clients are forced to use perfect mechanics on the balance apparatus or they will fail.
After clients have been introduced to new training loads (e.g., plyometrics), I implement full-session balance training for active recovery to help minimize delayed-onset muscle soreness. When we implement quick feet drills and plyometrics, balance is integrated, placing an emphasis on quick floor-contact time and requiring pause holds on top of the BOSU ball. I use balance in this part of the workout to break down plyometric drills into rep-by-rep maximums, with more focus on the ground contact time, and gain benefit by working on safe landings and deceleration on top.
Peter Twist, MSc
President and CEO, Twist Conditioning Inc
North Vancouver, British Columbia
With all of my clients I work on balance training primarily by training for core strength, as this will improve both exercise performance and functional performance. Lack of balance is typically a sign of core weakness. With clients who do not fall into a “special population,” I do traditional exercises on the BOSU ball, a balance disk, a wobble board or a stability ball. I also have clients stand on one foot to perform traditional exercises (e.g., shoulder press), and I often incorporate combo moves (e.g., alternating stationary lunges with lateral shoulder raises). In all situations, I emphasize abdominal muscle contraction, a head up/chest up/ straight-back posture, and utilization of the breath to maintain focus during the exercise. For an exercise on an unstable surface and for the one-foot method, I have clients fix their gaze on a steady point in front of them; this can significantly aid them in performing the exercise in a stable manner.
For special-population clients, such as my prenatal clients, I use more of the one-foot method. Lack of equilibrium increases during pregnancy, raising the risk of falling, so I do not train pregnant clients on unstable surfaces, such as the BOSU ball. Another balance exercise that I like to have prenatal clients perform is alternating opposing arm/leg extensions while they are on their hands and knees, holding each extension for 3–5 seconds while maintaining level hips; for added challenge they can perform this exercise while kneeling on balance disks (one under each knee).
For postnatal clients who have experienced a natural birth, I use exercises similar to those I use for the regular population, except that I initially tone down the intensity and then gradually increase both intensity and complexity as they regain their strength. For clients who have experienced a Caesarean birth, my approach is similar, but I use only exercises that they can perform standing or lying on their backs. Pelvic tilts are an excellent exercise for this population, as they tone the abdominal muscles and simultaneously build core strength, which aids in balance.
Clients of all populations may find balance training uncomfortable. If I see a client is really distressed over standing on one foot or standing on an unstable surface, I will start with simpler exercises, like having her walk a straight line along a flat strap or piece of tape on the floor, before progressing to the one-foot method and eventually to unstable surfaces.
Patty G. Jones
Certified Personal Trainer and Owner, Pathways to Fitness
Balance training on land is an excellent way to improve balance, but it can be risky or intimidating for some people. When clients are afraid of falling, it’s hard to train for balance. An integrated approach, using both land and water, can minimize the “fear factors” that prevent people from practicing balance skills on land. Taking balance training to the pool, where water can “catch” a stumble or fall, allows people to make movement errors safely and then practice corrections with more confidence. Water’s buoyancy and viscosity (thickness) support and slow down movements, lowering the risk of injury.
Use general water fitness safety principles when teaching balance training in shallow water. For example, have participants practice safety skills, such as recovery to a stand, in case they lose their balance.
Effective challenge to balance training should integrate the primary systems used to maintain balance. Here are those systems, plus some exercise challenges I use:
Visual System. This system provides information about the environment and where the body is in space, how fast it’s moving, obstacles in its path, peripheral vision and depth perception.
Challenge to Static Balance. Stand in a tandem stand—heel to toe, eyes on the horizon. Progress by closing the eyes. Hold 10–20 seconds and repeat with the other leg forward.
Challenge to Dynamic Balance. Face your partner. One person walks “on a line” with eyes closed, while the other acts as a safety guide. Walk forward and backward switching roles.
Somatosensory System. This system uses skin and muscle receptors to provide information about body contact and position. Skin receptors let us know about touch and vibration, and muscle receptors tell us about the position of our limbs and body. Muscle reflexes are important for helping to automatically correct and protect the body.
Challenge to Static Balance. Tandem stand in the pool with bare feet, hugging a water-resistant medicine ball, arms in front of the body. (The ball can be 6–10 pounds or as heavy as needed for you to feel grounded). Feel how the extra weight makes the feet more sensitive. To increase the challenge, have a friend run around you to create currents.
Challenge to Dynamic Balance. Tuck the medicine ball under your arm on one side; follow your partner, walking “on a line.” Draft behind your partner, using the current to pull you along; step to one side and challenge yourself by walking in your partner’s “wake.” Repeat with the ball under the other arm and switch roles.
Vestibular System. This system, located in the inner ear, includes receptors that provide information about movements of the head and where the body is in space. The response system is also known as the sixth sense or the “righting” mechanism (think of how a cat automatically rights itself when turned upside down).
Challenge to Static Balance. Tandem stand and rotate or tilt the head, looking for the “spider in the corner” or following the “plane overhead.” Repeat with the other leg forward.
Challenge to Dynamic Balance. Walk on a line shoulder to shoulder with your partner, gazing into each other’s eyes as you walk and talk. Switch places and repeat.
I begin balance training in the pool and then progress to land. I use the Thera-Band® First Step Kit with my clients to guide them through easy-to-understand progressions.
Mary E. Sanders, PhD (C)
Associate Professor, School of Medicine,
University of Nevada, Reno