Today I want to discuss a topic that is a very popular, important, and in my opinion deeply misunderstood.  That topic is balance.  I have taken clients who are over 70, and clients who are in their 20’s and remarkably improved their balance on one leg, and in their gait cycle in as little as 10 minutes.  How is this possible?  I work with balance by addressing two things.  I address the biomechanical/physiological component of balance by stabilizing the hip and changing the brains priority to inhibit compensation at the ankle/knee.  I also address proprioception, which is the brains ability to know where it is in space, and then compensate via a proprioceptive system.  Let’s discuss the mechanical component of balance first, because that is the one I see underutilized the most often.

When we walk we are forced to balance on one leg in the middle of the gait cycle.  If you think about walking for a moment and even walk around yourself, you will feel this transition if you slow down your gait.  At one point, you are forced to stabilize on one leg, even if it is very briefly.  Of course running, sprinting, jumping (one leg), etc. is the same system, just with more load and force.  The interesting thing is that although the human body is equipped with tools that help us balance inherently, we almost never employ them.  We seem to have forgotten about them.  The first thing we tend do when we get on one leg is feel the onus and pressure of our balance in our ankle.  If you try to balance on one leg you may experience your ankle rocking from side to side in order to stay upright.  With repetition, or with elite natural athleticism you may have excellent natural balance and not be forced to compensate into the ankle.  But eventually if you do lose your balance, or start to, you will feel your ankle rock to try to compensate.  To me, this movement pattern shows an over reliance on limbs and joints that are simply not designed to stabilize our entire body weight.  We have forgotten about our hips.

I am going to say something fairly controversial.  Stability and balance begins at the hips.  It begins with a stable hip angle, and that is achieved through a strong hip complex.  Look at the picture above.  This athlete is loading at the hip via his glutes.  Notice the bent knee and slight hip hinge. The hips should never drop/dip from side to side when going to one leg, either when balancing or in the gait cycle.  Once again we find the need for strong glutes and glute medius in order to achieve good stability through the pelvis.  But how do we know this to be true?  We can extrapolate this to be true, and that pelvic stability is directly impacted by the glutes by understanding what the glute medius does.  The glute medius controls the internal and external rotation of your femur.  What this means is when your knees fall into the mid line of your body, or a valgus position, most likely your glute medius is either weak, or inactive.  I work on activation of this muscle and programming of this muscle for all my clients.  It is essential for knee health.  What the glute medius also does is that it stabilizes the pelvis and keeps it level when we are in the gait cycle, or when we lift one of our legs in general.  A level pelvis means that the bodies’ kinetic chain is now stable from the hip.  If this is stable, that means the knee does not have to compensate for the hip dropping, and of course the ankle does not have to compensate as well.  In layman’s terms, finding your glutes and a stable pelvis automatically increases your ability to balance, provided there is ample strength in the areas you are trying to activate.

I had a teen age client a few months back that was experiencing ankle issues in athletics.  Instead of focusing on his ankle mobility first, I got him to neuromuscularly activate his glutes in his one leg balance work.  We worked on consciously forgetting about his ankle instability, and to find stability in the hip first.  He worked on the programming, accompanied with procioceptive work, and his ankle issues disappeared shortly.  If you think about it anatomically, when activating the glute medius it immediately helps with pronation, and helps to align the talus bone slightly in the ankle- thus achieving improved stability from the ground up as well.  We of course addressed ankle mobility as well, but that was not the main focus, that was a corrective at the end to make sure the issue never came back.  His one leg balance was poor when we first started this work.  He averaged less than 10 seconds on either leg.  He can now balance on one leg for an average of 30 seconds, with hardly any compensation in the ankle or knee.

I had an older client a few weeks back who was able to start walking without her instep she had been using her entire life to compensate for her “natural short leg length”.  When we stabilized her pelvis in her walk and got the glute medius to fire appropriately, she was able to walk without the instep for the first time.  She told me it was extremely challenging on her hip muscles to maintain a natural gait cycle.  Her instep had reinforced her hip instability, and made it that her glute medius never had to turn on.  She now can balance on either leg for over 15 seconds.  She is approaching 70 years old.  She used to fall at times because of her tendency to look for balance in her gait cycle by rolling the ankle to the outside of body.  We recreated this pattern on one leg, addressed the pattern, strengthened the muscles associative with this pattern, and the falling/instability disappeared.

I mentioned proprioception before, and it is absolutely worth mentioning now.  It should be a staple of everyone’s training/workout routine in some fashion.  Proprioception is the following according to the medical dictionary.

“A sense or perception, usually at a subconscious level, of the movements and position of the body and especially its limbs, independent of vision; this sense is gained primarily from input from sensory nerve terminals in muscles and tendons (muscle spindles) and the fibrous capsule of joints combined with input from the vestibular apparatus”

So how can we impact our body’s ability to proprioceptor?  We can work on balance as a practice, because the act of balancing on one leg, or even with a hand on the wall for support, is still challenging that system.  If you want a true challenge, try your balance work without visual input.  AKA close your eyes.  Balance work becomes incredibly difficult when we shut down our visual ability to know where we are in space.  I use components of proprioceptive training combined with neuromuscular cues and hip stability essentials to improve my client’s ability to balance no matter what age they are.  I should note, that when testing balance cues with neuromuscular emphasis, the success rate of my programming skyrockets when proper gluteal control is achieved without compensation from surrounding hip extensor related musculature. 

Last thing to mention.  Most people are entirely quad dominant in their balance work.  How do we know this?  They lock their leg when working on their balance.  This is an extremely common mistake I see in yoga, and other programming.  All balance work should be done in a similar manner in which we walk.  Soft knees, or a very slight bend at the knee allows the hip a chance to properly fire in one leg stance/balance work.  If you, or any loved ones have suffered from poor balance, ankle instability, or other related issues please comment below.  I have never had a client who suffered from ankle issues that also had proper hip strength/stability.  If we remember the body is a kinetic chain and address it as such, many such issues- including balance problems, can simply disappear.

Until next time everyone, stay safe out there.

https://medical-dictionary.thefreedictionary.com/proprioception

https://www.healthline.com/health/body/proprioception

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309156/

(None of the below is intended as medical advice, please do not take it as such)

Before I begin part three of this series, I want to mention what is going on all around us right now.  We are currently in a global pandemic and it is impacting all of our lives.  I hope that all of you are being safe and mindful during this time as we all try to do our part to prevent the spread of this infection.  I thought long and hard whether or not I wanted to keep releasing content during this time, and I have decided to continue.  I do this not to ignore or pretend that the physical issues I help others overcome is somehow greater than the global threat we currently face.  I do this to help people who regardless of the virus, are currently battling physical health issues that are limiting them on a day to day basis.  I have avoided sharing most of the particulars of the personal health issues that I overcame, because I viewed them as negative or that I wanted pity for what I went through.  I simply want to show you that if I can do it, maybe you can as well.  This is a message of hope.

If you are following my story you know that I was diagnosed with severe degenerative disk disease after my car accident.  What you don’t know is that two years after the accident, it would take me up 30 minutes to try to get out of bed each morning, each movement a stabbing pain.  Occasionally even the slowest movements would hit my body like lightning bolts and they would drop me to the floor.  The worst of this lasted for about 6 months.  I dropped 30 pounds during this time.  I went from 205 lbs. at 6’4 to 175.  I walked with a limp and was completely hunched over as standing straight was impossible due to pain.  People would walk up to me on the street and ask me if I needed help.  I was in my mid 20’s.  I could only sit for about 30 seconds before the sciatica would get so intense it would feel like a dagger in my leg.  My back health continued to deteriorate.  I had massages, chiropractic, therapy, personal training and medical doctors all take their shot.  In fact, one of the chiropractors I work with now helped me walk again over the course of two years of weekly visits during this time.  Some things helped.  Some things unfortunately made it worse.  I avoided pain medication, but would occasionally use muscle relaxers when it became too much to handle.  I used them sparingly and survived.  

I worked at an office job during this time and I was forced to stand.  I would work five days and on the weekend I would sleep all day, never leaving bed.  The second I got off work I was in bed with a heating pack, red laser treatment and a massager.  I could not have a social life because I was in too much pain.  The only thing that gave me any relief was laying down.  I had to stop all sports.  I had to stop all physical activity as every time I tried any exercise I would be in bed for a day or two, unable to move nearly at all.

In my 20’s, I felt like a cripple.  I suppose if I am really honest with myself I was practically hobbled.  I avoided friends and family for months, hiding my condition.  My own mother started crying the first time she saw me like this.  That was when I knew something truly serious had happened.  We all think that we are “Ok” and that even some of the worst things we have to go through are not a big deal.  We assume we will move past it, especially at my age where I had always felt invincible.  Before the accident, I would play basketball 5 times a week for 2-3 hours a night.  My body had never betrayed me so I assumed it would just snap back.  It didn’t.  My mother’s response was an eye opener.  Something had to change.

To do battle with the physical, we have to be mentally strong.  The strength of my mind had been weakened and battered by the pain.  I felt close to giving up many times.  Depression seeped into my mind like a slowly moving fog.  This period of time was one of the hardest things I have ever gone through.  This section alone deserves a book devoted in regards to the process I created of shifting ones priorities and developing tools to combat the darkness in our own minds.  One day after months of lying in bed I made a decision.  I was either going to give up, or I was going to fight.  I weighed the decision.  I decided that I would fight.

I started measuring progress in tiny increments.  Every day I would wake up I would try to tell if I had improved even 0.1% in regards to the level of constant pain I was in.  Some days I did not, but other days I did have that small improvement.  That improvement told me that I was going in the right direction, and that helped keep me in a positive mind set.  At the time, I could barely walk.  I could no longer run.  I could no longer jump.  Physical activity was completely beyond me, but I was still able to measure progress.  I think that clinging to the positive in our worst times can be very important in regards to maintaining sanity.  I also started to actively seek out solutions for my problem beyond just what I had been told medically.

It was around this time that a friend introduced me to Dr. Whitmire in Vancouver, WA.  It was just another random shot in the dark at trying to solve my problems.   I had been to many chiropractors, and most of them had either only very slightly helped me temporarily, or unfortunately caused me great pain after my appointments.  Whitmire was different.  After our very first session I felt shifting and even some pain relief.  He was a godsend.  Over the next two years I would leave work at 5PM and sit in 2 hours of traffic every week just to see him.  I was forced to massage my leg during these car trips just to distract myself from the intense sciatic pain.  Over these two years his work got me walking upright again.  My pain levels went from a 7-8 daily, to a manageable 4-5.  At the end of these two years he was very honest with me.  He did not know how to help me improve anymore.  I would leave his office in perfect alignment and come back needing a fairly serious adjustment in as little as a few days.  I would have to find other answers elsewhere.

I had been told by the medical community that my severe condition dictated my physical health.  But my condition/symptoms had improved with chiropractic work, though I was still in pain and discomfort.  This started me thinking that perhaps I needed to start looking into this problem myself.  I worked with a great personal trainer after this who helped expand my thought processes.  We would hit a wall together with my health as well, despite his expertise.  Instead of getting frustrated, I now became obsessed.  I had felt improvements and I knew answers were waiting for me.  I started reading and studying and experimenting daily on my own damaged body.  I would spend the better part of 3 years working through multiple methodologies.  I read up on Egoscue, Gokhale, Gray Cook, Dr. Starrett, Dr. McGill, and dove into the rabbit hole that is sports medicine.  Everything that I would read or watch on the internet I would try on my own body.  I devoured Jeff Cavaliers work with Athlean X.  I lived my life on Youtube watching and learning.  I listened to podcasts.  My life became health, fitness, and sports medicine.  My health continued to improve and I became able to be more active.  But I could never get past a certain point.  If I became too active, or moved too much, I would always throw my back out again and be out of commission for about a month.  I became frustrated again because technically I now knew the anatomical mechanics of how to get of pain, but the results alluded me.  My progress came to a stand-still and I was forced to live with back pain and discomfort still.  I was still limited at a time where I should be in the prime of my life.  After years of progress I was still in about a daily pain level of 2-3, with the ability to throw my back out at any time.  Then I finally found the answer.

I realized that regardless of our mental intentions to fire a particular muscle or move in general (certain muscles are essential for pain free movement) if that intention is not represented by the correct neuromuscular firing sequence into the right muscle, and sans the neuromuscular compensation patterns, then it simply will not work the right way.  Additionally, our bodies seem to have been designed with particular movement patterns in mind for healthy and pain free movement.  When we veer away from these movements, a large majority of us encounter physical issues.  By combining movement training with neuromuscular control, I started to see phenomenal and life changing results in my own body.  I have written a little about the creation of this process in past blogs and how my girlfriend was instrumental in helping to prove some of my theories.  There is no doubt now after working with hundreds of people that it works, and that it works for every one of every age, as my clients can attest to.

About five years has passed since I had first hobbled down Dr. Whitmire’s hallway.  I walked back into Dr. Whitmire’s office, completely pain free and about 25 muscular lbs. heavier. I walked in with a handful of papers detailing client testimonies.  He had many doubts in the beginning, but the results were undeniable.  We now work together on a weekly basis.  My work is being shown on a weekly basis to greatly assist his patients in holding their adjustments.  A few of his patients are now completely pain free after just a few neuromuscular cues.  I had come full circle.    

Sometimes the darkest things in our lives can become the brightest light.  As one of my clients told me the other day, hope is an incredibly powerful thing.  Do everything you can to hold onto yours.  You never know when that answer is just around the corner.

But why did my issues become so severe at such a young age?  I was not nearly as injured immediately after my car accident, but a few years later I could barely walk.  The answer?  Compensation.

Join me next week as I continue in part 4, discussing how our body’s ability to compensate could be a not only causing you pain and potential injury, but limiting performance as well.

Until next time, stay safe everyone.