Lisa Gigliotti, a pediatric physical therapist, is always working on balance.  Being able to balance and stay on your feet are essential skills for everyday life, but what factors make up all of the pieces of the balance puzzle?  And how can we work as parents and therapists to improve the balance of our children (and even ourselves?)

The concept of balance is usually broken into 2 separate parts: static balance and dynamic balance.

Static balance means being able to hold a stationary position with control.  This includes sitting still, standing still, and standing on one foot.

Dynamic balance means being able to keep your balance while moving, such as while walking across a balance beam or riding on a scooter or bike.

Having good balance requires coordination from 3 different body systems, including the vestibular system, the somatosensory system, and the visual system.  If these three systems aren‚Äôt all working together, it will affect our balance.

The vestibular system includes the organs in the inner ear.  It is able to sense the direction and the speed at which your head moves (and usually where your head goes, your body follows.)

The somatosensory system is made up of tons of little sensors that are all over your body and especially on your hands and feet.  They tell our body about where we are in space.  This concept is called proprioception.  Proprioception allows us to know whether we are sitting, lying down, or standing even while our eyes are closed and to do things like walk up the stairs without looking at them.

The visual system uses our eyes to tell us where we are.  Our eyes give our brain information about our movement, our relationship to the environment, and how stable surfaces are in front of us.

Another factor of balance is the alignment of our bones and muscles.  If we have muscle imbalances, where some muscles are strong and some are weak, it can throw off our alignment and have an effect on our balance.

Therapists can work on all of these different systems to help improve balance.  That is why, often during evaluations, we ask your child to stand on one foot with their eyes open and their eyes closed- it can tell us whether or not they may be relying too much on one system for their balance.

As therapists, we work on things like:

• Providing vestibular input to regulate the vestibular system with activities like swinging or spinning
• Stretching and strengthening  the muscles for proper alignment
• Coordinating movement with visual activities to help our eyes and our muscles communicate better
• Incorporating sensory input to help our proprioceptors tell us exactly where we are in space

All of these things can help us piece together the balance puzzle.

If you have concerns about your child’s balance, contact Child and Family Development for a physical therapy evaluation.