What Keeps Us in Balance?

How Input From Muscles and Joints Affects Our Balance

Just as a baby first learns how to balance by practicing and repeating certain movements, each of us adjusts to changing environments or health conditions throughout our lives to keep our balance. But how do our muscles and joints play into this?

Balance Maintained by Our Complex Sensorimotor Control Systems

Our balance is maintained by complex sensorimotor control systems all working together, and if one of these systems is upset or not working properly, we can lose balance. The three main systems of the body that provide sensory information to keep us in balance are vision, the vestibular system (inner ear) and the proprioceptive (or somatosensory) system.

It is the proprioceptive system that involves feedback to our brains from our muscles, joints and pressure sensors. This system has pressure and position sensors in the feet, trunk and spine. According to the Vestibular Disorders Association (VEDA), sensory information coming from our necks and ankles are the most important. "Proprioceptive clues from the neck indicate the neck indicate the direction in which the head is turned. Cues from the ankles indicate the body’s movement or sway relative to both the standing surface (floor or ground) and the quality of that surface (for example, hard, soft, slippery, or uneven).”

Information from muscles, joints and skin is produced from sensory receptors that react to pressure or stretching in tissues surrounding it in the body, telling our brains about our position in space.

How Does Motor Output Back to Our Muscles and Joints Affect Balance?

If we start tipping forward for example, the brain senses increased pressure in the front of the soles of our feet and our ankles bending.  The brain can then send instructions to the muscles along back of our body to keep us from tipping further forward and pull us back upright if we weren’t leaning forward on purpose.  The other two balance systems should help out with this reaction as well: the eyes should notice the forward sway relative to one’s surroundings and the inner ears should sense the forward tilt as well.

If one or more of these three systems is not working well, then the brain’s instructions to these antigravity muscles can be delayed or inaccurate, resulting in unsteadiness. Vestibular rehabilitation and balance training can help a person learn to compensate and improve their balance reactions by utilizing the remaining systems more effectively.

Contact us to find a vestibular therapist near you.

Taking Good Balance for Granted

It's Not Until Dizziness Becomes a Problem That We Notice How Important Our Balance Is To Us

According to the Vestibular Disorders Association (VEDA), the body maintains balance with sensory information from three main systems:

• Vision
• Proprioception (touch sensors in the feet, trunk, and spine)
• Vestibular system (inner ear)

The Brain Integrates Sensory Information to Help Us Keep Our Balance

These three systems send information to the brain, and in response, the brain figures out where you are in space and sends information to the eyes for steady vision, and to the muscles for balance. When your balance system is working properly, you feel normal when you are standing or moving around:

• you can keep your balance when you're doing different activities
• you can see everything clearly when you move around
• you don't give a second thought to whether or not you should move your head

But when the balance system isn't working, even small activities like walking on uneven ground or walking down the stairs can be challenging and even cause an accident.

When the balance system isn't working, walking down the stairs can be challenging

Conflicting Information to the Brain Causes Disorientation

If the brain is getting conflicting sensory information from the vestibular system, the eyes, muscles or joints, it is difficult to process it. The goal of vestibular rehabilitation is to correct problems in the inner ear, or create a treatment program for you that will help the brain re-establish the coordination between your inner ears, eyes, muscles and joints. 

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Why Am I Dizzy?

Spinning, Dizziness or Falling Can Mean the Complex System That Looks After Our Balance Isn't Working Properly

Dizziness can be caused by the balance organs of the inner not working properly

Our bodies have a complex system to look after our balance that includes the inner ear, brain, vision, muscles and joints. If any part of this system isn't functioning, the result can be a feeling of spinning, dizziness or falling. Many adults feel dizzy, and there can be many possible reasons, but one of the more common culprits is that the balance organs of the inner aren't working properly, or that some parts of the central nervous system that process information about balance aren't working properly.

The word 'dizziness' means different things to different people. People using that word may be trying to describe vertigo (spinning), feeling faint or light-headed, disequilibrium (loss of balance) or unsteadiness, falling, nausea, a sense of exaggerated motion or just feeling "off". The better you are able to describe what you mean by 'dizziness', the easier it is for your medical provider to try to diagnose what is going on.

Vertigo Usually Indicates a Problem with the Function of the Inner Ear

According to the Vestibular Disorders Association (VEDA), if you have vertigo (a sense of spinning or whirling), especially when you tilt or move your head around, that is likely a sign of a problem with the function of your inner ear. On the other hand, dizziness can mean that there is a different type of vestibular problem or other issues such as vision, metabolism, neurological, psychological or cardiovascular. Since there are so many different types of dizziness and possible disorders that dizziness can be a result of, it is sometimes challenging for medical professionals to diagnose, and difficult and frustrating for patients until help is found.

Many things can be the cause of dizziness, from ear infections or trauma to an ear, to Meniere's Disease, to medications, to age-related degeneration, to central processing issues such as a stroke, to migraine-associated vertigo, to cardiovascular problems, to the neck, among other causes.

Assessment is Crucial in Finding the Cause of Dizziness and Vertigo

The assessment stage of vestibular treatment is crucial in trying to find the cause of dizziness and vertigo. At LifeMark Dizziness & Balance Program, we take a thorough medical history first and screen for neurological problems. Our vestibular assessment includes vestibular-ocular reflex testing, or testing of the integration between the inner ear and the eye muscle to see if you can focus clearly while your head is in motion. It also includes many tests using an infrared camera in blackout goggles to check for nystagmus, which is an involuntary eye movement associated with vestibular problems. We also evaluate your sensitivity to specific movements and positions, your balance, and the possibility that other areas are contributing to your symptoms like your feet or neck.

Contact us with your questions!