Chapter 10 Balance-Training Concepts

Objectives After this presentation, the participant will be able to: Define balance and describe its role in performance and injury risk. Discuss the importance of balance training. Design a progressive balance-training program for clients in any level of training. Perform, describe, and instruct various balance-training exercises.

Concepts in Balance The Importance of Balance Maintaining balance is a key to all functional movements. Often thought of as a static process. Functional balance is static and dynamic The ability to reduce force at the right joint, at the right time, and in the right plane of motion requires optimum levels of functional dynamic balance and neuromuscular efficiency.

Balance Mechanism Balance training should constantly stress an individual’s limits of stability (balance threshold). Limit of stability The distance outside of the base of support that he or she can go to, without losing control of his or her center of gravity This threshold must be constantly stressed in a multiplanar, proprioceptively enriched environment, using functional movement patterns.

Balance Mechanism Proprioceptively Enriched Environments Floor Unstable yet controllable environment Must use the appropriate progressions and correct technique at varying speeds to facilitate maximal sensory input to the central nervous system Proper progression Floor Balance beam Half foam roll Airex pad* Dyna Disc

Scientific Rationale Benefits Improves dynamic joint stabilization.* The ability of the kinetic chain to stabilize a joint during movement The main goal for Balance Stabilization Exercises is to improve reflexive muscle contractions.*

Balance and Joint Dysfunction Muscle imbalances, joint dysfunctions, pain, and swelling can lead to altered balance. 80% of the adult population experiences low back pain. 80,000–100,000 anterior cruciate ligament (ACL) injuries occur annually. More than two million ankle sprains every year. Thus, the majority of the clients that fitness professionals work with may have decreased neuromuscular efficiency and balance.

Balance and Joint Dysfunction

Balance Training Effects on Injury Balance exercises are frequent component of integrated ACL injury prevention programs, which have shown promise in reducing the rate of ACL injuries On the basis of a recent systematic review (40), balance training programs that are performed for at least 10 minutes a day, 3 times per week for 4 weeks, appear to improve both static and dynamic balance ability.

Designing a Balance Program Exercise Selection Safe Progressive Easy to hard Simple to complex Known to unknown Static to dynamic Proprioceptively challenging Floor Balance beam Half foam roll Airex pad*

Variables Plane of motion Range of motion Frontal Sagittal Transverse Full Partial End-range

Levels of Balance Training There are three levels of training within the National Academy of Sports Medicine’s OPT™ model—stabilization, strength, and power When progressing Balance Training exercises go from stabilization to strength and then strength to power. The same goes for regressing.* The Single Leg Lift and Chop is balance stabilization.

Balance Stabilization Exercises Exercises involve little joint motion and are designed to improve reflexive joint stabilization contractions to improve joint stability. When the body is placed in unstable environments, it must react by contracting the right muscles at the right time to maintain balance.

Balance Strength Exercises More dynamic eccentric and concentric movement through a full range of motion. Require dynamic control in mid-range of motion with isometric stabilization at the end-range of motion.

Balance Power Exercises Develop high levels of eccentric strength, dynamic neuromuscular efficiency, and reactive joint stabilization.

Implementing a Balance Program Stabilization Level (Phase 1) Select Balance Stabilization Exercises Strength Level (Phases 2, 3, and 4) Select Balance Strength Exercises Power Level (Phase 5) Select Balance Power Exercises

Program Design

Summary A balance-training program is designed to ensure optimum neuromuscular efficiency of the entire kinetic chain. Balance-training programs must be systematic and progressive, following specific guidelines, proper exercise selection criteria, and detailed program variables. A proper balance-training program follows the same systematic progression as the OPT Model: stabilization, strength, and power.