Part 2 at a glance

  • Principle 4 Physical Health – How we move
  • Don’t guess, get assessed

Part 1 Review

In Part 1, we looked at how the first 3 Wellness & Movement Principles (Emotional, Biochemical and Nutritional Health) relates to balance. Now we will look at Principle 4: Physical Health – How we move and its effect on balance.

Principle 4 Physical Health – How we move

There are physical contributors to enhancing balance such as posture, environmental demands, respiration, mastication (chewing), vision, hearing and upper cervical function. This is the most complex Principle to cover with regards to balance. This article is presented in as much laymen terms as possible, but please note that this is an authentic wellness & movement as well as a holistic and integrative approach to enhancing balance.

Poor Posture and Stability and its Effect on Balance

Figure 1











Posture reflects our foundation, our “base” and has the most profound influence over the way we move. Poor posture compromises human function and is responsible for faulty movement patterns, which eventually lead to pain and/or injury. As seen in Figure 1, the poor posture images reflect imbalances in some muscles being short and tight on one side and long and weak on the other. Thus, creating movement compensations that will affect our body’s ability to acquire balance.

Posture and balance work in concert with one another and are both vital to enhancing balance. However, in order to maintain good posture and balance the body depends on stability. Specifically, segmental stability which is the ability for any joint complex in the human body to function without mechanical disorder or mis-alignment during normal human function.

Any muscle imbalance creates faulty movement patterns which will also increase the likely hood to injury. Segmental stability is absolutely necessary to protect joints and the spinal column. So, as we move and functional in daily, the body must react to the change in direction by maintaining proper joint alignment.

Stability can be broken down into 2 categories; static and dynamic stability

Static stability is when the spine is fixed in one plane of motion. An example would be balancing on 1-foot, which the spine is motionless. This still requires the recruitment of the inner core stabilizers to provide segmental stability.

The inner core is not visible to the naked eye, but as seen in Figure 2, those muscles are comprised of the transverse abdominus, the pelvic floor, diaphragm and multifidus muscles. These inner core muscles are what I call the first responders to segmental stability. The inner core responds first before the outer core.

Figure 2 – Reprinted with permission from the CHEK Institute

Dynamic stability involves movement of the spine. An example would be ballroom dancing, walking, running and throwing. These stabilizers are also referred to the “gross stabilizers”, responsible for movement stability.

They are made up of the outer core muscles as seen in Figure 3. The outer core is comprised of the gluteus maximus (butt muscles), latissimus dorsi (back muscle), shoulder girdle, chest muscles and psoas (hip flexors).

Figure 3

The outer core muscles work synergistically with the inner core muscles. The sequence in which they respond is from the inside out. To help illustrate this point, visualize dropping a pebble into water and how from the point of impact there is a ripple effect as seen below in Figure 4.

Figure 4

The point of impact represents the force that is being put upon the body and how the body’s nervous system is designed to respond and activate the inner and then the outer core in a sequential reaction that will provide ideal stabilization to the spine and all joints.

The body only knows movement and not individual muscles. During functional activity the body makes continual changes while preserving our equilibrium (a state of balance between opposing forces or actions that is either static or dynamic). When we are facilitating balance training exercises on people, we are training hundreds of muscles at once.

Environmental Demands and their Effects on Balance

Postural reflexes are responsible for the subconscious maintenance of the body’s posture when movement and position is altered and they ensure that the body remains upright and aligned.

It is the effects of gravity on the body which triggers their responds. These reflexes, which are ingrained in our nervous system during infancy and are uploaded into your motor program to work automatically without conscious effort.

In everyday life we encounter various environmental demands that require various levels of balance and coordination. From a person’s occupation, fitness and recreational activity, to working in the yard and just being functionally active. All require various levels of balance and the activation of specialized reflexes that are required to prevent us from falling.

These special reflexes are responsible for the reactions that throw our arms and hands up and out to catch ourselves. Like when we getting onto a moving sidewalk or escalator and it moves before we have had a chance to hold on. The brain feed forwards information to certain reflexes which creates the need to reach out and grab onto a rail or bar for balance. The two main reflex reactions I will be discussing are the Righting and Tilting Reaction Reflexes.

Righting Reflex Reactions: They help the body to respond to rapid loss of balance and assist with integrated movements of the head on the trunk. They are primarily used when we are on fixed and stable surfaces. For example; if you are walking and you hit your foot in a raised crack in the sidewalk and suddenly lost your balance, you would use primarily your righting reflex reactions to stabilize you.

Tilting Reflex Reactions: They are the more dominant reflexes that help the body respond to changes in support when the surface underneath us moves. Things like rocker boards and stability balls, foam pads and rebounders as seen in Figure 5 are some examples of balance training equipment enhance tilting reflex reactions. If you have ever used any of these, you’ll know first-hand how tilting reactions are needed to maintain upright postural control.

Figure 5

“If we could speed the reflex response time of our bodies by 50%, we would reduce the chances of acquiring an orthopedic injury by about 80%”.

Dr. Vladimir Janda Physician and Physio Therapist

Respiration and its Effect on Balance

We can only go so long without air before it becomes life threatening. Your brain’s top priority to protect the body at all costs and it does this through compensating where their physical imbalances.

Respiration is vital to our balance and if there are any respiratory obstructions due to negative postural changes it can cause an array of challenges. Respiration takes precedents over posture and posture therefore can be compromised to make respiration easier. In other words; increased postural imbalances lead to respiration compensation.

Looking at an image of forward head posture as seen in Figure 6, you can clearly see changes in the position of the head over the neck. This is one of the most common responses to faulty respiration, because the nervous system is very sensitive to faulty respiration and from a survival stand point the body will compensate in order to keep breathing, even if it means changes the postural alignment in order to do so.

Figure 6

Even a deviated septum (The septum is the cartilage in the nose that separates the nostrils) from a broken nose can have an effect on our respiration.

As the head migrates forward, it will create a loss of posture in the upper back as the shoulders round forward. This will disrupt the balance of the spinal column and will disrupt the postural alignment all the way down to the hips. Creating a host of muscle imbalances throughout the body. As the posture deviates towards dysfunction this will create challenges to how the body perceives balance as seen in Figures 1, 6 and 8.

Surprisingly; mouth breathing and inappropriate breathing techniques while exercising can create a host of challenges that can have an effect on a person’s ability to balance. One of the most common respiratory dysfunctions is mouth breathing and is a major underlying challenge to faulty respiration. This could lead to a person’s inability to maintain an optimal and stable axis of rotation while moving.

Correct breathing should be facilitated through the nasal airways, nose breathing has tremendous benefits over mouth breathing. Try this simple test, sit up tall in good posture and place one hand on your belly button and the other on your chest. Take a deep breath in through your nose and feel which hand moves first. If you felt the hand on your chest come up first than you are a chest breather, which is sign of faulty breathing. If you found it was hard to breathe through nose, you’re not alone.

Nasal breathing (as opposed to mouth breathing) increases circulation, blood oxygen and carbon dioxide levels, slows the breathing rate and improves overall lung volumes.

(Swift, Campbell, McKown 1988 Oronasal obstruction, lung volumes, and arterial oxygenation. Lancet 1, 73-75).

Although there are many reasons why people can’t breathe through their nose do to allergies, sinus drainage and/or deviated septum. One of the main underlying reason is directly related to poor posture, especially the upper back, neck and head positions. The imbalances between the muscles in front related to the back of the body can create a change in postural position.

Mastication (chewing) and its Effect on Balance

We have to be able to eat to survive and if we have any challenges with the jaw and the alignment of the teeth, this will create mastication dysfunction or what is known as mal-occlusion which is a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other as the jaw close.

We open and close our mouth as many as four thousand times a day. If for any reason your teeth don’t have ideal alignment this creates centric occlusion, which is when we hit and slide the teeth as we chew. There are many reasons for both mal and centric occlusion including: growth and development disorders, malnutrition, trauma, forward head posture and dental disorders.

How this effects balance; from a growth and developmental perspective, your central nervous system learned to arrange and necessary repositioning of all our body parts below the head in an attempt to restore the occlusions. If our teeth are out of alignment, our bodies compensate in order to get our teeth lined up so we can continue to eat and survive.

However; this compensation can create significant postural dysfunctions which will affects how the body perceive and facilitates balance. If gone unchecked this will result in many other challenges to the body such as, increased trigger points (highly sensitive areas of discomfort in certain muscles), which cause the muscle to fatigue early and or get very tight. From a balance perspective, any muscle dysfunction such as short and tight or long and weak muscles in the neck and shoulder area will affect the vestibular system and have an effect on balance. See Figures 1 and 8 for an example of length and tension difference creating a postural dysfunction.

Vision and its Effect on Balance

Your eyes have a primary function to aid in movement control, which is important to balance. To maintain balance and navigate space in our physical world, we must organize and integrate information from the visual (eyes), proprioceptive (information perceived through our muscles and joints to tell us where we are in space) and vestibular (inner ears sensing motion, equilibrium and spatial awareness) systems.

The Focal System; The Focal System consists of the aspects of vision responsible for detecting movement and locating objects in space. This system also influences your ability to balance. For example, if you were walking on grass early in the morning and your Focal System is impaired, you will not have the appropriate reflex response and you will lose your balance and possibly fall.

The Ambient System; is specifically for movement control and involves the entire visual field. This system helps detect motion and position and is vital for maintaining balance.

Poor eye sight can be a cause of forward head posture and will compensate due to one eye being more focal than the other. Near and far nearsightedness also has to be taken into consideration as they will either bring the head forward such as in nearsightedness which will disrupt the postural control center of the brain to bring the eyes closer to their focal point.

Hearing (Auditory and Vestibular Systems) and its Effect on Balance

The major task of the ear is to detect, transmit and transduce sound. Another very important function of the ear is to maintain our sense of balance. The ability to hear is related to the  Auditory portion of your ear and consists of three parts: the outer, middle, and inner ear.

All three parts of the ear are important for detecting sound by working together to move sound from the outer part through the middle and into the inner part of the ear. Ears also help to maintain balance. When there is impairment in one ear it can have a profound effect on how the body perceives balance. As an example, if a someone is clinically deaf in one ear, the body will have postural adaptations. Remember any change in posture due to short/tight and long/weak muscles will change how the body perceives balance in motion. Some may be subtle, while other postural imbalances (especially in the neck and shoulder areas) will have an effect on the vestibular system. All of which will reduce the person’s ability to balance and learn balancing skills.

The Vestibular System is responsible for sensing motion and speed of movement of the head in all directions and it has an integrated relationship with the cervical and visual systems of the body.

The Vestibular System is run by two mechanisms:

  1. The maintenance of equilibrium, which is a state of physical balance
  2. Visual motor control / stability, which is the ability to coordinate vision with the movements of the body or parts of the body.

Balance is a choreographed arrangement that takes sensory information from a variety of organs and integrates it to tell the body where it is in related to gravity and the earth. People who have vestibular disorders may report having dizziness nausea, headaches or what are known as cluster headaches, vertigo, and of course a loss of balance.

Upper Cervical Function and its effect on Balance

Upper cervical function works in tandem with both the mastication and vestibular systems in the hierarchy of survival. This topic is the most technical by far, the information in this last portion will only represent a basic understanding of how upper cervical dysfunction can have an effect on balance.

The upper part of the neck where the brain-stem sits is seen in Figure 7. The brain stem controls every automatic function and response in the body, such as: sleep, digestion, blood pressure, heart rate, body temperature, balance and equilibrium, and many more.

Figure 7

When the head and neck are out of alignment, it will cause the shoulders to twist, and the hips to shift forcing the entire spine out of alignment as seen in Figure 8.

Figure 8

The synergistic relationship between the upper cervical spine, vestibular and visual systems help produce the necessary reflexes for all the environmental demands. When the upper cervical spine is out of alignment, all joints, muscles, ligaments and tendons become a slave. This compensation dysfunction is the driving force to various muscle and bones disorders.

In fact; it is believed that the 85% of people who have lower back pain (LBP) is a direct result to cervical misalignment’s. The upper cervical communicates with the lower spine and as a result to misalignment to the cervical it creates a compensatory reaction below at the lower spine and sacrum (where the back meets the hips as seen in Figure 8), all way down to the feet.

Our body achieves maximum balance and stability when all of our weight bearing segments are in vertical alignment over our center of gravity. To truly develop balance skills, it is vitally important to start with the control center from the top down and from the inside out. Addressing all the contributors to enhancing balance.

Before You Start Your Fitness Program; Don’t’ Guess, Get Assessed

Your fitness and exercise journey should start with a comprehensive lifestyle / physiological readiness, physical and neurological assessment by a holistic and integrated healthcare practitioner.

My motto is this; “You Must First Feel and Move well, Before Moving More”. This applies to everyone, not just the older adult.

If you would like to learn more about the Wellness Movement Center’s Comprehensive Wellness & Movement Lifestyle Consultation and Assessment contact us , 828-667-9334 or go to to learn more.

“Brian’s knowledge of the musculoskeletal and nervous systems and respect of physiological and psychological wellness and how they interact are arguably top in his field.”  – Debra Y. Asheville, NC