Balancing upright is a very import aspect of our lives, it is something that we learn from a very young age and sets us apart from other species. Since this is a learned trait, we often take it for granted and do not realize how important single limb balance is during activities such as running.

Balance requires interactions of multiple systems including: the nervous system, the musculoskeletal system and the environment. If one of these systems is not working or interacting properly, a person is more prone to falling, tripping or injuring themselves. Balance training is believed to help stimulate receptors in muscles and around joints to enhance sensory input for the control of movement.

In our clinic we come across a lot of weakness in hip stabilization and muscles of the pelvis, specifically the gluteus medius. This can cause uneven hips leading to femoral internal rotation and a line of issues and injuries down to the foot. A progression of single limb balance activities similar to the ones listed below are used in therapy sessions to increase strength, balance and to decrease injury.

Single limb balance upright

• The starting point for single limb balance is standing on one leg with your hips perpendicular to the floor and both front hip bones even on a horizontal line. Your shoulders should be directly over your hips, with no evidence of leaning. When leaning or hip drop occurs it is used as a compensation for weakness. Once this is mastered it can be made more difficult by holding the position and moving your head from side to side or trying to close your eyes.

Single limb balance on a foam pad

• As with the single limb balance upright the position of the body is supposed to be in alignment, shoulders over hips evenly. The use of a foam pad, that we use to stand on, is used to decrease the stability of the surface simulating uneven surfaces that can be encountered on a run. Lateral leaning, locking of the knee and hanging on anterior Y- ligaments (locking your knee backwards and pushing your hips forward while leaning your trunk backwards) are all methods of compensation. Once mastered head turning, side to side or around a clock, as well as closing the eyes are used as a progression. The next progression we use in our physical therapy clinic is Single Limb balance in an Athletic Position.

Single limb balance in an Athletic Position

• The athletic position used is, standing on one leg with the knee slightly bent, a forward lean from the hips without arching the back, elbows bent and slightly in front of you, head up and looking forward. This position is used to simulate the position used during running. To obtain this position start with two feet together, put a slight bend in your knees, lean forward and lift up one of your legs. Your knees should not touch, and your elevated knee should be directly below your hip and your foot should be in direct line behind your knee. As with the two previous balance progressions your shoulders should be in line with your hips and your hips should be level on a horizontal line parallel to the floor.

Single limb balance in an Athletic Position with functional reach or resisted bands

• Once the Single Limb Balance in an Athletic Position is mastered the difficulty level can be increased with the use of cones or a resisted band. Cones should be placed in various positions (10 o’clock, 12 o’clock and 2 o’clock) at an arms length away. Keeping your balance, start in the athletic position and reach down and touch one cone, return to your starting position. Repeat with each cone. A resisted band at waist height can also be used to challenge your balance by performing a single arm row with the arm on the side with the elevated leg. Maintain your stance while squeezing your shoulder blades and bending your elbow back along your side and then slowly release the tension on the band.

All of the progressions listed above should be performed in multiple intervals of 20-45 seconds or starting at 3-5 repetitions. Make sure you master ever step before you move on, and with a combination of strengthening exercises you should see improvements in your balance and mechanics while running.

The author of this article is Alexa Bancel, PT, MPT from Athletico – Gold Coast.