The premise for using such devices, is the dramatic improvements in functional balance and core conditioning that can be achieved. This is often the case when these abilities are compromised through injury or other deficits but not always the case when talking about  sport-specific gains that are reported from using all these tools.

What Is Balance Anyway?

Uninjured or impaired athletes don’t have the same balance training needs as the rehabilitating athlete.  In order to fully critique the current use of balance training for athletes, we should first have a general idea of what balance is. Balance, is simply defined as the ability to maintain the center of gravity (COG) over the base of support (BOS).

This ability is made possible by the co-operation and co-ordination of three primary sensory systems: the visual, the vestibular (inner ear), and the somatosensory (Click here for a Power Point Presentation – Proprioception changes with injury) systems. These three systems are often referred to as the triad of postural control. It is through the combined feedback from these three key systems that we are able to move and maintain balance without falling over.

Balance Strategies

An important concept to understand how we regain balance after losing it is postural sway. Postural sway is the normal, continuous shifting of the COG over the BOS. When an individual is able to keep within their limits of stability, balance is maintained. However, when postural sway exceeds these limits, a restabilizing strategy is required in order to prevent falling. There are three fundamental strategies for regaining balance that have been identified: the ankle strategy, the hip strategy, and the stepping strategy.

During mild postural perturbations, most people will use the ankle strategy to regain an upright stance. This strategy simply recruits the ankle platarflexors, dorsiflexors, invertors and evertors to correct any minor disruption in upright stance. No stepping action is necessary with this strategy. Several common balance devices such as the rocker board, foam rollers, and balance pads elicit the ankle response.

If postural perturbations are even greater, the hip strategy might be used alone or in conjunction with the previously mentioned ankle strategy. During the hip strategy, balance is regained by flexing and extending the hips and spine in order to keep the COG within the confines of the BOS. If successful, no stepping action is needed.

With even more disruption to ones balance, the body calls upon the stepping strategy in which a forward, backward, or lateral step must be taken in order to restore balance. This type of strategy is much more common in sporting type of situations as it typically occurs under more ballistic conditions than the previous mentioned strategies. Also, due to the speed in which these corrective steps must be taken, little or no feedback is used to modify the movement. This type of control is also known as feedforward or open loop control, and it is common to many sports and even daily activities that require speed, quickness, or a fast reaction time.

When an athlete is standing on a balance device, they are typically only working the ankle and hip strategies to regain balance and are able to receive adequate feedback about how to correct their balance. This is not very specific to the demands of real life and sport so these balance drills can hardly be called sport-specific. Also, many of the surfaces (foam rollers, Swiss-balls) differ greatly from any surface found in most sporting situations.

Unless incorporating very innovative training drills the reality of using most of these devices, is that they are specific skills that may really only help the athlete learn how to better use the particular device. While there is probably no harm in using them, one has to ask if time could possibly be spent doing something more beneficial. Balance, like most other motor qualities, is specific to each task and sporting situation. Good balance in one situation does not guarantee good balance in another!

So What Is One To Do?

There is nothing wrong with using these devices so long as their limitations are realized and other, more sport-specific exercises are not being left out.  Many of the devices are a lot of fun to perform and can provide novel variation for athletes.  I personally like to use the various balance devices as active recovery or during periods of lower loading as might occur in a periodized program. However, if ones time is limited, only the most beneficial exercises should be included exercises such as variations of Olympic lifts, the 3 power lifts (squat, deadlift, and bench press), (Click here for downloadable document on Plyometrics) Plyometrics, and other important accessory movements should never be omitted for specific balance exercises.

If one includes variations of gymnastics tumbling, hopping, skipping, jumping, and sprinting activities in is hard to think that any further balance training is necessary. The martial arts also provide some very dynamic and effective forms of balance training for athletes. Getting back to balance devices, there are a couple of that I think prove to be more useful than others. The Fitter Bongo and Indo board serve as useful balance challenges that can be made to be much more unpredictable than the common balance board and foam roller exercises.

Additionally, if one takes an upright sport-specific drill, Olympic lifting or strength movement and closes the eyes (or wears a blindfold!), the proprioceptive demands increase considerably. The late Dr. Mel Siff, world-renowned sport scientist, referred to this as imperfection training. One can, for example, shift slightly back and forth while at the bottom of a Snatch, holding a bar overhead, or during the beginning of a Squat before the descent. With a little creativity, one can turn any drill, exercise, or sport-specific movement into a balance or imperfection drill.

Purpose of Russian Twist:

Strengthen hamstrings, bottom muscles and activate muscles that control the lower spine and pelvis. Strengthen abdominal wall in rotation.

Russian Twist on the mediBall

Instruction:

1. With knees bent and ball behind back, slowly roll backwards until ball is under shoulders and back is straight.
2. Raise arms toward the roof and clasp.
3. Roll arms and shoulders from side to side.

Body Check

• Tongue on roof of mouth
• Head, neck & shoulder deactivation
• Chin tucked slightly
• Activate TVA (pull umbilicus towards spine)
• Activate multifidus (confirm with tape or by pressing fingers against multifidus the back muscles mirroring the belly button)
• Pelvic Floor Activation
• Maintain Neutral Spine

Postural Alignment Check

• Ear, shoulder & hips in alignment
• Knees & ankles in alignment

NB. Fatigue is always the guide to repetition i.e stop, rest & then try a few more reps.

Disclaimer: This is a basic guide to improving balance, muscle tone and flexibility. All exercises should be performed with care and caution, if unsure about an exercise please seek professional assistance, we take no responsibility for injuries caused by stretches performed incorrectly. Reproduction of any material without written permission from the publishers is strictly prohibited.

By Odd-Egil Olsen et al – Sports Trauma Research Center, University of Sport and Physical Education, Oslo, Norway

BMJ  2005;330:449 (26 February), doi:10.1136/bmj.38330.632801.8F (7 Feb 2005)

Introduction

Regular physical activity reduces the risk of premature mortality in general and of coronary heart disease, hypertension, colon cancer, obesity, and diabetes mellitus in particular.

Balance Pad Drills For Throwing & Catching

However, participation in sports also entails a risk of injury for all athletes, from the elite to the recreational level.   Studies from Scandinavia document that sports injuries constitute 10-19% of all acute injuries seen in emergency departments, and the most common types are knee and ankle injuries.  Serious knee injuries, such as injuries to the anterior cruciate ligament, are a growing cause of concern.  The highest incidence is seen in adolescents playing pivoting sports such as football, basketball, and team handball. In these sports, women are three to five times more likely to contract a serious knee injury than men.

Injuries to the anterior cruciate ligament may require surgery, always entail a long rehabilitation period, and drastically increase the risk of long term sequelae.  Although treatment methods have advanced notably, there is no evidence to show that repair of a ruptured anterior cruciate ligament or isolated cartilage lesions prevents early development of osteoarthritis. 

Wobble Board Drills While Catching & Throwing

Effective methods for preventing injuries therefore need to be developed. Some studies report promising results, indicating that it may be possible to reduce the incidence of knee and ankle injuries among adults  and adolescents. However, these studies are small and mainly non-randomised, with important methodological limitations.  Prospective randomised intervention studies are therefore needed, especially among children and adolescents, to assess the efficacy of interventions aiming to reduce injuries. We conducted a randomised controlled trial to investigate the effect of a structured programme of warm-up exercises used to prevent acute injuries of the lower limb in young people playing sports.  To minimise overlap within clubs, we used a cluster design.

Conclusion A structured programme of warm-up exercises can prevent knee and ankle injuries in young people playing sports. Preventive training should therefore be introduced as an integral part of youth sports programmes.

Here is an interesting article on proprioception and ankle rehabilitation.

Purpose of Single Leg Lift:

Challenge your balance by minimising your base of support.

Single Leg Lift on the mediBall

Instruction:

1. From Seated Base position, lift one leg and extend.
2. Alternate legs.
3. Keep your back straight.

Exercising on a mediBall® has many benefits including:

• Dynamic Flexibility
• Balance
• Core Strength & Control and more..

Body Check

• Tongue on roof of mouth
• Head, neck & shoulder deactivation
• Chin tucked slightly
• Activate TVA (pull umbilicus towards spine)
• Activate multifidus (confirm with tape or by pressing fingers against multifidus the back muscles mirroring the belly button)
• Pelvic Floor Activation
• Maintain Neutral Spine

Postural Alignment Check

• Ear, shoulder & hips in alignment
• Knees & ankles in alignment

NB. Fatigue is always the guide to repetition i.e stop, rest & then try a few more reps.

Disclaimer: This is a basic guide to improving balance, muscle tone and flexibility. All exercises should be performed with care and caution, if unsure about an exercise please seek professional assistance, we take no responsibility for injuries caused by stretches performed incorrectly. Reproduction of any material without written permission from the publishers is strictly prohibited.

The term “goniometer” comes from two Greek words that mean “angle” and “measure.”  This is essentially what you are doing when you measure range of motion — measuring an angle.  Here is a typical goniometer – the common range of sizes are 6″, 8″ and 12″