Maintaining Balance – 60 Seconds That Might Save Your Life

By Martin Sigrist

Accidental falls in the USA, UK and many other countries account for as many premature deaths each year as road traffic accidents (1,2,3,4). Every year millions of falls cause serious injuries which can lead to a sudden and immediate permanent reduction in life quality. In the USA hospitalization rates due to falls are increasing at 4 percent annually (5). Unrecorded millions upon millions suffer pain associated with some of the major causes of falling to a level that severely limits their options in terms of how they can choose to live their lives.

Physical health has four “pillars.” These are cardiovascular, strength, mobility and stability. A little time spent regularly on the last three of these will significantly reduce the chances of being one of the statistics above. Cyclists need to pay particular attention because while our preferred sport can give us a strong heart, it can lead us to neglect the other essential aspects of fitness.

At the end of this article are four different exercises that specifically target the lower body. They can assess potential risk areas, treat them if present and prevent them if not. They require no special equipment and can be done by almost anyone of any age anytime anywhere. One repetition of each will take 60 seconds and give you immediate actionable feedback that you can use to rectify something that may only be a small matter now but could be a significant risk factor if left undiagnosed and untreated.

As a bonus it is also likely that they will cause you to notice that standing, walking, running and even cycling become easier.  In terms of cost vs. benefit they are, in my opinion, the very best exercises, period.

If you are short of time please skip the next few paragraphs.  They just provide some hopefully interesting background. Head straight for the exercises.

A Problem With Humans

The reason these exercises work is that they address a fundamental “design fault” in humans. We are the most extreme of bipeds. We are inherently unstable. Skyscrapers require solid foundations. We just have our feet. Our main form of locomotion, walking, is actually just a controlled fall, teetering from one leg to the other.  We are all, literally, one false step away from disaster, as anyone who has put their foot into a concealed hole or tripped over a rock can testify.

We are all at risk because our bodies have not evolved to optimize us for this way of life.  Birds, descendants of the dinosaurs, have had millions more years to do so and their legs with toes for feet and their heels up where our knees are now are altogether more adapted for the task. https://www.whatbirdsareinmybackyard.com/2019/12/why-do-birds-knees-bend-backwards.html

This would make walking and running a lot safer, easier and faster though bike gearing might be a bit more complex. Still since an ostrich can reach top speeds of near 45mph and “jog” at 30mph, bikes might not even be necessary if we all had bird’s legs.  

But we don’t and just have to learn to live with the ones we were born with.

Our main problem is that to walk safely our bodies, especially hips and below, need to be perfectly symmetrical. But they are not.  Even from birth most of us favor one foot or the other and as time passes the imbalances get greater as, for example, we injure an ankle which makes one leg slightly unstable causing us to shift load to the other in a less than ideal manner. 

We tend not to notice the effects of this fault until too late, because our bodies are good at adapting if things are not functioning correctly. They have to be, otherwise our ancestors would never have survived long enough for us to be here now. Cyclists can be at especial risk because our favorite sport masks symptoms a runner would notice much earlier.

Over time, little minor niggles can turn into big serious injuries.

I’m a case in point. I damaged my left ACL in my mid 20s and it took until my late 50s for my body to give up trying to juggle all the resultant problems and call time, forcing me to stop every half block of walking by making my knees seize up in pain. A scan revealed both had osteoarthritis and I was advised to consider replacement surgery. Only a chance bike fit to fix a problem that I thought was just causing me hot foot during long rides prevented me going down that path. A custom insole that restored stability to my right foot and many reps of the exercises below has meant no knee surgery, no pain and me being able to walk for hours on end just for fun.

This might seem like a miracle, but it’s actually just basic science. My right foot was unstable and this meant that every joint in my lower body was working in an unbalanced manner with every step adding a little bit of unnecessary stress so that in the end my knees started to show signs of wear and tear aka osteoarthritis. It’s similar to when you have an imbalanced wheel on your car. It can judder quite noticeably, something that just a tiny weight in the right place can fix. If left untended it could end up with the suspension collapsing or the wheel falling off.

The insole was a bit like that weight. It restored stability so my lower joints moved more as they were meant to. In the case of my knees the pain went away because the pressure of each step was applied correctly in a slightly different place, so lessening the load on the parts most affected by arthritis.

The Exercises for Balance

The key to these exercises is that they are single leg. This prevents the body’s natural adaptive defence mechanisms from kicking in to allow the strong side take care of the weak.

Three are illustrated with videos are all from the same source Squat University. Please, do not be put off. Dr Aaron Horschig is an acknowledged leading authority of the prevention of and recovery from injury in sports people and he has worked with some of the best athletes in the world.  His YouTube channel is the best online source for this important subject that I have come across.

He puts the emphasis on “squat” because it is a movement we all do every day, just not with a barbell in a gym. It is also an example of a single exercise that can both diagnose and fix fundamental issues, but this time the whole body not just the lower half. If you can perform all of the exercises here with ease then, in fact, going on to learn to squat correctly would be the next best step to take to ensure long term health. (This doesn’t need to involve any weights.

See here for a complete guide: https://squatuniversity.com/2016/07/22/perfecting-the-overhead-squat/.)

I especially recommend Aaron Horschig because, as in these examples, he gives very precise cues as to how exactly to perform an exercise. This is critical since the body is very good at moving badly and only minor deviations from good form can result in an exercise being useless or even harmful.

I cannot recommend too strongly that everyone should at least try these exercises out. There is nothing to lose except a few minutes of time and they could be the best workout you do in your life and even save it. If they do work for you then please spread the word. If these exercises were taught to every child so they became a habit then we may stand a chance of reversing the current seemingly inexorable year on year rise in falls and resultant harm.

Here are the exercises

• Stand on one foot. With bare feet simply lift one foot off the floor and balance for 30 seconds on the other. Focus on your foot being a “tripod” with weight spread evenly on the base of the largest toe, smallest toe and heel. The arch should be fully engaged and it should feel as if your foot is a bit like a hand, gripping the floor.

This may feel easy. If so do it again but with your eyes closed. This could well be much harder. But persevere. This simple exercise tests and builds your body’s proprioception. This vital sense is the one that keeps you upright and will kick in when you trip to mean you only stumble rather than hit the deck.

30 seconds eyes closed is the benchmark for this exercise. If you reach this and want to make it a bit harder extend the time limit and/or move your upper body around the hip joint while keeping the supporting leg stable.  Standing on a balance board will also increase the difficulty.

Of all the exercises this is the simplest to do anywhere, anytime. Bare feet are ideal but not obligatory. So it’s something you could do while waiting to be served in a queue or even just after a bike ride as little ritual immediately after taking your cycle shoes off to get your legs ready for walking again.

• Romanian deadlift (though shown with kettlebell it is not necessary or even recommended for beginners)

• Bulgarian squat (if like me you have restricted knee motion then this will mean the rear foot may be lower.)

• Touchdown (this should be easier than the Bulgarian squat and so can be used as a bridge to help with this if having difficulty. However it is also a great exercise in itself, especially if you increase the height of the platform, little by little, every week. So I would not skip it.)

There are three ways to use the last three exercises, assessment, treatment and prevention.

Assessment – Simply do one rep of each exercise on each leg (for the Touchdown try a platform of around 3”-4”). The absolute priority is good form, it is not a test of strength. Ideally have someone video you while also checking you are following Dr Horschig’s cues. If this isn’t possible use a mirror, the bigger the better.

Everybody who does not already have a serious pre-existing condition should be able to do 1 rep with good form and move on to prevention.

Treatment – If you can’t manage 1 rep on one or other leg of any of the exercises it will be because one or more of your foot, ankle, knee or hip on the affected leg has a problem. It may be that simply doing the exercise will help you determine which. Treatment requires restoring the mobility of any problem area than strengthening the muscles associated with it so the return to normal function. My recommendation would be to adopt a multi-pronged approach to this by doing all the below:

• Google “Squat University XXXXX” — where XXXXX is the word that describes your problem area. This will show a number of videos that will help with detailed diagnosis and suggest mobility fixes.
• Do reps of the exercise that you have an issue with to the point where you start to lose form then attempt to go just a tiny bit say ¼” more.  Just a few reps each day may help your body relearn a correct movement pattern if the damage is not too far gone.
• See a physiotherapist. If you explain which exercise you have a problem with they should show some immediate recognition. If they don’t and they try to dissuade you from doing it I’d look elsewhere. Not all physiotherapists are necessarily good and this is one way to sort out which is which. 

Prevention – If you can do 1 rep do more every now and then. The more and the more often the better but regularity with good form is the most important thing.  If you can get to double digits in terms of reps with no difficulty then you can start to add weights as these are also a great way to build strength (including core) but this really is the icing on the cake. 

Sources:

1. https://www.cdc.gov/nchs/fastats/accidental-injury.htm
2. https://www.cdc.gov/homeandrecreationalsafety/falls/data/deaths-from-falls.html
3. https://www.theguardian.com/news/datablog/2011/oct/28/mortality-statistics-causes-death-england-wales-2010
4. https://bmjopen.bmj.com/content/9/12/e033462
5. https://pubmed.ncbi.nlm.nih.gov/24916685/

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Now among the world’s fittest sexagenarians Martin Sigrist started riding on doctor’s orders in 2005 and had to push his bike up his first hill. Next year he soloed the Tour de France. He has since experienced every form of road cycling from criterium to ultra endurance. His ongoing mission is to use the latest in science and technology to fight a, so far successful, battle against Father Time.