Physiotherapy for Balance and Falls Prevention

What is balance and how does our balance system work?

Balance is the ability to maintain the body’s centre of mass over one’s base of support. Balance is something we often take for granted when it is functioning properly but notice significant difficulties in daily life when it is not functioning as well as it should.

Balance is maintained through a complex system of sensory inputs, brain processing and motor outputs. The sensory inputs that are vital to balance are:

  • The vestibular system: Our “balance organ” within the inner ear, which provides the brain with information about the body’s movement and position relative to gravity.
  • Sensory receptors in our skin and muscles: These provide the brain with information about movement of the body, such as where the ground is underneath our feet or where the chair is underneath our buttocks.
  • Our vision (our eyes): This provides information relating to our position relative to surroundings. Verticals and horizontals in our environment act as a point of reference to tell us whether we are upright or tilting, stationary or moving.

    The brain collects all this information and processes it at incredibly fast speeds to form an accurate picture of where the body is relative to gravity and its surroundings. After processing this information, it sends out instructions that constantly adjust to the changing environment and maintain our balance and vision. These motor outputs are:

  • The muscles of our trunk and limbs: Reflexes contract and relax muscles that keep us upright and stable. For example, if we are swaying to the right, muscles in the left side of our trunk, as well as muscles in both feet contract to pull us back upright. These small corrections occur constantly without us even realising.
  • Our eyes: Reflexes also contract muscles that control the position of our eyeballs in order to maintain stable gaze on the surroundings while the head and body are moving.

What can go wrong with our balance system?

Our balance can be affected when there is any interruption to the sensory inputs, brain processing or motor outputs listed above. Some common examples of this include:

  • Impaired vision: When our vision becomes impaired, this reduces our ability to use our surroundings as reference points to where we are relative to gravity, therefore affecting our balance.
  • Reduced strength in our limbs: As we lose strength, particularly in our legs which commonly occurs with ageing or injury, our ability to respond to the balance outputs produced by the brain is impaired.
  • Vestibular conditions: Problems with our vestibular system can affect our balance, as the vestibular organ within the inner ear is our main “balance organ”, providing information to the brain about our movement and position relative to gravity. Click here to learn more about the vestibular system.
  • Reduced sensation in our extremities (eg. Foot numbness): This can reduce the sensations coming from our feet about the position and texture of the ground, which is important information that the brain uses to maintain our balance.
  • Impaired processing in the brain: Many conditions that can affect the ability of the brain to process information can affect our balance. These include head injury, dementia, use of certain medications as well as other short-term factors such as alcohol, lack of sleep or high stress/anxiety.

What can Glebe Physio do to help me with my balance?

This depends on which areas of the balance system are causing the impairment in balance. In general, balance specific exercises that target the relevant systems listed above are effective in most cases for improving a person’s balance. General strengthening and cardiovascular fitness also play a large role so should be addressed, as well as any vestibular conditions that the patient may have. Our physiotherapists are highly experienced in the assessment and treatment of balance conditions and will tailor treatment depending on each patient’s individual case.

What should I expect at my physiotherapy appointment?

Arriving for the appointment:

At your first physiotherapy appointment, you will be asked to arrive 10 minutes ahead of the appointment time to complete a short form about your injury. If you have any paperwork related to your injury, please bring this with you. This may include scans, reports, previous treatment, doctor’s letters etc.

Initial consultation:

At your initial appointment, you will be asked a series of questions relating to your balance problems, as well as any relevant medical history and contributing factors. The physical assessment will often include a series of simple strength, balance and fitness assessments. If indicated, the physiotherapist will also perform a series of special tests for your vestibular system while you wear Frenzel goggles, which use an infra-red camera to track your eye movements. Once the assessment is complete, the vestibular physiotherapist will explain the findings and relevant treatment. The treatment will then be commenced within this initial appointment and the physiotherapist may give you exercises and strategies to follow on with at home.

Follow-up consultations:

At follow-up appointments, the physiotherapist will start with a reassessment to check the progress of your recovery, followed by further appropriate treatment. The number of follow-up appointments depends on each individual case, with some requiring only one or two follow-ups to provide guidance, whereas more long-term conditions may require several follow-up appointments.

Do I need a referral to make an appointment?

No. Physiotherapists have been first-contact, primary healthcare professionals in Australia since 1976. That means that you can book a physiotherapist appointment without seeing your doctor first. Many of our patients are referred from GPs and specialists but many choose to see us themselves.

How much does an appointment cost?

For our latest pricing, please see our fees page.

Do you accept private health insurance?

Physiotherapy is covered by private health funds as part of “extras” cover and we have HICAPS facilities to charge your health fund on the day of the appointment. The amount that your private health fund pays will depend on your policy.

Is physiotherapy covered by Medicare?

Physiotherapy is generally not covered by Medicare but you can get part funding from Medicare through a Chronic Disease Management Plan if your GP refers you with one of these.

Get Active!

For more, visit our Frequently Asked Questions page.

If you would like to ask a question about our services or anything else, visit our Contact Us page to get in touch.

If you are ready to make an appointment, visit our make a booking page and let us help you with your fitness or recovery.