Friday, July 11, 2008

Better Balance - How to Prevent Falling

For starters,  where, exactly, is your ankle? The common idea of ankles is that it is a 4-6 inch area in the vicinity of the two ankles bones just above the foot. If you think (and act)  more clearly and precisely about your ankles, and how they work, you can reap many benefits. It can literally change your life. When balance improves, the entire nervous system "settles" and become more calm, the eyes don't "startle" so much, we are less "jumpy" and we can take life in stride, and be much more poised and relaxed during the day. We don't realize how much energy our system expends when balance has become an issue. 

The kind of work you are going to learn here can prevent a serious fall, it can help you stay independent and erect as you grow older. It can help you avoid using a cane when you reach age 85.  And my experience tells me that I probably am not exaggerating.

Do you think your ankle bones are part of your ankles? In common linguistic usage, yes. But to be anatomically precise, the two ankle bones are really leg bones - the lower ends of the tibia and fibula bones of the lower leg. The ankle, functionally speaking, is whatever is between the leg bones and the foot.

What is between the leg bones and the foot? The talus bone. Please look this up in an anatomy text, or look at a picture online. It is very important that you have a clear visual image. Or better yet, get a plastic foot skeleton, and touch it, feel it, play with it. That is what I did, and it tremendously increased my effectiveness when working with people's ankles. 

Learning about the talus bone may seem like a fine distinction, of little use, but it is not so. Otherwise, the Romans would not have taught their soldiers to stand, walk, run and fight "from the talus bones".   That really sounds strange, until you have experienced it. But later you understand. Once you understand this, I am hoping you will be motivated to do a few simple ankle exercises. These can prevent "weak ankle syndrome" as you grow older. Then can help your poor overworked feet to relax, and they will definitely improve your balance. They will enhance your athletic ability. They can even greatly reduce or eliminate chronic pain. Numerous times I have seen whole-body-pain diminish or vanish quickly, by restoring normal ankle usage. It seems that the tense ankles resulted in an over-tense body, and that was causing their pain. 

Consider a few assorted facts:
  • Again, the Roman soldiers were trained to walk, run and fight on their talus bones. 
  • The feet are meant to soften, lengthen and widen as we take weight on a foot - not grip and tense! As most folks do. 
  • If the feet learn to relax and not grip, this allows the ankles to do the work of balancing, instead of the whole body, starting with tense gripping feet!
  • The lower leg muscles are long and strong - MUCH stronger than the tiny intrinsic foot muscles. It is obviously better to let balance, in standing and walking, happen through the ankle, connecting to these long and strong muscles, rather than tensing the feet (which immobilizes the ankle - making it rigid, so that the lower leg muscles have diminished ability to accomplish anything) and keeping the whole body vigilant to balance. That vigilance is a source of chronic tension, chronic pain, tight breathing, shortened life span, stress, and psychological disorder. People with that kind of vigilance will startle easily, they have a short temper, a frayed patience. Their eyes will look tired, but jumpy. The eyes of such persons have taken on the job of visually orienting to maintain balance - as the primary balance strategy, instead of letting the ankles and foot-proprioception make their proper contribution.  
  • A soft foot allows the sub-talar joint (see below) to send messages to the long, strong lower leg muscles as to what to do, and when. 
  • There are more nerve endings at the sub-talar joint than there are nerve endings at the bottom of the feet. Obviously, evolution is telling us something here. The sub-talar joint is important. Yet for most folks, that joint is locked tightly, never used, for lack of proper understanding and lack of a few simple exercises that should be practiced every day in odd moments. It's easy to feel whether a sub-talar joint is mobile or not; I know this within five seconds of touching a person's foot. Often, I'll know just by looking at them in standing. 
  • The sub-talar joint is probably the most important joint in the foot, yet most people have never even heard of it. 
  • In ancient times, there was not such a preponderance of flat surfaces to walk on, nor were there shoes that were so tight, and cushioned and form fitted and with heels. The feet were more supple and adaptable in ancient times - meaning more relaxed and capable. People went barefoot a lot more. 
Most of us have learned to tense the feet to stand and balance; therefore the ankles are not in the easy field of our awareness. When one again becomes aware of the ankles - meaning the talus bones - than the foot begins to relax, and the ancient, primal and wonderfully efficient balance reflexes that work through the ankles - come into play. The eyes relax, the shoulders drop, the breathing opens, we look more relaxed and feel so much better!  Then the sub-talar joint begins to loosen up and articulate in weight bearing, finally (although this may take some months of private work or group ATM classes). Then the lower leg muscles can do their reflexive work of instantly responding to our shifting of weight, our slow or sudden movements, to keep us stable, balanced and ready to move in any direction. When the eyes and the whole body take on that job instead - which they were never intended to do - life becomes a burden. 

So, what can be done? Luckily there are a few simple exercises that anyone can do - at practically any time of the day or night, that will gradually bring us back to natural usage of feet and ankles (to speed up the process, you'd need to get private work or take ATM classes regularly).

Strategies to Restore Normal Usage of the Ankles:

1) Touch or sense without touching (if you can) your two "ankle bones". Say to yourself "these are my lower leg bones". Then touch just below those two bones, but above the foot. Say "this is my talus bone - this is my ankle bone." Then, touch or hold your foot, and say "this is my foot." Repeat this until you can do easily, without touching. Learn to mentally make those distinctions instantly, whether sitting, standing or lying down. While this seems elementarily silly, I have found that most people cannot, unassisted, make these distinctions. That even applies to many dancers, or nurses or athletes, who should know better. Before we can do any exercises, we have to be able to make these distinctions.
2) Every morning in bed, make  circles or better yet, write the alphabet with your big toes, but move the toes from the ankles. Your feet, especially your toes should remain completely limp, completely without effort, completely soft. Your intrinsic foot muscles (muscles that begin and end in your foot and do not connect to your lower leg) cannot move your foot in a circle. An outside force has to act on the foot. That outside force is the lower leg muscles, coming down through the ankle. So you need to think and sense your ankles as you move your toes in a circle. If you think of your feet, you will tense the feet. If this sounds confusing, do this: make a fist and see how easy it is to make wrist circles with your tense fist. Not so easy, right? It is easier with a relaxed hand, to make circles in the hand from the wrist, tensing the fist only interferes. It is the same idea with the feet - foot tension only interferes with ankle mobility. If only people  were taught this early in life, so they would not have to figure it out later! If you learn this one thing, your balance will greatly improve. You will have learned how to sense and move your foot without tensing it - as most people do. That will carry over into relaxed, functional - intelligent ankle, better balance - standing. You'll have less likelihood of falling.

3) Stand and walk while trying to sense the talus bones. Once you "get it" you will begin to feel the power, the grace and ease that the Roman soldiers felt. Maybe that is why they were so successful, in their time. At first it will kind of feel like standing and walking on ball bearings. 
4) When you wake up, before you get out of bed, first sense your feet, and make any little movements you can, without tensing the feet. You may need to do this before you try to write your name, or the alphabet in the air with your toes. This will encourage soft feet, supple ankles and active lower leg muscles all day long. Set the pattern before you get out of bed.

5) Get foot massage as often as you can. Don't turn down a pedicure if you get a manicure. Don't turn down a chance to get some foot reflexology. Massage your own feet often. They crave the stimulation, they crave the impetus to relax, they crave the attention. Chronically tense feet need much mentoring and outside assistance in order to learn how to relax (in fact, I'd say I have never seen anybody for which this is not true). It's why I spend 5 to 20 minutes with practically every client doing "foot work" of various sorts (Feldenkrais related foot work, not foot reflexology, although I have find that Feldenkrais foot work gives many - if not all - of the same benefits as foot reflexology). It's not just that the feet need massage to relax - that's hopeful, but sadly and realistically overly-simplistic. Foot work needs to be related to balance and "function" meaning standing, walking, etc with intelligent ankles - then the feet will much more willingly relax, and stay that way indefinitely. Feet  will automatically grip when balance is not clear, not good - no matter how many strategies you implement to relax the feet. 
6) Stand quietly, holding onto a door frame or bookshelf. Slowly shift your weight from side to side, taking 4-5 seconds to go from one foot to the other. Notice - do not try to change anything - be clear: what are you doing with your feet as you take weight on a foot? What happens as you transfer weight to a foot? Do you tense and grip the foot? Or do you let the foot soften, widen, lengthen while the ankle and lower leg muscles automatically do all the work of keeping you nicely balanced? If you find yourself gripping - I can promise you that if you pursue this line of thinking, you will find amazing benefits, improvements and just plain joy of living. You have no idea of much extra unnecessary work you have been doing. You have no idea how good it will feel to let all of that go. If the work of balancing your body has been done with tense feet, rigid ankles and vigilant eyes and body - you have been living life with the gas pedal to the floor, while keeping your foot on the brake pedal. Your life will become much more graceful, productive, joyful, easy and powerful - with less effort with minimal frustration.
7) Start walking slowly. What are you doing now? Gripping the feet every time you take a step and take weight? Don't try to change anything,  just be very clear about what you are doing, when you are doing it, and how. That lays the foundation for change to happen spontaneously, effortlessly. Otherwise, if you jump ahead and command the feet to relax, you'll be trying to change something, or relax something, without even knowing exactly what you are doing or exactly when you should be doing it. 

8) Walk a little blindfolded or with eyes closed every day. Even a minute or so will work wonders in time. It will wake up forgotten powers o balance, of orientation, of proprioceptive memory, of intelligent ankles. Do this safely, slowly in your own home. Keep one hand on a wall. Later, when you know where things are, you can even walk from your bedroom to the bathroom with your eyes closed. That would be a great way to start your day - provided you don't bang your shin on a chair leg!

9) Stand near a wall. Close your eyes, and fall into the wall. Create many variations, slightly turning the hips or the head one way or the other, and positioning yourself at all kinds of weird angles to the wall. You can even cross one leg over the other. Catch yourself with your hands and arms. This might provoke a moment of panic - causing you to tense your feet and ankles, making them less serviceable, just when you need them the most. By practicing this, you can learn to override the panic impulse, and instead stay present with your soft feet and intelligent ankles. You can learn to soften and relax your whole body, in that "panic moment". This can prevent a broken hip bone, should you ever actually fall. Excess tension while falling might be the real cause of the broken  hip, not the fall itself.  This will serve you very well in those unexpected moments in life when we might be prone to falling. One minute a week of this will give a huge pay-off. Like many Feldenkrais-related movements, the "payoff" is far out of proportion to the effort you put into it. 

1 comment:

Anonymous said...

I have read and re-read this post, and gotten so much from it. Thank You. In a matter of a few months I have seen a marked improvement in my movement, and as you point out in the first paragraph truly my entire nervous system has 'settled' noticeably. I had always thought I was overly sensitive, to things like loud noises and I startled easily, now I see it was all due to my rigid ankles. WOW and Thank You.