“I just have bad balance” - this is a phrase we hear often from patients of all ages and activity levels. Maybe you can’t do a lunge without holding onto something or almost fall over if you try to put your pants on standing up. Balance gets the blame for a lot of things that it doesn’t deserve. There are a lot of factors that contribute to your ability to balance on one leg (either when standing still or moving during exercise). Two of the biggest factors are hip and ankle/foot stability.
Stability is a muscle’s ability to maintain a certain position against some kind of resistance.When we stand on one leg, the muscles surrounding our hip, knee, and ankle must work together to maintain that position. The hip and ankle heavily influence the knee joint, so you may notice your knee collapses inwards when you do single leg exercises. The glute muscles, especially glute medius, are key muscles for single leg stability. When the hip and ankle can’t stabilize well, your body finds the path of least resistance to get the job done. These compensation patterns can lead to pain and injury if not addressed.
A great place to start is to practice standing on one leg with a goal of 30 seconds - notice if you tend to lean backwards or sideways, hike your hip up, or roll your foot in/out. These are common ways to compensate for hip and ankle instability. If done properly, you should feel the muscles in your standing leg working, especially at the side of your hip and in the foot. Once you can hold this position easily, it’s time to progress to dynamic movements such as step ups, lunges, and single leg squats or deadlifts.
If you are active with strength training or running, you definitely need to include single leg training in your regimen! This area is often neglected and can lead to pain throughout the leg (or even the low back). Don’t wait until an injury occurs to address these things! It takes time to gain stability and control, but you are not destined to a life of blaming your “bad balance” every time you almost fall over doing lunges!
Shannon Braun PT, DPT, SMFA, Certified Functional Dry Needling L1