How to Test and Improve Balance and Gait
Balance…the key to good movement and good health
Every step walking or running is a one legged balancing act, and how well you manage each step is dependent on good balance!
Good balance, in every day activity and sport, is dependent on footbed sensory nerve activation, primarily called proprioception, so, whether you are;
- running to catch a train
- playing a running based sport
- walking up or down a flight of stairs, or
- carrying a tray of drinks…
…it’s true to say that good balance is essential in helping you achieve your goals safely and efficiently…and not spilling the drinks of course!!
Balance and Health
Balance is also strongly tied to health; several studies have shown that good balance can increase your lifespan, and conversely bad balance has been shown to be an early indicator of brain deficiencies like Dementia and Alzheimer’s. Click to read an article in the BMJ titled ‘Inability to balance on one leg reflects risk of brain bleed; https://www.bmj.com/content/349/bmj.g7746
Dr Michael Mosley highlighted the connection between bad balance and dementia in a widely published newspaper article. He said ” having good balance is a powerful predictor of dementia, as well as how long and healthily you will live”! Read the full article here; https://www.pressreader.com/uk/the-mail-on-sunday/20190407/282634623990322
It is clear that by improving our balance we improve our ability to safely and efficiently perform daily tasks, improve sporting performance, reduce our risk of fall-related injuries and improve our health and general quality of life. click to learn more; https://www.psychologytoday.com/gb/blog/the-athletes-way/201309/fear-falling-creates-downward-spiral
The Facts about Falls in the UK
- Injuries caused by falls cost the NHS about £450 million a year.
- About a third of all people aged over 65 fall each year, with higher rates among those over 75.
- Falls represent over half of hospital admissions for accidental injury, particularly hip fracture.
- Half of those with hip fracture never regain their former level of function
- One in five die within three months.
- Of those older people who enter falls prevention programmes, most do so only after they have fallen, by which time they may have suffered serious consequences.
An Expert view
Click here to listen to Stuart from All About Balance interview with Dr Jake Cooke, a leading Neuro- Chiropractor who specialises in balance related problems. https://www.youtube.com/watch?v=U42tgx3G3TA
How do Humans balance?
Balance is controlled by three things;
• Our eyes focusing on a fixed point
• A part of the inner ear called the Vestibular
• A nervous system called Proprioception
The tests and exercises we use are geared towards assessing and reducing inefficiencies in balance by improving Proprioception. So the question is…what is Proprioception?
Proprioception and what it controls;
Proprioception, described in Wikipedia as the Sixth Sense, is a system of sensory nerves, embedded in muscles, joints, tendons and fascial tissues all over the body. They create reflex responses to movement.
To learn more about proprioception and whether it can be improved click here; https://lermagazine.com/article/can-proprioception-be-improved
Taking the foot as an example, we have approximately 200,000 proprioceptive nerves in each foot, and when we walk or run we load weight in to each foot as it makes contact with the ground. This load deforms the tissues, which in turn alters the proprioceptive nerve receptors, creating reflex responses in other parts of the body to;
- absorb shock on landing
- activate the ‘stretch reflex’ = injury avoidance
- provide stability
- create spatial awareness
- improve balance, and
- encourage good muscular skeletal alignment.
As noted above, the entire proprioceptive nerve system is embedded in soft tissue, in particular fascia. So, to appreciate proprioception we need to understand how fascia works.
Fascia the Facts
A leading fascial researcher Van der Wal says “it is the architecture of the fascial connective tissue in relation to the muscular tissue components and skeletal elements that play a major role in the coding of the proprioceptive information that is provided.” …Got it?? No, don’t worry…me neither!
The Gray Institute®, says “movement is task-specific and context-dependent, which to simplify, appears to mean that the information generated by the different proprioceptors will depend on the initial position of the body that alters the architecture of the fascia (context) and the movement being executed (task)”…hmm, almost got that one!
In spite of our less than optimal understanding about fascia and the nerve endings in fascia, there can be no doubt that to move well the body must have an efficient myofascial system with full mobility and extensibility.
Why is this information so important?
To try and simplify those statements;
- Movement turns on proprioceptors
- Proprioceptors turn on muscles
- Muscles control our movements
- Efficient (functional) movement is key to safe and efficient exercise or activity.
An efficient proprioceptive system helps maximise the efficiency of;
- Spatial awareness
- Symmetrical muscle activity
- The stretch reflex (our injury avoidance system).
Improve balance with every step
Our simple balance and gait tests, or our more technical gait assessments, are equally efficient ways to gather information about proprioceptive efficiency and body movement symmetry. Furthermore, the use of high tech gait analysis systems such as Optogait, enables us to assess gait and movement then improve them, in real time using visual biofeedback.
Through enhanced proprioceptive stimulus at the feet provided by BarefootScience patented insoles, and with simple exercises and brain (or cognitive training), the body will learn how to become balanced, symmetrical and self-supportive once again, putting you on a course to a happier, healthier life.
How do we test balance?
At All About Balance we assess static balance through some simple tests that in themselves become the initial training to improve balance.
Testing Balance the low tech way
First we start with a static balance test;
- Stand on one leg with eyes open and simply count (in seconds) how long you can do this before placing your non-standing foot down.
- Then repeat the test with eyes closed.
Any change in ability between the two is directly related to your proprioceptive ability, and any asymmetry (difference between left and right leg) is the most likely cause of injury and inefficiency.
The addition of a 15-20 degree Slant board to challenge the body with the feet and ankles placed in different positions while standing on one leg offers further evidence of proprioceptive deficiencies.
Retesting the client after they walk 300 steps wearing Barefoot Science insoles reveals the benefits they provide.
As I pointed our earlier, walking and running are a series of one leg balancing acts – a person with good balance will have better symmetry in their gait and a person with poor balance will not.
Now let’s go high tech
Dr Peter Gorman, Chiropractor and President of Microgate USA is the developer of a protocol using Optogait infared temporal spatial gait analysis system to identify and correct gait imbalances (asymmetries), and deficiencies in balance through the gait cycle while in dynamic movement.
In an attempt to find ways to reduce these harmful asymmetries he assessed patients barefoot and shod, and before and after the inclusion of various orthoses. He found that Orthotics changed some of the data in gait parameters, but they did not reduce critical asymmetries in load response or contact time! This is of significant importance;
Recent research (Joubert et al) has shown asymmetry in contact time to be the greatest cause of injury, and the most significant indicator of running and walking inefficiency;
Step forward Barefoot Science insoles
Having found that Orthotics did not reduce asymmetries in these critical gait parameters, Dr Gorman then discovered Barefoot Science insoles and tested patients in them in the same way.
Dr Gorman has found, in nearly 3000 cases, Barefoot Science creates significant and progressive improvements in balance, and reductions in asymmetries in the gait cycle.
He states that in those case studies every client received a pair of Barefoot Science nerve-stimulating orthotics “to aid their proprioceptive enhancement”. He goes on to say “with increased balance and proprioception, you will be on the road to optimal performance”.
See Proprioceptive stimulation at work with Barefoot Science:
His methods consist of 4 steps:
Step 1. Analysis
Walking in the Optogait system objectively measures the gait parameters to see exactly how symmetrical they are. First, we get a baseline by walking with shoes off, and then again with shoes on. Comparison of the two will show us how effective your footwear is in reducing asymmetries. We establish which shoes are best for you.
Step 2. Intervention
We add Barefoot Science insoles to your shoes. Barefoot Science is a unique insole with 7 different levels of insert designed to progressively improve dynamic balance control and reduce gait asymmetry through mid-arch stimulation, slowly but steadily strengthening your arch over time. On the first visit, you will begin at insert level 1, and you will move to higher levels as your balance and proprioception improves.
Step 3. Re-Test
This step ensures that improvements are not only being made, but are being properly learned by the brain and body. With Barefoot Science insoles in their ‘best’ shoes, the client walks on the treadmill at a comfortable pace in what Dr Gorman calls “the 2nd Screen of Optogait“. The 2nd Screen allows you to see the asymmetries for any gait parameter in real-time as you walk, enabling you to make minor adjustments to reduce any imbalances you may have. In this way, you can strengthen the neural pathways required to keep you walking in perfect balance.
Step 4. Practice
For lasting improvements you should continue to improve your balance by working on the same static balance ‘low tech’ tests you performed. ie; stand on one leg, and see if you can hold your balance for 15 seconds – if you cannot, you must practice until you can.
Once you are able to hold balance for 15 seconds on each leg you can move on to harder levels;
- eyes closed,
- standing on a foam pad eyes open,
- standing on a foam pad eyes closed,
- standing on a bosu ball eyes open,
- standing on a bosu ball eyes closed, and so on.
You should not progress to harder levels until you master the more basic ones for at least 15 seconds.
Stronger with every step
By routinely monitoring and improving your balance, you will open yourself up to increased functionality and a happier, healthier life. So don’t just walk, walk therapeutically in Barefoot Science insoles, reducing asymmetry and increasing balance and proprioceptive ability, making you stronger with every step.
Finally, it is important to recognise that balance can be easily trained and enhanced at any age, without the need for visits to a gym or special exercise classes, but simply with the addition of Barefoot Science insoles in as many pairs of shoes as possible…strengthening your feet and improving your balance with every step.
i Van der Wal, J.C., Proprioception. In Fascia – The Tensional Network of the Human Body Schleip R., Findley T.W., Chaitow L., Huijing P.A., Churchill Livingstone 2012.
Anyone that puts Barefoot Science insoles in their shoes will have an increase in performance and a greatly reduced chance of injury. I now wear my Barefoot Science every day and recommend them to all of my clients.
Richard Pady, CanadaTriathlon Coach, Trainer and Competitor
I wear Barefoot Science, I know that every football player will benefit from an increase in balance, performance and reduced risk of injury that this product provides!
Roger Spry, UKUEFA staff coach educator and Sports Consultant
I have used Barefoot orthotics on some of my toughest casesof plantar fasciitis, tibialis posterior tendinosis and metatarsal- gia and have had excellent results. These are people who have tried and failed traditional orthotics, stretches and various other devices. Barefoot orthotics are easy to sell as people can see the logic in the approach. Thoroughly happy with the product and service
Mark GillhamPhysiotherapist, Cowra NSW, Australia
Immediately from stepping onto my insoles with level one insert I felt a subtle but reassuring change in posture and balance. 8 weeks later I am up to level 6 and two weeks ago I was able to start running again pain-free for the first time in 14 months since a back injury. By way of an update; "Thank you Barefoot Science:- I am completely stoked as I just ran a personal best for a 10k trail over mixed terrain, pain-free!" ...........This afternoon's time was 57:28 - pretty ordinary for many but great for me as my goal has been to get 10k covered in under an hour......... and, after all, I am 186cm, 108kgs and 49 1/2 yrs old! I first 'ran' again in May and took 11 mins to cover 1.6km / 1 mile!
Tim in Alton, HampshireA member of EDC Crossfit
In our office, Barefoot Science (BFS) has been effectively used to help improve this proprioceptive deficit. Barefoot Science is a non-orthotic mid-arch stimulator. Due to its ability to create mid-arch activation, BFS mimics barefoot walking in sand and over time can dramatically help to reduce a proprioceptive deficit and improve foot strength. We highly recommend that all take a look at this wonderful product.
Dr. Peter Gorman and Dr. Chelsea KeeslerChiropractors New York
I wanted to let you know how I’m getting on with the Barefoot Science insoles as I just moved up to insert no.5 after almost 6 months, which I am finding very comfortable. I can feel them, but in a comforting sort of way. I have to report that I have had hardly any instances of dizziness since about a week from starting to wear them. I am so IMPRESSED! I am trying to do a few balance exercises every day as you recommended, and as a near 70 year old with seven small grand-children, four of them only two so they need floor level attention, I am conscious of the need to keep my balance while getting down and back up! The knee bending is okay up to a point and I’m hopeful it will improve as I use it more. But, as far as the balance side of things go I am thrilled. I think it is positively miraculous and am very grateful to you for suggesting them.
Veronica BarrattA Guildford lady with balance issues
Hi There, My name is Andrew Coltart. I was a golf professional on the European Tour for 19 years and a former Ryder Cup player. I now walk the fairways of the world commentating for a Major Satellite TV Company. My problem came to the fore when I was 47 years old. I had developed Plantar Fasciitis and it was becoming unbearable and debilitating with pretty much constant pain out on the course and in spite of various types of treatment no signs of improvement. I was starting to wonder if I’d be able to carry on working in my current role. Then I met Stuart Gordon of All About Balance and he explained The Barefoot Science Foot Strengthening System. Basically, because of these simple little nerve stimulating plugs that you insert into the underside of the insole, walking has become pain free and enjoyable again. These are no ordinary insoles. Don’t be fooled by expensive orthotics. The Barefoot Science Foot Strengthening System worked wonders for me, not only helping me continue in my work without any pain, they have also improved my balance…an essential factor in general life and massively important to achieving a consistent golf swing! I highly recommend investing in some.
Andrew Coltart UKFormer European Tour and Ryder Cup Golf Pro., Satellite TV on course Golf analyst.
I have been using Barefoot Science insoles consistently since the beginning of the year. They took me a while to use regularly but with the addition of extra pairs, I am able to ensure that I am using them on almost all occasions. This includes walking, CrossFit WOD's, running and every day wear. As you know, my flat feet caused me terrible pain with shin splints and tight calves every time I did any high impact training including running, even just the shortest distance. I haven't rushed through the stages and have only just moved onto level 3. Tonight I completed a 5km run with zero pain. This is the furthest I have run since 2011 and I even shaved 1 minute off my best 1 mile time!! I've found something comfortable that offers me a solution to pain free training, and I'm only half way through the 6 level programme. Thank you so much for introducing me to the Barefoot Science insoles. ☺
Claire ChiversCrossfit athlete EDC Alton, Hants.
Personal, Barefoot Science testimonial 26 April, 2013 To my fellow Pod people and persons that have foot related problems, I've found a product called Barefoot Science. I like this product and I use it daily, both for myself, and my Podiatric patients, I personally have had foot related injuries and deficits that caused daily foot pain for years as a result of my military service, not any longer though with my Barefoot Science inserts. I would not go without these inserts in my shoes. I was introduced to this product at a foot healthcare symposium, by Mr. Derek Denton of Alamo Medical services... As an employee of a Podiatry Service of a VA hospital in Texas, I perform highly technical work involved in the design, development, fabrication, alteration, assembly, fitting and repair of orthotic foot braces and orthotic shoes for Veterans as related to their post military service, i.e.: disease ,injury and overuse of the feet and ankle(s). I interpret Podiatrist' prescriptions and perform all steps required in the fabrication and fitting of the several types of orthotic braces, for many of which there are no models or precedents, including but not limited to ankle, foot and lower limb, as related to Podiatric disabilities and advise physicians concerning all types of corrective devices available and modification necessary; to help heal or ameliorate these conditions. *Presently now with the Barefoot Science product(s) I personally have noticed over the years the Pedorthic/Podiatric appliances and more complex appliances in the Pedorthic /Podiatry labs were more accommodating to the “functional foot conditions” that kept the foot aligned and rigid, yet never strengthened the foot, although there is a myriad of devices that claim they do so. I have tried most and until now none of them worked for this purpose of strengthening the intrinsic muscles. I started working with Barefoot Science a few years ago, and it has really turned our practice into a healing clinic. Helping ameliorate painful Podiatric conditions such as plantar fasciitis, metatarsalgia, claw toes, hammertoes, corns, plantar fasciitis, patellar misalignments, chrodromalacia patella, ITB syndrome. I have been working in this field of Podiatry since the mid 1980’s, both with U.S. Navy and Marine Corps personnel, now with Veterans of all armed services as a triple Board Certified Pedorthist and Podiatric clinic manager. I wished we would have had this Barefoot Science product while I was on active duty as a Navy Corpsman, this may have prevented a lot of future/past foot related conditions that we see now. I have also noticed currently within our Podiatric practice a remarkable shift for continuity of care while using these barefoot science rehabilitative foot inserts. The patients get better and stronger while walking not sitting with their feet elevated and hoping the Nsaids do the job. I’ve noticed a reduction of fatigue from all our patients now that they can walk and repair themselves; we have reduced the need for pharmaceuticals (pain meds), orthotics, foot-braces, or surgical interventions, finally solutions ,for these chronic and painful foot problems! *I agree with the following statement of use, and I could not have said it better! Each Barefoot Science Arch Activation SystemTM comes with a pair of insoles to fit into your existing footwear and a series of progressive arch activation inserts. To start, just pop Level 1 into the underside of the insole, slide them in your shoes and get on with your day! It feels like a mini foot massage, sending waves of comfort throughout your body. That sensation is actually your foot muscles waking up and getting stronger. When the sensation fades, usually within a week, your feet are ready to move up to the next level. It’s that easy! With each step, your feet become stronger and more efficient. I recommend this product, and I am not just a practice of one, I work with Dr Karen Brooks, a Podiatrist, we tag team on every Veteran that enters our offices for Podiatric services, she too has over 25 years’ experience in Podiatry Practice and is also very happy with the results of this innovative design and the multiple uses of this barefoot Science rehabilitative and preventative shoe insert to help our Podiatric patients/Veterans. Sincerely, Mike Olden... P.S. Please note: We have a Zebris gait lab pressure measuring platform onsite in our clinic’s Pedorthic lab, that is used to measure our results on every patient pre and post usage of the Barefoot Science rehabilitative inserts. Both static and dynamic is monitored, along with postural sway, including the shoes that they are worn in. The proof is in the pudding, try it for yourself! Michael P.Olden, H.t; Ost; C-Ped; Pmac. Department of Veterans Affairs American Board for Certifications in Orthotics, Prosthetics and Pedorthics. *Board Certified Pedorthist cert no: Cped0724. KD DIV.HERT Team Decon Coordinator /Instructor KD DIV.Podiatry PAVE TEAM Coordinator/Trainer KD DIV.Local AFGE 2281 Steward+SGT-AT-ARMS KD-Disaster Emergency Medical Personnel System-Team Coordinator Advanced Disaster Life Support Instructor-Cert. Advanced Disaster Medical Response for Providers-Cert. AHA-Basic Cardiac Life Support Instructor-VA-Cert. ECU2 Containment Unit- Staff Trainer-KD-Div. Surgical Service, Code 11C Podiatry / Pedorthic Clinics KD -Div. South Texas Veterans Health Care Systems 3600 Memorial Blvd., Kerrville, Texas. 78028-5768 Wk: (830)-792-2660 Fax :( 830)-792-2532 VA Cell (830)370-2887 Twitter – DEMPS17 Email: Michael.Olden@med.va.gov
Michael P.Olden, H.t; Ost; C-Ped; Pmac.Department of Veterans Affairs American Board for Certifications in Orthotics, Prosthetics and Pedorthics. *Board Certified Pedorthist cert no: Cped0724
Hello Barefoot-Science Team :-) I wanted to let you know I've been using your products for more than twenty years. This product is the one and only item I ever purchased from a TV infomercial back in the early 2000s! At the time I was struggling with orthotics. They were expensive and I found that anytime I was not wearing my orthotics, I had pain and strain issues. This technology is brilliant. It has given me the strength and freedom to run and play in my bare feet. It's also good to see you have continued to advance and add to the technology. I'm looking forward to receiving my new pair of Therapeutic Plus full-length insoles. With gratitude, Zeta Lay
I have been using Barefoot Science Innersoles for almost a year now. I have quite flat feet and was getting bad shin splint pain when running. I very slowly over 5 months went from the smallest to largest inserts of the Innersoles and find they have really helped me. I now run 10k without foot and ankle issues. My advice is to go slowly up the insert sizes and run less until you are used to them. I will keep using these innersoles, they have worked really well for me. I used them in all of my shoes. Thanks, James.
James ClarkeRunner, Godalming, Surrey
As a personal trainer I will run approximately 25 miles a week and Nordic walk a similar distance with my clients. I am always trying new kit that will benefit clients and prolong my working life. I started using Barefoot Science Foot Strengthening System in January 2020 and a year later can report that my feet and legs, and my balance have never been better. I have happily recommended them to clients who have all reported similar benefits. I have finally found an insole that I will be sticking with long-term.
Andy WebbPersonal Fitness Trainer Haslemere, Surrey.
I am a 51 year old long distance runner and completely ruptured my plantar fascia in the left foot a couple of years ago. I was told by an orthopaedic foot surgeon that I should ‘change my sport’. After 6 months of no running I slowly got back to it but it wasn’t until I tried the BFS system one year later that I started to be able to run better and pain free. I would like to see more of this system tested in the NHS and, where appropriate, used by musculoskeletal and orthopaedic doctors and physiotherapists. I think they have a role to play both in sports and in the role of improving mobility in all age groups. The system certainly gave me more benefit than my expensive ‘custom made’ orthotics a few years before!
Dr Susie Cooper MBBS, MRCP, MRCGP, BSc(hons), PgDip (SEM)GP and Rheumatologist with a post graduate Diploma in Sports and Exercise Medicine
The Barefoot Science people know their insoles work – they’ve done extensive trials that show dramatic pain relief and improved energy. But I honestly don’t think they realize how truly remarkable a product they’ve invented. These insoles help so many people with such a variety of complaints – not just because they align posture or provide cushioning and support for feet (like orthotics) – but because they activate the plantar musculature and foot bed proprioception which I believe cross trains the body out of the core bias that underlies a multitude of inefficiencies and subtle imbalances. I believe it literally completes the upright posture circuit and brings about posture without effort!
David M. Lemke, NMT, sEMG TechDave offers neuromuscular therapy and wellness consulting, while he also conducts research to develop and test core wellness exercises and equipment.
Foot and ankle injuries are a huge problem in professional and amateur sports. BFS is the only product out there that allows for complete foot and ankle strengthening.
“As an athletic development coach who works with professional athletes on a daily basis, the BFS system has become the greatest tool to have at my disposal for strengthening the lower extremity musculature. It’s been especially helpful in correcting muscle imbalances that might negatively affect foot strike patterns in gait as well as strengthening and stretching the ankle and foot following an injury.”
Gray CookBoard-Certified Orthopedic Clinical Specialist, a Strength & Conditioning Coach and a USWLF Weightlifting Coach. Author of Movement: Functional Movement Systems—Screening, Assessment, Corrective Strategies (2010) and Athletic Body in Balance (2003)
As a Somatic Movement Educator and Comprehensive Pilates teacher I have found the Barefoot Science Insoles Incredibly useful for myself and for my dancers. Right from the beginning you are able to feel very subtle shifts happening within your body which travels beyond the feet, through the legs, pelvis and beyond. I have found them incredibly useful because those subtle shifts help the body to realign itself and maintain a more accurate centre of gravity, which can often get thrown out through injury, overuse or tiredness. As a result, not only have I found these insoles help with the technical demands and fine motor control needed for dance and movement, but also provide increased levels of comfort for the joints during the course of a busy working day. Having tried many different products for feet over the years covering a full spectrum of cost, for me, Barefoot Science insoles come out on top and are a really worthwhile investment to help optimise your dancing and, more importantly, have great potential to be part of your toolbox for healthy, happy dancing feet!
Sarah Pritchard, RSME (Registered Somatic Movement Educator) and Comprehensive Pilates Teacher
Since using the Barefoot Science insoles I’ve seen and felt improvements both in gym based training and athletic performance. As I've progressed through the levels over the last 3 months, currently on level 3 of 7, I have increased my Back Squat by 10kg, and Snatch by 5kg! The security in the position is most noticeable with leg drive, and positioning in squats seeming far more stable and powerful. Within my athletic performance in Cricket I have also noticed significantly increased stability in my movements, especially my bowling action, with far clearer and stronger foot contact at delivery. Looking forward to continuing up the levels and see what comes next!!
Shae Taylor. HE lecturer on Sport Science (Human Performance) programme. Strength and conditioning Coach for Athlete Movement, Liphook, with main focus on Olympic lifting.
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