Balance has always been considered an important component of post injury or surgical recovery, and it is frequently used as one of the criteria for allowing someone to return to work, sports, or activities. In Orthopedics and Sports Medicine, the gold standard when testing balance has long been to time how long a person can stand on one leg with their foot flat on the ground, with eyes both open and closed, with an ideal goal of achieving a 60 second eyes closed stance prior to loss of balance.
When analyzing the dynamic nature of most running and jumping sports, it is important to note that rarely are these athletes in a foot flat position on the ground. A track and field sprinter’s heels will not touch the ground during a 100 meter dash. A volleyball player at the net looking to block a shot is often side shuffling on the balls of their feet. A soccer player sprinting after a ball or looking to dribble past a defender is not in a foot flat position. In basketball, a defensive slide is performed with the players heels off the ground. In many sports the term “flat footed” carries a negative connotation, as it refers to being caught in a position that is unsuitable for a quick reaction or change in direction.
I would like to propose that with an athletic population, a narrow based single leg stance (standing on one leg on the balls of the foot) is a good litmus test for assessing dynamic balance / reaction time. The ability to hold a narrow based single leg stance for 30 seconds with no loss of balance is an excellent way of identifying when an athletic individual has the mobility, strength, stability, and lower extremity coordination to safely initiate plyometric and return to sport/leisure activities.
Two important quality related things to look for during a narrow based single leg stance.
1) Lateral Weight Bearing
Weight bearing should be primarily over big and second toes. Lateral weight shift is a compensation and risk factor for injury.
2) Balance Strategies
As an individual approaches optimal balance, you should notice increased responsiveness at the foot and ankle. If balance / reaction time are dysfunctional, then you will notice a lot of upper body counterbalancing. This is an addmition that the stabilizing muscles of the foot and ankle are not activating fast or efficient enough to maintain proper balance and posture.
In a soon to come blog post we will discuss specific exercise progressions to maximize balance potential!
PT of Costa Rican National Soccer Team for 2007 World Cup in Victoria, CAN. Clinical Instructor for University of Minnesota Doctor of Physical Therapy Affiliations
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