by | Aug 18, 2020 | Uncategorized | 0 comments


With my diagnosed condition (ataxia) I have chronic balance issues. I was hoping to share some subtleties of this complex set of systems. Hopefully this will lead to improved understanding–understand that this is a very brief overview and not a comprehensive discussion.

Human balance

Human balance depends on 4 systems: the cerebellum, the inner ear (called the vestibular system), our spinal cord (especially the neck) and the bottoms of our feet. Inputs from all these systems are integrated by our brain keeps and also keeps us upright (which is why some conditions that present with brain issues sometimes cause balance problems e.g. migraines or MS) i. If our balance system doesn’t work well, patients have a risk of falling. This is a big source of hospitalization and broken, injured joints and bones. Unfortunately, if one or more of these systems fail -even though there is redundancy- it leads to increasing risk of falling; the other systems unfortunately cannot fully compensate.

What does that mean for you? For chronic balance issues, patients need long-term PT (physical therapy).  The goal of PT should be to strengthen other systems. As mentioned above, the exercises, although important do not let the other systems revert back to baseline. Life unfortunately becomes a series of ongoing challenges.

Words of advice

  1. As you challenge yourself-make sure you are safe

2.  Do the PT exercises daily.

3.. Eliminate things in the house that can trip you up and may make you fall-e.g. area rugs (on that note-be careful around pets.). Some PT providers offer this service-examine your home and advise you on dangers

4. Examples of how to challenge yourself: Close your eyes; walk deliberately on grass.

5. Try to stay at one level in your house- avoid going up or down stairs if possible


Unfortunately, balance problems become more common as people age- loss of muscle mass (frailty) and development and progression of diseases. Staying fit by engaging in regular exercise like walking, and core strengthening will help by diminishing muscle loss will certainly help—unfortunately, this does not prevent falls-but this would help.

Do you want to understand your health condition?


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