Lee Burton: Balance and Stability for Older Clients

Lee Burton looks at mobility restrictions and the resulting compensations and discusses the training implications of seeking balance and stability for older clients.

Excerpted from The Future of Exercise Program Design: Gray Cook, Lee Burton & Alwyn Cosgrove

What does the older client want? Mobility. Balance.

Let’s get more specific. He’s 70 years old. When we start talking about older clients, we talk about balance and stability. But we can’t talk about stabilization unless we clear his mobility restrictions.

He has a locked-up thoracic spine. He’s going to sacrifice that stability in his shoulder to move. He has locked-up hips. Think about that; he has a locked-up thoracic spine and locked-up hips.

Where is he moving?

He’s sacrificing stabilization in his shoulder and scapula and in his low back or knee to offset the lack of mobility in his hips and thoracic spine. This compensation is something we all do, and it creates problems every day.

We know he’s doing that. He can’t do single-leg stance very well, so let’s try to do more single-leg stance work. His hips are locked up. His ankle may be locked up. We have to improve his mobility. That’s where we learn our movement pattern.

Gray Cook often talks about the tremendous mobility that babies have. What do babies learn to do? They learn to stabilize. That’s what our brain knows.

If we’re going to get a 70-year-old to start moving better, we have to make sure he has mobility first because that’s going to open up and improve his proprioceptive awareness to allow better motor control.

That’s how we learn to move.

We have to train him to learn to move just like we would train a baby. But we don’t train babies, do we? They automatically learn to do it. What we do with a 70-year-old is put him in a position where he has to go up against his weakness and the learning happens automatically.

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balance and stability for older clients - The Future of Exercise Program Design