Kilian Jornet running down steep cliffs, Leo Messi dribbling all the defenders and any of us in Zumba class have something in common: that (usually) we move without falling.
A feat courtesy of evolution that we see with such normality that we ignore its value.
The physiologist Hendrik Reimann sums it up in this sentence: "
Mobility is the mere matter of going from A to B without a catastrophic event in the form of a fall
."
That is, there are possibilities, but man has been avoiding them his whole life.
First, thanks to the modifications in the curvature of the lumbar area and in the pelvis that allowed humans to stand upright and walk or
run
on two feet, say anthropologists.
For example, the iliac crest was flattened to improve the center of gravity, and the pelvic cavity was widened to accommodate more robust muscles.
As the apes advanced (and continue to do so) by dropping their torso towards the supporting side or stretching their arms to rebalance themselves, the humans began to arm their arms in a rhythmic way and the glutes took charge of compensating the weight of the unsupported side.
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In this evolutionary process, the operating centers were also modified: the cerebellum and the brain stem.
“The cerebellum enables smoother and more precise motor coordination, helping with functions such as locomotion, posture and balance.
The different structures of the brainstem are critical to regulate muscle tone and enable the organization of movements that involve the muscles of the trunk of the body and that of the extremities.
All of this affects the regulation of bipedal locomotion ”, declares neuroscientist Diego Redolar Ripoll, researcher at the Cognitive Neurolab group at the Open University of Catalonia.
Once the mechanism was established, the human had to learn to capture and manage the data about the position of the body and the obstacles of the way so as not to fall flat on the ground.
Responsibility for the process, which is called proprioception, was given to sight, hearing and various balance sensors
located along the neurolocomotor system (muscles, tendons, ligaments ...).
The young and healthy specimen has all those qualities intact: it can wander without looking where it steps and emerge gracefully.
In a mishap while standing still (a braking on the bus, for example) responds in a period of 50 to 200 milliseconds
and in a push running in the park, 600 milliseconds.
Come on, that the time that the central nervous system needs to process the orography of the terrain, the trajectory and speed of the race itself and the most favorable musculoskeletal possibilities to avoid falling, from a torsion of the trunk to repositioning the ankle to better assume the impact It is negligible.
The reaction is almost instantaneous.
In an octogenarian, however, no.
“Generally, young people have no problem walking in the dark or with their eyes closed.
But
the sense of proprioception decreases in the elderly
and in people with neurodegenerative diseases, leading to a much greater dependence on visual signals to maintain balance ”, explains Professor Jason Franz, from the University of North Carolina (USA). ).
But, of course, when you turn one, your eyesight suffers ... We are hearing you think: "I have an eagle's eye."
Well you go ready.
Why you should care about balance
Stability can be measured and the results give an idea of the fullness of the organism.
An easy method is the
Balance Error Scoring System
(BESS Test), which consists of
three mini-tests in which you must control how long you last
: upright, with both feet completely together — one next to the other — and your hands on your hips;
to the limp, and in a tandem position (one foot immediately in front of the other).
It is done with the eyes closed and counts until the subject opens them or loses balance.
Of all the
exercises
, the most revealing is the one that imitates a flamingo (on one foot):
holding a little indicates poor proprioception, possible cognitive impairment and even lax ankle
with ballots to have a sprain.
The physiotherapist Pablo de Santiago López also suggests doing a test walking backwards: “It requires greater neuromuscular control, proprioception and reflexes compared to doing it forwards”, he clarifies.
Don't underestimate it.
"It is implicit in everyday tasks like sitting on a sofa or opening a door."
But you don't have to do weird things to know that you stumble easily.
In the dark, everyone, at any age, tends to walk with short steps, with our feet wider apart and at slower speeds.
Truth?
Because it reduces the time we spend in an unstable situation, allows each step to be strengthened and returns to that part of the body the mission of an outpost that evolution had planned for it.
And, although, unlike other animals,
the human foot lacks hair, in return, it has multiple nerve endings to know the state of the ground
and an enormous muscular plasticity to cling to unstable surfaces.
There is no reason tightrope walkers go barefoot.
But you go to work, shopping, going for a walk or playing sports, no.
You have more than one shoe ...
“
By putting on shoes, we increase protection, but we lose that ability to receive the information that balance requires
.
And the small muscles of the foot lose mobility ”, intervenes the podiatrist Víctor Alfaro, director of Podoactiva, who, to exercise them, suggests picking up small objects, arching the instep as if you were wearing heels (with straight fingers) and stretching the plantar fascia (for For example, sitting, with the foot resting on the ground on the heel, grab the big toe, pull up and towards the ankle and hold for 15 to 30 seconds, they explain from the Cigna insurer).
How you position your legs, even when you are still, also does its thing.
The balance increases if they are separated and in parallel, and it decreases if they are put together or placed one in front of the other
.
What do you experience when you go by subway (or by boat)?
And in motion: when you walk on a line — okay, it’s not normal, but it’s key to knowing that something is happening — feet follow one another and stability occurs when one's heel is supported next to the other's toe, demanding maximum proprioception and sobriety.
It is one of the reasons why they recreate it (technologically) in the psychotechnical of the driving license and force you to do it in the breathalyzer tests ... With a few more drinks we do that (the cerebellum is especially vulnerable to alcohol).
Many more moments when you limp
"Fatigue is one of them.
When a long-distance runner is fatigued, he tends to stoop, he lifts his feet less ... His proprioception and reaction capacity decrease and that is when falls come, ”warns the physiotherapist Isidoro San Justo Molleda.
“They also affect chronic pain or traumatic injury to the ligaments.
The proprioceptive information that reaches the brain is deficient and the movements can be unsuccessful, ”says his colleague Ana Mostazo Guerra.
"
Sedentary lifestyle would be another factor
.
We have seen it with covid-19: muscle mass is lost due to being bedridden for a long time and the ability to react to stimuli and maintain balance is reduced.
In recovery we work specifically to help remember proprioception.
We do it without getting up and even lying on their backs, for example, tracing circles with their feet or knees ”.
Ah, you don't have an armchair, or you don't use it ...
Or do you blame the virus for destroying all illusions by moving?
Ditching a lot of downtime, giving up walking for laziness, wow, it also impairs the body neurolocation program, but it doesn't eliminate it.
There is always going backwards.
This is how Professor Redolar Ripoll relates: “It is controlled fundamentally from structures such as the cerebellum and the brain stem, lacking the plasticity that, for example, the cerebral cortex does.
For this reason, it is unlikely that sitting for longer will generate long-term changes in the structure or function of the critical regions that control these motor functions ”.
In other words: don't leverage yourself.
If you have walked and there are no injuries, you can do it again.
How do you train?
Stability can — and should — be worked on, whether you're recovering from an injury or want to get rid of it.
Ignacio Hernando Valle, physical-sports educator and co-director of Nachos con Fitness, targets
a specific point: the
core
(you know, abs and lumbar).
“It is the main stabilizer of the body, the central lever from which the force is transmitted and controlled to the rest of the joints.
By exercising it, we improve postural control, prevent falls, and stay away from back or knee injuries.
In addition, we increase performance.
That's why elite athletes, whatever their specialty, include it in their training.
Don't be surprised if one day at the gym you see someone standing on a kind of cylinder or bosu (half a rubber ball with a hard platform) while their trainer gives them little shoves or throws a ball to catch it on the fly. .
It is not torture: it is training balance.
“Any surface that provides instability is suitable: a mat, cushions or a somewhat deflated ball.
Then the difficulty will depend on the physical state.
If it is optimal, you can do it
with your eyes closed, on the limp leg, trying to grab objects or resisting the shoves of an opponent
.
The more sensors we inhibit or the more we complicate it, the more we force the rest to wake up to supply them ”, explains the educator, who adds that the objective also influences.
“I have seen soccer goalkeepers perched on a togu [an air-filled cushion], with cleat boots to add difficulty.
But his job involves making changes of direction in positions that generate a lot of bodily uncertainty.
In normal life we don't get that far.
Now
slacklines,
a taut tape to walk like a tightrope walker
, have become fashionable
.
It is worth it if you are a
trail
runner
or a climber because you need maximum coordination and agility to react quickly to the least instability ”.
Stretching is another good way to stay upright
.
“By stretching, you launch a stimulus to the muscle that the brain must process, know how far it can go and regulate it so that it does not break.
At the same time, you improve joint mobility.
This is important because stiffness is a limitation of proprioception.
If the muscle does not have elasticity or strength, you will not keep your balance ”.
Don't go crazy looking for weird routines.
“It can even be the static stretches of a lifetime, as long as the posture is not held for more than 30 seconds.
Above that time it affects the elastic force ”.
Reserve 10 at the end of the sporting activity and do it with the whole body.
The older the more important it is
Around the age of 70, one in three people have balance problems.
And not only because of a deterioration of motor and neurological faculties.
Incontinence, obesity, fear and sedentary lifestyle lead to progressive loss of balance and open the door to the dreaded falls.
According to epidemiological studies,
around 30% of those over 65 have fallen on their faces at some point in the last year
.
This figure can reach 50% in the case of those over 80.
Far from throwing in the towel, it is necessary to continue training him with the focus on strength work, because
at those ages muscle mass diminishes
: this is what is known as sarcopenia.
Hence, the elderly are increasingly slower and worse off from a bump or a push.
It is one of the main points of the physical activity programs in residences implemented by the physiologists Mikel Izquierdo and Alejandro Lucía.
You will understand why in the East it is easy to see parks full of adults doing 'tai-chi'.
“They call it multi-component: strength, resistance and balance,” explains Hernando Valle.
Exercises range from walking holding onto a railing to standing up and sitting down with the help of a broomstick
, walking in a straight line, or practicing
tai-chi.
“In 4-8 weeks the incidence of falls is reduced by up to 50%.
They gain confidence when they move and many go from using a walker to walking upright, even with the arm of a caregiver.
Balance is quality of life ”.
Before you start training,
go through the scrutiny of a posturographer
.
“It is a system of cells and weight sensors that record the load, displacements and pressure exerted on them.
It measures the ability to maintain standing and analyzes the oscillation of the center of gravity and the load in the transfers when sitting down and getting up ”, explains Borja Castañeda de Luis, a physiotherapist at the Casaverde Foundation.
When determining which points weaken, they
are worked in a specific way, whether it is one leg or both, the back, the neck
.... "It is a system in view of the patient, which allows them to feel an active part and to be involved in a more aware.
This way you gain more control and speed in rehabilitation ”.
The next thing to avoid accidental falls is to achieve
age friendly
cities
,
without potholes, pivots or vehicles on the sidewalks ... But that is already another matter.
Enjoy this and other stories in the new issue of BUENAVIDA, which you can find on newsstands, free of charge, with EL PAÍS.