STILL IN MOTION
Because slowing down isn’t in the plan.
TUESDAY DEEP DIVE: THE STRETCH
Sunday’s issue introduced the Ankle Alphabet Balance Drill. Today we add two vestibular-specific drills that address the inner ear balance system, which is distinct from proprioception and is specifically undertrained in most balance programs.
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DRILL 1: ANKLE ALPHABET BALANCE (SUNDAY’S FEATURED DRILL)
The eyes-closed progression is the critical advancement: when the eyes are closed, the brain cannot use visual information to correct postural sway. It must rely entirely on the ankle and hip proprioceptors and the vestibular system. This is the most specific training available for the sensory systems that actually prevent falls in real environments, where there is rarely time to look down at the feet before a misstep occurs.
Progression: after the eyes-closed alphabet is manageable, add slow head turns during the balance. Turn the head slowly left and right while maintaining single-leg balance. This adds the vestibular challenge of gaze change to the proprioceptive challenge of single-leg stance.
DRILL 2: HEAD MOVEMENT BALANCE TRAINING
Best for: Specifically training the vestibular-ocular reflex and the brain’s ability to maintain balance during head movement — the scenario most commonly associated with falls during turning and head-turning movements.
How to do it:
Stand in a comfortable stance near a wall, feet shoulder-width apart
Slowly turn the head to the right and hold 3 seconds, then to the left and hold 3 seconds — 10 repetitions each direction
Then tilt the head back to look at the ceiling and hold 3 seconds, then down to look at the floor — 10 repetitions
Progress: perform in tandem stance (heel to toe) during the head movements
Further progress: perform with eyes closed during the head movements
The inner ear (vestibular system) is most challenged by head movements, particularly in combination with postural demands. This drill specifically trains the vestibulo-spinal reflex — the automatic postural adjustment that the body makes in response to head movement — which becomes slower and less accurate after 60.
DRILL 3: GAZE STABILIZATION EXERCISE
Best for: People who experience dizziness during head movement, who struggle with balance in visually busy environments (crowds, stores, traffic), or who feel unstable when quickly changing visual targets.
How to do it:
Fix a small target (a dot on a piece of paper taped to a wall) at eye level about 2 to 3 feet away
While keeping the eyes fixed on the target, slowly turn the head to the right and then left — the head moves but the eyes stay on the target
Perform at increasing speeds: slow (2 seconds per rotation), medium (1 second), and then quickly (0.5 seconds)
20 repetitions each direction, 2 to 3 rounds
If dizziness occurs, slow the head movement speed and gradually build tolerance over days to weeks
This exercise trains the vestibulo-ocular reflex — the coordination between vestibular signals and eye movement that allows the visual field to remain stable during head movement. Degradation of this reflex is a primary contributor to the ‘wobbly world’ feeling that many adults over 60 experience in busy visual environments.
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COMING UP
Thursday expands the tandem stance work with three reactive balance progressions, including the perturbation training that directly trains the fall-prevention response.
Still moving forward,
— The SIM60 Team
simsixty.com · Because slowing down isn't in the plan.
Educational content only. Not medical advice. SIM60 is not a medical provider and does not diagnose or treat any condition. Consult your physician or a licensed physical therapist regarding your specific symptoms before beginning any exercise described here.
