NASM: Chapter 17 - Balance Training Concepts

When the body is in equilibrium and stationary, meaning no linear or angular movement.

Maintain and handstand without falling over

The ability to move and change directions under various conditions without falling.

Running on uneven surfaces

Speed, endurance, flexibility, strength

1. Optimal muscle balance (length-tension relationships and force-couple relationships)

2. Joint dynamics (arthrokinematics)

3. Neuromuscular efficiency using visual, vestibular (inner ear), and proprioceptive inputs.

Adequate force reduction and stability are required for optimal force production.
(The ability to reduce force at the right joint, at the right time, and in the right plane of motion requires optical levels of dynamic balance and neuromuscular efficiency.

1. Alters the firing order of the muscles activated

2. Disturbs specific functional movement patterns

3. Decreases neuromuscular efficiency

4. Prime movers may be slow to activate

5. Synergistic and stabilizers substitute and become overactive (synergistic dominance)

Joint dysfunction –> muscle inhibition –> joint injury –> swelling –> altered proprioception (interruption of sensory input from articular, ligamentous and muscular mechanreceptors to the CNS) (like with ankle sprains, ligamentous injuries to the knee, and low back pain).

Balance threshold
(The distance outside of the base of support that he/she can move into without losing control of his/her center of gravity).

Must be stressed in multiplanar, proprioceptively enriched environment.
Must use functional movement patterns to improve dynamic balance and neuromuscular efficiency.

1. Reduces the rate of ankle sprains and other lower extremity injuries.

2. Frequent component of integrated ACL injury prevention programs.

3. Integrated injury prevention programs that include balance exercises in addition to plyometric (reactive) or strength training exercises treated influenced the ability improve lower extremity biomechanics and may reduce risk of lower extremity injury.

1. Performed for at least 10 minutes a day

2. 3x/week

3. For 4 weeks

To continually increase the client’s awareness of his/her limit of stability (or kinesthetic awareness) by creating controlled instability.

1. Change surface - from stable (floor) to unstable (half foam roll, foam pad, balance disc)

2. Visual condition - eyes open (easier) eyes closed or moving head around to look at various object or performing cognitive tasks simultaneously (harder).

3. Change body position or add movement

1. Single-leg balance

2. Single-leg balance reach

3. Single-leg hip internal and external rotation

4. Single-leg lift and chop

5. Single-leg throw and catch

1. Involves little joint motion

2. Designed to improve reflexive (automatic) joint stabilization contractions to increase joint stability.

3. During balance-stabilization exercise, the body is placed in unstable environments so it learns to react by contracting the right muscles at the right time to maintain balance.

1. Dynamic eccentric and concentric movement of the balance leg through a full range of motion

2. Movements require dynamic control in mid-range of motion and isometric stabilization at the end-range of motion

3. Specificity, speed, and neural demand of each exercise are progressed in this level

4. Designed to improve the neuromuscular efficiency of the entire HMS

1. Single-leg squat

2. Single-leg touchdown

3. Single-leg Romanian deadlift

4. Multiplanar step-up to balance

5. Multiplanar lunge to balance

Designed to develop proper deceleration ability to move the body from a dynamic state to a controlled stationary position as well as high levels of eccentric strength, dynamic neuromuscular efficiency, and reactive joint stabilization.

1. Multiplanar hop with stabilization

2. Multiplanar single-leg box hop-up with stabilization

3. Multiplanar single-leg box hop-down with stabilization