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Balance

Balance or equilibrioception is the ability to control your center of gravity in all situations, in all planes. It involves coordinating the information from the vestibular system (a group of sensors encased in bone in the inner ears) and the visual system, with, the musculoskeletal system to detect and regulate acceleration. The vestibular system serves as the internal balance reference, and the visual system and musculoskeletal systems use it as a guide for overall balance function. When the athlete’s vestibular system is damaged (as in many contact sports), he feels off-balance (dysequilibrium), and may fatigue early, have visual blurring, reduced mental processing, and ultimately diminished performance on the playing field.

We place a heavy emphasis on understanding the biomechanics of proprioceptors, which are specialized sensory receptors located within joints, muscles, and tendons. These critical structures relay information concerning muscle dynamics to the conscious and subconscious parts of the central nervous system, allowing tight control of the body in three-dimensional space and the performance of complex coordinated movements. This kinesthetic awareness is the hallmark of a graceful athlete. To stress the proprioceptors, it is not adequate for elite athletes to perform simple gym exercises that only move in one of the body’s three cardinal planes. Since few athletic movements occur only in one plane, rigorous exercises must be selected that require movements between the planes. We apply the overload principal to continuously advance an athlete's plyometric program; this involves explosive movement in all directions from balanced positions, maximally challenging proprioceptors. The result is that our athletes have a refined kinesthetic sense, allowing them to maneuver effortlessly on the playing field.

The vestibular system and the visual systems can be directly trained to improve an athlete’s balance using recently developed technologies. Vestibular retraining therapy (VRT) - originally designed to enable NASA astronauts to withstand the micro-gravity of space and for military fighter pilots to endure the demands of piloting a high performance jet- involves exercises that increase the functional performance and endurance of the vestibular system. There are several pieces of technology used to measure the balance system, with particular emphasis on the vestibular response: video-oculography (VOG), the EquiTest system (computerized dynamic posturography), and the VORTEQ system. Each of these tests quantitatively measures the function of the balance system - two through eye stability (VOG and VORTEQ) and the other through postural stability of the body (EquiTest). Visually, if an athlete can maintain eye stability when his head is moving, he can see the opponent or the ball with clearer vision. VOG and VORTEQ measure eye stability through an infrared video camera and report two objective measurements: (1) the strength (called gain) of the eye response and (2) the timing/reflex (called phase) of the eyes to the head at different frequencies of horizontal and vertical. If a specific head frequency is abnormal on the test, our team will design a specific program of exercises to improve the athlete’s values and enhance his eye stability. Standing balance is measured with the EquiTest system, which was originally designed for the NASA space program to measure balance in astronauts, since they commonly experienced dysequilibrium coming back from space. Improved balance organization measurements with the EquiTest can mean increased speed, endurance, and other attributes, as the athlete is not expending as much energy to maintain a sense of balance. The test also measures what is referred to as motor latency/timing, similar to the phase and the gross strength in the leg muscles separately. A lag in the motor timing functionally means a delay in the athlete’s push-off and explosive first step. Any deficits that we measure in our athletes can be overcome with an appropriate training program.

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