Balance is the body’s ability to maintain the line of gravity within the base of support.  With balance, you can make automatic postural adjustments to maintain posture and stability throughout everyday life.  There are three key players in maintaining your balance:  Vision, Vestibular, and Proprioception.

  • Vision: Your vision tells you where you are relative to other objects.   Because of your vision, you can sense motion between you and your environment.  The receptors in the retina are called rods and cones.  Rods helps with low light (night time) and cones help with color.  With stimulus, the rods and cones send visual cues for identifying your surroundings and where they are relative to your periphery.


  • Vestibular: Inside your inner ear, you have a vestibular apparatus that maintains equilibrium.  This system is sensitive to changes in head position, linear acceleration, or the ability to sense forward/backward or upward/downward movement, as well as angular acceleration, or the ability to sense rotation of the head.  While all of this is occurring, your eyes can remain still.  The vestibular apparatus can direct control over your eyes so you don’t feel like you are moving with your head movements.  About 20% of nerve fibers in your visual system interact with the vestibular system.


  • Proprioception and kinesthesia: By using muscle proprioceptors like muscle spindles and Golgi Tendon organs, you can detect changes in muscle length or tension.  There are also joint receptors that are sensitive to changes in joint angles and pressures.  This information is sent to your central nervous system and gives you a sense of spatial position and movement relative to the support surface.


With these three components, you have a lot of information that is sent to your brain stem where it is interpreted.  Other parts of the brain like the cerebellum and cerebral cortex aid in deciphering this information.  The cerebellum participates by providing automatic movements that have been learned through repeated exposure, and the cerebral cortex contributes with previously learned information.  When all this information is processed, messages are sent to the musculoskeletal system to maintain your balance.  In physical therapy, we can challenge these systems to improve your balance during sport or to decrease your risk of falls.  With habituation and neuromuscular retraining, physical therapy can reduce symptoms and improve performance.


Balance is a constant dynamic equilibrium with intricate pathways.  Talk to your Wallace and Nilan physical therapist to see how balance training can be incorporated into your care.