by Dr. Sam Mossaed

The process of human balance requires coordinated participation of the sensory (visual, vestibular, and proprioceptive) and motor systems. Because of this complexity, treating balance often requires cooperation among different health care specialists. Among these professionals, a chiropractor is able to positively affect proprioception and motor control of and is equipped to both detect and improve biomechanical fixations and imbalances. Injuries to the lower extremities, whether acute or from chronic deformation can alter proprioception and diminish motor response of balance. Any musculoskeletal abnormality such as weakness of the ankle joint or reduced range of motion of the ankle joint decreases stability.

Because the center of gravity is near the lower abdomen, we rely on two major balance strategies involving the lower extremities; an ankle strategy and a hip strategy. The body can use either strategy or a combination of the two.
The ankle strategy requires adequate range of motion and muscle strength about the ankle, a firm and secure base, and the ability to sense the support base. It would not be surprising that individually designed stabilizing orthotics are a key adjunct to this strategy. This is due to the fact that orthotics:

a) Support normal range of motion
b) Provides structural support and joint alignment
c) Maximizes proprioceptive feedback for muscular stability and coordination

Many adults are faced with cumulative traumas, combined with degenerative conditions of ligament laxity and decreased afferent input. Therefore, having research showing that Orthotics enhance balance and proprioception is encouraging. Stude, Brink and Gullickson demonstrated that experienced golfers, after wearing Orthotics daily for a period of six weeks, showed improvements in balance and proprioception1,2,3. This is significant given the fact that experienced golfers would be expected to have maximized their coordination and balance abilities as it relates to the game of golf.

Chiropractic adjustments improve proprioceptive input by normalizing joint alignment and muscle tonus in general. Adjustments are most effective when supported by proper muscular retraining, rehabilitation, and orthotic support. The feet contain approximately one quarter of all the body’s joints and a concentration of proprioceptive fibers. Therefore, it makes sense that supporting the postural foundation using individually designed Orthotics will help enhance balance.
References

1. Stude DE, Brink DK. Effects of nine holes of simulated golf and orthotics intervention on balance and proprioception in experienced golfers. JMPT 1997; 20(9): 590-601.
2. Stude DE, Gullickson J. Effects of orthotic intervention and nine holes of simulated golf on club head velocity in experienced golfers. GuidancePa 2000; 23(3): 168-174.
3. Stude DE, Gullickson J. Effects of orthotic intervention and nine holes of simulated golf on gait in experiences golfers. JMPT 2001; 24(4); 279-287.