Lawrence resident Thelma Hehn tries to maintain her balance as she keeps an eye on her thumb during a session on strength, balance and precautions against falling at Meadowlark Estates.

Some mature health concerns are obvious: osteoporosis, heart problems, loss of hearing, diminished eye sight and weight gain.

One problem that doesn’t get much attention until it’s gone is balance.

At any age, balance-related falls large or small can equal bruises, strains, sprains and broken bones, though they are especially dangerous for those middle-aged and older. Yet balance just doesn’t get the splashy health headlines or community concern as those other oft-discussed maladies.

“Until there’s been an injury, there’s been a fall — that’s when it becomes a concern,” says Whitney Samuelson, a personal trainer with Studio Alpha, 2449 Iowa, who says balance is usually the least of her clients’ initial concerns.

Yet, addressed early — or at all — balance can be improved, decreasing your chances for a fall or injury as you age.

Understanding balance

Balance isn’t just a single skill, says physical therapist Dorian Logan. Rather, it’s an ability knitted together primarily from three major body systems.

“The ability to balance takes a number of our body systems. Vision is one. Our tactile sense, or how we feel the ground, is another one. And then our vestibular system, which is the inner ear system that tells us where we are in space and if our head is upright or horizontal,” says Logan, who works out of the Baldwin City office, 814 High St., of Lawrence and Baldwin Therapy Services. “All of our systems as we age decrease in their functions. Part of the reason our balance decreases and is not so good as we age is just because those three systems that are largely involved are decreasing in their ability to function.”

Thus, if you begin to notice your balance is feeling shaky, it could be the result of one of those systems not working quite as well as it was previously. Logan says that in her experience, vision is often the culprit — especially for younger individuals — but it would take a trip to a therapist to know for sure what the problem might be.

“We rely so heavily on our visual system,” Logan says. “Even in an athlete that I might see, if you have them balance on one leg and take away their eyesight by closing their eyes, most people can’t do it for very long, sometimes just a few seconds even before they have to touch down on something or put their foot down.”

Improving on balance

Luckily, balance is something that can be improved upon, preemptively, or after a fall.

Logan says if a therapist or doctor has identified a specific area that is causing balance issues, the other components of balance can be improved to help a patient compensate.

Other important adjustments? Compensating with at-home habits (like turning on lights at night), removing tripping dangers (area rugs and bath mats) and not trying to “hide” an instability or trying to “self-correct” by buying, but not learning to use, something such as a cane or walker.

“I think most people who have instabilities kind of recognize that already. And sometimes they try to hide it,” Logan says. “Sometimes they just grab an assistive device like a cane or a walker and are like, ‘Well, this is going to keep me safe.’ It’s kind of like a security blanket.”

For a person who has no self-apparent balance issues as of yet but has concerns about preventing problems later, Samuelson suggests adding balance training to their fitness regimen. Yoga, stability ball work, planks, BOSU Trainer exercises or anything in which you must use one leg or arm at a time could help improve your balance on the whole, she says.

“If you’re at the gym, doing single arm or single leg exercises,” Samuelson says. “If you’re in good shape and doing a plank, put one arm up or leg up or alternate arms and legs — anything with any sort of imbalance would be beneficial in becoming stronger with balance.”

If you’re not fit, she says simple exercises like brushing your teeth while balancing on one foot or trying to get out of a chair on one leg could be an easy way to start improvements. She also says focusing on core strength — which can improve your stability — has a side effect of helping to improve balance.