Originally published in Body Sense magazine, Autumn/Winter Copyright 2008. Associated Bodywork and Massage Professionals. All rights reserved.

For a child wobbling atop a two-wheel bicycle for the first time, getting it to remain upright is a scary challenge. But once that child has mastered the art of balancing on the bike, the body just remembers what to do.

That’s the way it is with balance. Our body has lots of tools at its disposal to help us control our upright posture, and these tools function largely at the subconscious level. We’re constantly making small corrections in our posture to keep from falling over.

When one of those tools fails to work properly, our system of balance can get out of whack. Neurological conditions, such as Parkinson’s disease, can throw off our balance. Problems with our feet can definitely hamper balance. Eye conditions can rob us of stereoscopic vision, which helps us properly locate ourselves in space. And, of course, inner ear problems can greatly affect our balance.

Many of these balance-affecting conditions are related to aging. In fact, it’s estimated that one of every three people older than 65 will suffer some kind of fall this year. And half those people will fall again within 12 months.

That’s why healthcare providers promote strength-training exercises and Pilates for older people. Strong ankles, knees, and hips can help a body to stabilize itself quickly and avert falls.

Bodywork can also help. Certain modalities can improve and restore balance, particularly through reeducating the body in the most efficient ways to move. Just like our bodies once learned the best way to stabilize atop a bicycle, they can also learn new, better ways to stabilize aging feet and legs.

With half the population of the United States now older than 45, many bodyworkers find themselves with a hugely receptive audience, anxious to learn new and more efficient ways to stand and move—ways that will keep them healthy and upright, not bedfast with broken bones. Here’s a look at how three bodywork modalities—structural integration, the Feldenkrais Method, and tai chi—may help.

Structural Integration

Jane Elmore, MD, is a champion dressage rider, which means she spends much of her day perched atop a 1,200-pound prancing horse. Her safety absolutely depends on keeping her balance.

She’s been doing dressage for more than 10 years, but she’s found the greatest success just in the past year. She credits her improvement to the structural integration sessions she’s been taking for the past year and a half.

“I just feel so much more secure in the saddle now,” says Elmore, who owns a ranch in Denison, Texas. “They talk about the rider being a dance partner with the horse in dressage. Well, I was never a dancer. I was always overweight. But what I find now, in order to have this horse be able to respond to you, you have to be subtle in being able to shift weight from a left seat bone to a right seat bone, to both seat bones, to rotate in the seat so your shoulders follow the horse’s shoulders. All this is much easier for me now, simply because I’m much freer in my movements.”

Structural integration is based on the work of Dr. Ida Rolf, a biochemist who founded the modality called Rolfing, as well as the Rolf Institute in Boulder, Colorado, in 1971. Structural integration involves manipulating the body’s connective tissue—the fascia—to rebalance the body and bring about pain relief from stress and injury.

“Most people come to structural integration because they’ve got something that hurts and can’t make it better,” says Marilyn Beech, past executive director and president of the board of the International Association of Structural Integrators. “But structural integration isn’t really so much about getting rid of the pain as it is about getting the body lined up again. A lot of times your body is so misaligned you can’t get your center of gravity over your foot. A lot of structural integrators work with athletes. It’s common that afterward, they’ll feel more coordinated, more efficient in their movements, and they’ll have better balance.”

Thomas Findley, MD, PhD, who is director of research at the Veterans Administration Medical Center in East Orange, New Jersey, and a certified Rolfer, likens it to separating the pages of a book that have been dropped in water.

“Over time, fascial layers get stuck to each other. So we try to loosen them up. And if you can move more easily, your body can respond more quickly to changes in balance. If you put your foot down on a rock and your ankle is rigid, you’ll go right over. But if your ankle is flexible, you’ll just roll with it.”

Findley has published a number of research papers demonstrating the role of structural integration in improving subjects’ balance.

That’s been Elmore’s experience. In fact, she’s found structural integration more effective than other forms of physical therapy when she’s had to recover from horse-related injuries.

“I’m a radiologist, so I’ve seen a lot of broken bones,” she says. “I’ve come to believe there are pathways and mechanisms that we don’t understand, but they’re there, and they do have an impact on how our bodies move.”

Feldenkrais

Like structural integration and tai chi, the Feldenkrais Method improves balance by teaching individuals to be more aware of proper movement.

Developed by Ukrainian-born physicist Moshe Feldenkrais, the method stems from Feldenkrais’ study of judo and its emphasis on perfect balance. Promoters say the method can help people experiencing pain in the back, neck, shoulders, hips, legs, or knees, but is also useful for healthy individuals, particularly athletes, who want to move more freely.

“Unlike physical therapy or occupational therapy, Feldenkrais is an educational process,” says Denver practitioner Sissel Rhyme. “It works with the central nervous system. It’s bones to brain.”

Sissel typically leads students through a sequence of precise movements, either sitting or lying on the floor, standing, or sitting in a chair. Throughout the process, she asks students to think about how various positions feel.

“This is intelligent exercise,” she says. “You have to be a part of it mentally. It’s not like being on the treadmill for 30 minutes and it doesn’t matter what you think about.”

By increasing the awareness of how it feels to move properly, with everything structurally balanced, students can learn to let go of old patterns of movement and develop new ones that result in improved flexibility and coordination.

There are literally hundreds of such movement lessons, which vary in difficulty and complexity. Lessons can be 30–60 minutes long and can be done in groups or privately with an instructor. The instructor will touch the students, but only gently and noninvasively. It’s not at all painful or strenuous, though Sissel reports students may find themselves exhausted after an hour.

Studies have shown that 10 weeks worth of Feldenkrais lessons leads to notable improvements not just in balance, but in the participants’ sense of confidence in their ability to balance.

Tai Chi

Students in Don Lyles’ tai chi class at the Wellness Center at Denver’s St. Anthony Hospital move slowly and gracefully, concentrating on their breathing and feeling the floor beneath their feet. Every step is measured, every movement gentle.

“The deeper you bend your knees, the more your body will feel what it is to be totally balanced,” Lyles tells the class. “Become aware of your body’s connection to the earth. Let your body memorize this feeling, to have perfect posture, relaxed and balanced.”

Some call tai chi “meditation in motion.” David Ferlic, a 56-year-old psychologist from suburban Denver, just calls it fun.

“Since I’ve started taking this class, I’ve started doing more dancing,” Ferlic says. “I guess the first word I’d use to describe it is rhythm. It’s given me a real sense of balance.”

Lyles says the oldest student he currently has is 82. “Over the past year he’s been demonstrating with great glee his ability to stand on one leg for a period of time. He’s told me the reason he comes to class is to correct his balance. That’s his whole goal.”

Tai chi is an ancient martial art—gentle and flowing, not at all violent or aggressive. It consists of some 100 different movements. Those who practice tai chi assume different postures, with one posture flowing gracefully and slowly into the next. The emphasis is on technique, not strength, though the repetition of the exercises can certainly result in strengthened muscles.

Beyond that, the exercises teach the body how to move gracefully and with precision. The result: A 1996 study from Georgia’s Emory University School of Medicine found that people over 70 who practice tai chi regularly are only half as likely to fall as those who do not. Other studies have shown similar positive findings.

Improved balance is just one of a host of health benefits linked to tai chi. It’s also been shown to reduce stress, lift depression, improve flexibility, and boost energy.

“I’d say 100 percent of those who stay beyond three lessons have been helped in some way,” Lyles says.