Standing on 1 Leg WON’T Improve Balance! Here’s Why

References

Most balance training for older adults is completely missing the mark. Standing on one leg for 30 seconds might look like you’re working on your balance, but it’s not addressing the real issue. In this eye-opening video, vestibular and balance specialist Dr. Jeffrey Guild reveals the number one system responsible for balance as we age: the vestibular system.

You’ll learn:
• Why standing still isn’t enough
• How fast head movements stimulate real balance gains
• What most rehab and fitness programs are doing wrong
• How to actually train your balance to stay youthful and independent

If you’re over 60 and serious about staying active, avoiding falls, and even boosting your brain and cognitive health, this video is essential.

Video Transcript

I'm going to start this episode with a controversial statement. If we want to improve our balance, if we're over the age of sixty or seventy years old, we are wasting our time focusing on staying on one leg. I'll say it differently. If we want to make our balance better, the key is not to stand on one leg for a length of time. The key is not to do single leg stance. in fact, I'll even say, this is a waste of time. Now, the reason I'm saying this is because balance, especially if we're over the age of sixty seventy years old, is so much more encompassing other than just the act to be able to stand on one leg for twenty or thirty seconds. Balance is so much more dynamic. There are so many other facets to balance. And most importantly, all these different areas of balance are so important when it comes to our daily life and the way we interact with the world. And I'll give you some key examples here in a little bit. if we think about the world around us, the way we interact with it, we have to be able to look around us as we are walking and be able to turn our head and view the environment. And we need to be able to do this all at one time. I often give this scenario that we need to be able to cross a busy street while moving our head side to side very fast While having a conversation with someone else while avoiding a pothole and then about to step up on a curb and continue to walk and we need to be able to do all of this while continuing to walk in a straight line without getting dizzy and with all the information coming in and all of our reactions to this environment going out, all this has to work together very seamlessly. So that the information doesn't get confused. Our body has a tremendous ability to be able to do this. So then the question becomes what happens when a wrench gets thrown into the system or when the system becomes weak or if it starts off weak? this is the reason why this over-focus of being able to stand on one leg to ensure good balance is... The wrong path to go. It's not that it's not a small, important part of balance, but what we are doing in rehab, in physical therapy, in exercise facilities, What has grown popular as a whole amongst the older population as far as the emphasis on balance is This overemphasis on single leg stance on standing on one leg is completely out of balance. Being able to stand on one leg is one little important part of our balance system as a whole, but is one little important thing that we should be able to do. If we're over sixty seventy years old, yes, to be able to stay on one leg for a few seconds is very important. If we can do it for a very long period of time, great. But I've also seen people be able to stand on one leg in their 80s But when we have them do very basic tasks like turn their head side to side, then their system completely fails. So I want to refocus the idea of balance and what gives us rate balance. As a vestibular specialist, someone who has specialized in the main central balance system of our body and clinically treating disorders Related to the Vestibular system for over a decade. Relentlessly studying this system. How to optimize it. How to improve it. How to treat it when the system goes awry. even how do I identify problems with this system when nobody else is looking at it? very commonly, when we look at our population, eighty plus, 80s and 90s, Almost everybody needs training on their vestibular system if you are over the age of eighty But how often is this done very specifically? the best way we can stimulate our vestibular system is head movement. And not just head movement, but head movement And in coordination with our eyes and how we view the world. Now, sometimes we need to be able to just swoop our heads side to side and just allow all this visual information To enter our vision and to be able to handle all that information. And I'll even find people who are very healthy, very normal individuals over the age of seventy or even sixty who do not do this well. Very healthy, very normal, physically active individuals, but they no longer do this well. They no longer choose to allow their eyes to just swoop across the world around them as they turn their heads fast. Because their body has already stopped doing it. Because their body has to take in all this visual information when they do this. I'll give you another example. The other thing we need to be able to do is to be able to fixate our gaze, fixate our vision on an object while we are moving our head. it's a very small amount of head movement that we need to be able to do this well, but it's very important to be able to have a very strong vestibular system. Because having a strong, well-functioning vestibular system is the main thing we need, the number one thing we need in order to have great balance as we age. Now there's a number of other things that we need, but this is the main system that we need because this is our main central balance system. And it's not an inner ear system as we commonly think about, and there's a number of reasons why it has come about that we think of this as an inner ear balance system. It is a neurological system. Just one of the main organs for the vestibular system is in the deep inner ear protected by the skull. But the rest of the vestibular system goes to the brainstem, the most primitive part of our brain, to the cerebellum, the coordination part of the brain. To the mid brain and all the way into the cortex where we have to consciously interpret information as well, and we are to this day still mapping out how much the vestibular system projects the upper levels of the brain. And this is profound because we are still understanding how this system works. And this explains the very large amount of symptoms that people were experiencing when they have a problem with their vestibular system. And that's not to even mention How the system then goes down into the rest of the body and can interact with the rest of the body. And I don't think we've even really begun to grasp the extent of that. what we do know for sure is the vestibular system is a neurological system that spreads all throughout the brain and goes down our spinal cord. And then has to interact with other areas of our body. So our vision is also a very important part of our vestibular system. In fact, it's very difficult to even separate the two. Because the vision and the vestibular system work so intimately together that we might as well think of our vision as part of our vestibular system as well. Because the two have to interact together. And if they don't interact well together, then we can be become extremely impaired in our daily lives. this vestibular system also has to interact with what's called proprioception. The ability to receive information about where our joints are in space, especially where our leg joints are in space. We have to be able to receive that information coming back up and then we have to interpret all this information coming together our vestibular system which receives information about head movement Our visual system, which receives visual information, and then our proprioception, That tells our brain about where we are in space and then our Feeling of our feet on the ground. Our body has to put all this information together. in a very dynamic environment, Where we are having to move our head fast. The main way that we stimulate our vestibular system is head movement. It's not standing on one leg. That's a small part of it. But it's the best way to stimulate the vestibular system. The most potent way to stimulate the vestibular system is head movement. Sometimes with the eyes open, sometimes with the eyes closed. We need to be able to do both. And if we cannot do both, then we can become very impaired. We lose our ability to balance. If the vestibular system does not work, or there's a dysfunction associated with it, or if it has become weak, then Our balance will decline. And that is when we're at risk for falls. That's when we're at risk for our physical abilities to decline. Let's be more honest, we look older. We look less youthful. We cannot walk as fast. We cannot get around our environment as well. We walk more rigid. All this makes us look older. Let's talk about something that people like really care about. If your vestibular system declines, you will look older. You will look less youthful. You will look more youthful, you will look better if you have a stronger vestibular system. So how do we strengthen the vestibular system? How do we make it better? To talk about it very broadly, head movement. Head movement and fast head movement is the key to strengthening our vestibular system Our nervous system in general acts very specifically to the type of stimulus it receives. So if we are used to lifting weight slowly, our nervous system will be trained to lift weight slowly. Fundamental strength and conditioning principle. So if you stand up from a chair slowly, even if you're capable to stand up from a chair fast, your nervous system will learn to stand up from a chair slowly. But if we... Stand up from a chair fast, and we do that on a regular basis, our nervous system will train, will become trained, so our body will then stand up fast. And be able to stand up faster and faster and faster. And our vestibular system is this way as well. If we only turn our head slowly. Then our vestibular system will only be able to handle. The head turning slowly. It will not be able to handle the head turning fast. And the realities are the dynamics of life require fast head movement. We must be able to scour a room when we walk into it and look at what's around us. We must be able to look and move our head fast when we cross the street, looking side to side, looking for cars. We must be able to turn our head fast when a friend calls our name and all of a sudden grabs our attention or when there's a loud sound and we turn our head fast to look at what's going on. These are all instinctive reactions we need to be able to do and so we need to be able to turn our head fast in order to have great balance. I bring this up kind of as an introductory episode talking about the importance of fast head movement As an essential component to balance. It's not about standing on one leg. It's not even about standing feet together, eyes closed. That's a very superficial... Level look at our balance system. When we look deeper and what we really need to be able to do in daily life, our vestibular system requires so much more. So if we want to remain active and independent, if we want to look And act youthful. If we want to slow the decline with aging. If we want to begin to thrive as we get older. and I’m not exaggerating this because we do this with our clients in their 70s 80s and 90s every single day and we're able to see how they can begin to thrive As they get chronologically older, if they do the right things, if their bodies are given the right stimulus over time, their vestibular system can get stronger, they can move more easily, they can move more youthfully, and they can Physically look better. And that's not to mention other areas of benefits of the vestibular system that Affect even our cognition, our ability to be able to, figure out where we are in space to be able to figure out where to go. When we're walking around, when we're driving, all these are important parts of the vestibular system because of how much the vestibular system projects into the upper level parts of the brain and even interacts with our ability to Have good thinking capabilities, memory, cognition, more and more science is coming out all the time that shows us how much these things are connected and what happens when the vestibular system declines. then what happens to our abilities to think, to have better memory, to be able to problem solve, which are very important things that I know people care very deeply about. If you ask older people, do you care about your legs being strong, a very large percentage of them will say yes. But, you know, okay, leg strength, leg power, walking fast, this is very esoteric things. But what people... Overall, if you ask a hundred of them what do they really care about as they get older, I would imagine 99.9% of them will say that Maintaining their thinking capabilities to not lose their brain is a very important part of their body they would regret losing. And our vestibular system is a part of this cognition system as well. To summarize, if we want to strengthen our balance system, if we want to have better balance as we get older, we need to strengthen our vestibular system with fast head movement. And the challenge here is to be able to do this safely. That's the additional challenge because it's not necessarily safe to just have everybody go and Stand in the middle of a room and move their head fast. Please do not do that. There needs to be a certain level of guidance with this, so that can be the challenge. It's not quite as safe as working on just standing up and down from a chair. that's the additional challenge with all this. How to do this safely. And that's where we as vestibular specialists will guide people on how to properly advance their vestibular system. The fundamental principle, if you do not use it, you lose it. This is very, very true with our listed bar system. I'll tell you a quick story about this. When I was a new parent, I was about thirty-four years old First child, few months old, little baby daughter. I'm on a swing with her for the first time. very slowly, not much movement, not something that should make me dizzy or anything. But I got very dizzy and sick and nauseous just with a small amount of movement. And the reason I tell you this story is because at the time, and even now, very physically active individual played sports and everything else. Lift weights, run, all that stuff. And already in my mid-30s, My vestibular system had declined to the point where I got sick and nauseous and dizzy just by rocking back and forth gently in the swing with my baby daughter. And she seemed to be tolerating it just fine, probably better than me. And you know this experience as well when you were a kid and your parent who was In their 30s or 40s would not go on the spinning rides with you. They said, oh, no, that'll make me too sick. That'll make me dizzy. I don't like that. Whereas I'm sure they went on those spinning rides when they were a kid. What happens is even by our mid-30s, our vestibular system declines so much Because we don't spin around in circles and laugh with our friends like we used to. We don't go on spinning rides or go on swings or do any of these things that stimulate our vestibular system like we used to. Because like many parts of childhood, we stimulate our vestibular system in the form of play in order to make this system very strong so that we can become functional adults. So we can interact with the world around us, by our mid-30s and probably even before then, our vestibular system declines compared to when we were ten twelve this is profound because think then what happens by the time we are in our 70s, 80s, and 90s. And why this is even more important is because as we've seen with our clients every single day when we stimulate our vestibular system properly This system can improve and get stronger even in our 80s and 90s. And what ended up happening with myself was as soon as I went on swings more often as I had, more children. I was on the swings more, I had no problems going on swings. then when I have gaps of time when I won't go to the park for a while, I will tend to get more sick and nauseous when I go on the swing again. So this needs work. This is a fundamental principle of if you don't use it, you lose it. So how do we strengthen and make our vestibular system better is fast head movement. That is the key. When we start with that, then we can. Begin to optimize our vestibular system so that we can have very strong balance so we can most optimally interact with the world around us. Thrive as we age look younger and stop looking older as we're moving around and look more youthful, more confident as we walk in the world around us. Hopefully this information was helpful for you or someone that you care about. If you like this, subscribe to our channel, share this with someone that you know that will benefit from this and we'll get more out to you and we'll see you on the next one.

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Kayleigh Burns

Physical Therapist

Kayleigh has had a passion for understanding movement and the intricacies of the human body from a young age. She had several loved ones growing up that required Physical Therapy, that sparked her interest in becoming a Physical Therapist and making an impact in other's lives at such a critical and vulnerable time.
Kayleigh Graduated from California Baptist University with her Bachelors in Pre Physical Therapy in 2014 and received the Deans award for Leadership and Academics. She then went on to Western University of Health Sciences and received her Doctorate of Physical Therapy in 2017 where she was awarded the Phoenix award for overcoming diversity. Since graduating she has focused on the Geriatric population dedicating the last 7 years to Skilled Nursing Rehabilitation bringing diversity and quality care to an often forgotten population. She has implemented programs that focus on Dementia rehabilitation and adaptation, wound care and emphasized neurological point of view with varying diagnosis. She has also led Rehab teams varying in size from 7-25 people. Regardless of her position, her calling has been the same, to inspiring individuals to keep living life to the fullest, to not accept age as a barrier and to provide perspectives and opportunities to overcome limitations. 
When Kayleigh is not immersed in the world of Physical Therapy, she is prioritizing her family whether it's spending time on their land with her two small kids and husband or traveling around the World. Make every day an adventure and seek new heights each day!

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Matt Langford

Physical Therapist

Hi there! I'm Dr. Matt Langford. I have been working as a physical therapist in DFW for three years. My wife, our golden doodle named Birdie, and I love to spend our time going on different adventures whether it be hiking the Trinity trail or traveling to new places. I also love playing golf, pickleball, and serving at our local church in Fort Worth. My goals in life include learning more about the field of physical therapy so I can provide better care to individuals, pursuing my faith in a way that helps others know about Christ, and making as many memories as I can.

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Client Liaison

Kasondra is a mother and a pet lover, she loves spending time outdoors with her children and furry friends. With years of experience in client relations, her passion is ensuring that every client is heard and taken care of. As our Client Liaison, Kasondra takes pride in building strong relationships with our clients, ensuring that their needs are met and that they feel comfortable and confident throughout their time with us.

Jason Livas

Physical Therapy

Jason joined the Optimove team November 2023. He earned a Bachelor of Science in Exercise Science from the University of Texas at Arlington in 2012 followed by an Associate of Applied Science in Physical Therapy from Navarro College in 2019.
Jason’s clinical interests include neuromuscular training for healthy aging and longevity of the older adult, orthopedic rehabilitation and strength and conditioning. Jason also maintains certifications as a Certified Strength and Conditioning Specialist (CSCS) and trigger point dry needling (Cert DN).
Outside of work, Jason enjoys cooking, reading, strength training and spending time with his beautiful wife and kids.

Connie Thomason

Occupational Therapist

Connie holds a Master of Occupational Therapy from Texas Woman’s University (1997) and boasts over 26 years of experience as an Occupational Therapist. Her expertise lies primarily in neurological rehabilitation within a hospital-based outpatient setting. Throughout her career, Connie has worked across various healthcare settings including Acute, SubAcute, Skilled Nursing, and In-Patient Rehab.
Her specialization in Vestibular Rehabilitation since 2005 has equipped her to effectively treat a wide array of conditions, including BPPV, Vestibular Migraine, Meniere’s Disease, acute and chronic hypofunction, Acoustic Neuroma, PPPD, balance disorders, central vestibular disorders, concussion, and Superior Canal Dehiscence.
Connie holds numerous certifications, including the 360 Neuro Health Certificate of Competency in Vestibular Rehab, Emory University Vestibular Rehabilitation Competency-Based Course, 360 Neuro Health V2FIT for concussion, Lee Silverman Voice Therapy (LSVT) BIG for Parkinson’s patients, Neuro Developmental Treatment (NDT) for stroke patients, and NASM Corrective Exercise certification. She is also certified in the Montreal Cognitive Assessment (MoCA).
Active in professional communities, Connie is a member of the American Occupational Therapy Association and the Vestibular Disorders Association.
Outside of her professional endeavors, Connie enjoys spending time with her husband of 30 years, along with their two rescued bulldogs. Her hobbies include riding motorcycles, traveling, running, painting, and reading extensively about health, wellness, and vestibular research.

Andy Altmoyer

Operations Manager

Andy grew up as part of a military family, living all over the country and abroad. He is so glad to have finally landed back in Texas. He earned a bachelor’s degree in Secondary Social Studies Education, minoring in Vocal Music and Theater from West Liberty University in West Virginia. Since then he has used his outgoing nature, education background, and organizational skills in healthcare management and operations. When he isn’t working he enjoys spending time with his family and dogs, reading Marvel comics, and cooking.
During Andy’s first venture into healthcare, while living in Ohio, he worked for a practice focused on Orthopedics where he spent time managing their Physical Therapy front desk across multiple locations as well as being a group fitness instructor for seniors, folks with special needs, and those who have had total join replacements. It’s here that he realized his deep love of helping people navigate the healthcare system and connecting them with those can meet their mobility needs.
Sad to leave that company after over 7 years, Andy and his family moved to Dallas where Andy spent 3 years as Operations Manager for a large Neurology practice. He continued helping people connect with top tier healthcare providers, navigating the pandemic, and moving the practice’s location in stride. It was during this time that Andy met Dr. Guild. The Optimove Team became a favored referral source for some of the physicians on staff and Andy got to work with their team closely as they coordinated care for the patients.
This collaboration led to Andy joining the Optimove Team in August of 2021. Andy has a unique blend of experiences not only professionally but personally as well. He has been able to assist so many people reach the correct providers to have their needs met and provides valuable insight to the workings of the healthcare system at large and how to make it work better for our clients. This also comes from helping his mother navigate worker’s compensation and disability as well as assisting his family setting up his grandparents with memory care, assisted living, physical therapy, and other services. Andy has often been quoted as saying, “I may not be the one laying the healing hands but connecting folks to the right people who can help them makes me feel like I’m a part of something great and makes me feel good.”
Andy would like to be a part of your journey towards independence and wellness. He loves getting to know our clients and being one of their biggest cheerleaders throughout their journeys. Give him a call and take the first steps to achieving your goals.

Peter Langlois

Physical Therapy

Peter keeps our clients laughing, and the whole Optimove Team as well. Hand-picked by Jeffrey from their previous rehabilitation work, when he is not being “The Joint Whisperer” and making the seemingly impossible happen, Peter is MacGyvering up some gadget for our clients to help them move better.
Peter is originally from Rhode Island. He received his bachelor’s degree from the University of Rhode Island where his first career was as a ship captain, where he travelled the world and experienced many different cultures. Peter later developed a passion for physical therapy from his running career as a long distance runner doing marathons and ultramarathons. This led him to switch careers as he wanted to learn more about injury prevention and rehab. Peter has worked in various facilities over the last 8 years as a therapist throughout the metroplex including skilled nursing, outpatient orthopedics, and home health. He now enjoys working with our clients on various movement disorders, gait mechanics and balance issues. In his spare time Peter enjoys chopping wood and going for long trail runs with his family.

Jeffrey R. Guild, PT, DPT, (Former CSCS)

Owner, Therapist

When Dr. Jeffrey Guild is not working as business owner and clinician, he is dedicating time to his wife and children. His other hobbies include working out (Mainly in the weight room), music (Listening, playing, & researching), history, science, and studying business and successful people.
Jeffrey is originally from Bettendorf, Iowa and went to The University of Iowa and graduated with a bachelor’s degree in Health Promotion (Minors in Integrative Physiology & Psychology). He also worked as a Strength & Conditioning intern with The University of Iowa for 3 years and volunteered in cardiac rehabilitation at The University of Iowa Hospitals & Clinics. Upon arriving to Texas, he interned at the Cooper Aerobics Center.
Jeffrey’s first career was as a strength & conditioning professional and personal trainer. Even in the fitness industry he specialized in working with people who were older and with physical limitations. His particular emphasis as a personal trainer was identifying basic movement problems to prevent injuries BEFORE the training started, which gave him a greater understanding about human movement and was a natural segway towards Physical Therapy.
Jeffrey graduated with a Doctorate Degree in Physical Therapy at The University of North Texas Health Science Center in Fort Worth in 2013. He received the Dean’s research Award for the Allied Health Department and got published in multiple journals. After physical therapy school he started his career by receiving mentoring for over a year working in a vestibular/neurological specialty outpatient practice. Since then he has worked in a number of areas of physical therapy including inpatient rehabilitation, acute care, skilled nursing, memory care, and even pediatrics. In 2018 he started his own practice with the name “Optimove” with the emphasis on a combination of “optimal movement” and “optimism.”