Balance training can benefit people of all ages.

Children as young as 18 months can learn balance by walking a line chalked on the floor.

Seniors avoid injury through balance drills that can help prevent falls.

And athletes who rupture knees or sprain ankles use core strengthening exercises for rehabilitation.

Balance training, also called core training, is far from new.

For years, fitness trainers and physical therapists have focused on strengthening the muscles that support the body’s trunk. Balancing exercises, as crazy as this may sound, focus on instability. Standing on one leg is a common drill to improve balance because it helps teach smaller “fringe” muscles to support and stabilize the major joints at your hips, ankles and knees.

Even balance training tools – BOSU balls, slide boards, stability balls – are most effective when they wobble.

“Balance is more about strength than flexibility, but there is a neurological piece to it,” said Russ Certo, a physical therapist who founded the Medically Oriented Gym on Grand Island.

A good sense of balance hinges on a concept called “proprioception,” knowing where your body is in space through the receptors in your joints, said Certo.

“Muscles control your joints, so strength is important, but after an injury, receptors in your joints need to be retrained,” he said. “If you don’t attend to the neurological part, you won’t be able to catch yourself from falling all the way down.”

Staying centered

“Everyone has a center of gravity,” said Torey L. Hirsch Sr., who coaches the Junior Olympic Team program at the Greater Buffalo Gymnastic & Fitness Center. “In the sport of gymnastics, balance is critical to everything we do. When they’re upside down, they have to keep their balance.”

At one end of Hirsch’s massive gymnastics complex in Getzville, Madison Penetrante glides barefoot across a wooden beam 4 inches wide and 16 feet long. The sixth-grader practices stepping forward and backward end to end without falling.

How does she keep her balance?

“I just try and stay centered and bend my legs. If I think I’m going to fall, I’ll put my arms out,” said Madison, who is 11. “And I squeeze everything.”

Coach Hirsch explained.

“The tighter you are, the more control you have over different parts of your body,” he said. “The loose parts of your body will cause you to fall.”

To strengthen a gymnast’s core, the youngsters are led through a series of trunk twists. With feet planted and apart, they stand and twist at the waist. To increase resistance, the youngsters hold small hand weights.

For leg muscles, Hirsch prescribes frog jumps – a favorite exercise of Savannah Penetrante, Madison’s 7-year-old sister. Leg lifts and leg lunges will follow.

Balance training is not only accomplished in the gym, noted Hirsch, a former college gymnast.

“Many different activities on a day-to-day basis require us to keep our balance, whether it’s walking upstairs, or stepping over or onto something,” said Hirsch. “Those who do not exercise lack the awareness of their own body. As you get older you lose that awareness. Even using a walker, the more you walk the more likely you will progress to a cane.”

Winter’s ice and snowy conditions often lead to increased injury due to falls, Hirsch cautioned.

“Adults and older adults who are walking outside in the snow might step on something slippery and their foot slides forward just a little bit. All of a sudden, their center of gravity and balance will dramatically change ... If they’re not ready for it, they may end up falling down.”

Physical therapist Certo sees many patients who require therapy after a fall.

“Once you have an injury to a joint, it is never the same,” said Certo. “In order to return stability, you have to embark on some balance training. We start them out simple.”

Retrain the brain

At age 83, Elaine Johnson is a former science teacher who has attended Silver Sneakers exercise classes for adults age 65 and older at the Grand Island MOG for at least five years. The classes that she attended two to three times each week have made a big difference in her balance.

“Balance is an incredible concern as you get to be older,” said the Grand Island resident. “Something happens to your brain, and you have to retrain it. Many times I think people don’t understand. They think it’s something unique to them, that their balance has been compromised. ... It’s so insidious you don’t know it’s creeping up on you. You think: ‘Wait a minute I used to be able to do this.’ ”

In November, Johnson developed arthritis in one of her hips, so she started physical therapy sessions at the MOG with Kristen Schimley Toscano.

“Before I went into therapy, I was not aware that my balance had been as compromised as it had,” Johnson said. “By challenging the balance I realized I was starting to lose it. As we went on, I found myself improving.”

Under Toscano’s supervision, Johnson went through a range of balance drills. Standing on one foot, Johnson first counted to five and then was told to close her eyes – all the while trying to maintain her balance. Joints lose their mobility as a person ages. Ligaments are not as pliant, and muscle tone and stamina decrease.

A chair was stationed nearby in case she lost her balance.

“It’s a matter of retraining your brain,” Johnson said. “It takes a lot of concentration. At the beginning I’d be grabbing onto the chair but after doing it for several months I could do it.”

Toscano changed the exercise surface to mini-trampoline.

According to a survey published in February 2011 by the National Institutes of Health, mini-trampoline training increased the ability of elderly exercisers to recover balance during forward falls.

Johnson would soon be sitting on a stability ball, lifting one knee at a time like she was marching.

“Another thing I find is that as I get older, I have to stand for a while before I start walking,” Johnson said. “You’re not really aware of all the changes that are taking place with your body. It’s important to be aware.”