Hello

I thought it might be interesting for you to know a little bit more about the parts of your body involved in balance. This will (hopefully) also help you in understanding what your therapist tells you and therefore will help you in selecting an appropriate therapist. So here is a brief overview:

- the eyes: the visual system provides information about the outside world through the eyes. Often, the visual system is used to compensate for deficits in other systems. If your balance problems increase when you close your eyes, this means that you use the visual system to overcome deficits in the other parts involved in balance.

- the skin, joints and muscles: we all take information from the outside world through these receptors. This information will then go to the centres in the brain and this information will then be processed in order to maintain balance. Touch, pain and temperature are important parameters here and they need to be assessed in order to get a picture of your deficits. Deep sensation is information coming from your joint and muscles. We all know when our big toe for instance is in an upward position or downward position when someone else hold the toe in this position (without looking!). This is one aspect of deep sensation that we need in order to have appropriate balance reactions.

- the cerebellum: this is the small part of the brain and the in-between centre between information coming from the body and interpreting this information, and information going from the small brain to the cerebrum (the 'big' brain) in order to adequately coordinate our movements. It is a very complex system with a lot of different connections between different parts of the body and nervous system. Impariments in the cerebellum give you problems with coordination (for instance when you can not clap your hands as fast as you could before but all the other aspects of movement like force/power etc. are ok).

- the vestibular system: this system is located in your ear and it gives information about your head movement. Problems here (like a severe ear infection or neurological damage) give you balance problems because the information coming from this system is contradictory with the information coming from other parts of the balance system. This then typically not only results in balance problems but also diziness, vertigo, pathological eye movements, or nausea.

As you can see, balance is a complex phenomenon and finding the real deficits is essential in providing you with the appropriate treatment programme.

Hope this helps and I hope you have (had) a good recovery.
Best wishes