Three Questions with Meghann Koppele Duffy

Episode 22 - Are You Balanced?

• Meghann • Episode 22

Share episode

Think balance is just about standing on one leg or wobbling on a BOSU ball? Think again.

In this episode of Three Questions, I unpack what balance really means beyond the wobble boards and “core work.” From head position to vision to the inner ear, your brain is constantly piecing together sensory information to keep you upright. And sometimes those systems argue more than they agree.

In the episode you’ll hear:
 ✅ Why your head position might be tricking your brain into thinking you’re “straight” when you’re not
✅ How to train your three balance systems so they stop fighting each other and start working together 
 ✅ Simple ways to challenge your balance in daily life without adding another workout to your plate

Whether you’re training clients, chasing athletic goals, or just hoping not to trip over your own feet, this episode will help you rethink balance as more than a skill. It’s a strategy your brain uses to feel safe, steady, and adaptable in every part of your life.

Resources mentioned:
Episode 2: Sensory Preferences and How They Dictate Who We Are!
Neuro Studio Advanced Neuro Techniques For Movement Pros
Find a Neuro Studio Teacher Near You
Connect with me on Instagram
Connect with me on Threads

Meghann Koppele Duffy: Welcome to Three Questions where critical thinking is king, and my opinions and research are only here to support your learning and deeper understanding. Hey, I'm your host Meghann, and I'm so honored you clicked on Three Questions today to talk about balance. Now, balance, that's a pretty important topic to me.

I feel like this is kind of what I do for a living. Help people improve their balance. Now, the great thing about working on your balance systems and being more balanced is it's going to kind of trickle down to every part of your life. So if you're having issues with walking, you need to be balanced to walk.

Maybe you're trying to do a new exercise or compete to be at a higher level. Well, your systems need to be balanced in order to do those activities. And you know, if we, uh, get a little deeper, I mean, isn't that the goal to be like balanced in life? Um, I am not there. Um, but, you know, whatever. I'm doing my best.

So let's get right into question one. Do you know where your head is in space? I know that's kind of a weird question. You're like, yes, it's sitting on top of my shoulders. But really, do you know where your head is in space? How far forward is your head? How far back is your head? Do you notice it's slightly tilted to the right?

Is it slightly tilted to the left? What is the head position you take when you're taking a picture? So right now, I want everybody to smile like they're getting a picture taken. If you're watching me on YouTube, you could say that I tilted my head a little to the left. Now what I want you to do is pretend someone's taking your picture and try to tilt your head to the opposite direction.

It ain't gonna be cute. Why it's not gonna be cute is you might not have the balance in your neurological systems to move your head in that direction without it being uncomfortable. Okay, so there we have it. Today's episode, maybe this will just help you take pictures better. Who knows? Everybody has their goals.

Now, what determines our headspace is a few things. So number one, our vestibular system. What is your vestibular system? It's these three semicircular canals in your inner ear. Okay. They've got little hairs and they're filled with fluid. So when our head tilts to the right, the fluid moves along. The hair, the hair, the sensory information of that gives signal to your brain about where your head is moving in space so that the body can follow or counterbalance it so we don't fall over.

There's also features like a vestibulo-ocular reflex so that when we move our head, so say I'm moving my head, or I'm walking and my head's moving, my eyes are still able to be focused while I'm looking at you. So right now I want everybody to pick a visual target in front of them and then just turn their head right and left.

Do it slow and do it fast. Okay. What happens when you do it fast? Is it still. Can you still see the target or did you just get a little bit disoriented? So, our vestibular system is critical. It's going to really tell our brain the position of our head, but it's not just about the vestibular system. Our visual system is also going to tell us where our head is in.

Okay, so a lot of times I have this problem with my husband. He's very tall. He is like six six, and I'm five three. I do this thing where instead of looking my eyes up at him, I tilt my head back to look at him. Why? It's less taxing on my eyes. I don't know. It's become habitual. So what happens is my brain, because I'm looking up and talking to him so much, that feels like straight to me.

I don't feel like I'm tilting my head back. I feel like I'm just lifting my eyes up to look at him. Okay, now you might be thinking, yeah, but Meg, we move our head all the time. Is that bad? No. The problem occurs is when it's your only option. Now let's talk about the third thing that determines your head position, your proprioception.

That's the, uh, how do I best simplify it? Not so you know, where your head is in space. I mean, all the systems do that, but based off the tension on the skin, the tension on the muscles, the sensation through the muscles, the sensation through the joints of your face, head and neck, all those are going to give your brain information.

So if take your head into a stretch. Bring it to one side, so that stretch in the muscles, or you might be feeling a stretch in the tendon. If you're hypermobile, that information is gonna be sent to your brain, so your brain knows how far you moved your head. Now there's some problems with head position.

Now, if you have any spinal curvature, like scoliosis, or maybe just because you've had an injury, maybe you have foot drop or you hurt your ankle, so now you're limping and you might have some curvature in your spine. Our brain is so smart. So there's this thing called the writing reflex, where that if our, if we have scoliosis or a spinal curvature, so everybody drop your right shoulder down a little bit towards your hip.

Okay? So our spine is curved a bit. We're not gonna walk around with our head like that. What the brain does is it tilts the head so that the eyes are looking straight ahead. Okay? So, oh my God, that is so great that the brain does that. However. What happens is once we work on a client's spine, so now I want everybody to drop to the right and tilt your head up so your head's straight.

Now can you touch your head and one of your shoulders? So you just measure the distance. Now I want you to lift up your right shoulder so your body straight, but now your head is gonna be tilted to the left. Do we think, do you think our brain likes this? A new, so this is why when we straighten out clients, they go, this doesn't feel straight, because it's not normally proprioceptive issue, it's often a visual and vestibular.

So when we get them straight based off a habitual pattern, what we think is straight for them. Their visual and vestibular system is like, um, excuse me, Mo, this is straight. When their body is that way, it's because their head has been in that habitual position. So how the vestibular system is sending information to the brain and how the eyes are sending information to the brain, those two systems are like, no, this is straight.

And proprioceptions like might think that might be straight two against one. Who do you think is gonna win? Also, proprioception is not always a reliable narrator. Okay? This is why a lot of you are like, oh my God, this really hurts. And then you go to PT and they're like, yeah, but that's moving fine. This is problematic, right?

The whole body's connected. So what we often feel like we need to do to feel better is actually what we don't need. It's based off what we are sensing. Okay, so a lot of times I work with a lot of, I work with people with neurological conditions, professional athletes, movement professionals. What I often do is have to give them lead with visual and vestibular to shift their proprioception because they believe what they feel is gospel.

Not because they're bad movement teachers. It's because their proprioception is yelling at their brain and saying, this bitch is wrong. I'm right. Okay. And I believe that you are the expert at your own body. So I'm not here to like fix your alignment or tell you you're wrong. I'm here to try to help your visual vestibular and proprioceptive systems integrate better.

Okay? Now think maybe you've got hypermobility or EDS. Proprioception is gonna be affected. So your proprioceptive system is always trying to like get information. This is why you guys like end range stuff. Maybe you like tight clothes, maybe you like loose clothes. You'll have really specific sensory preferences.

My people are hypermobile or have proprioceptive issues. They can't stand still. Okay? I work with a lot of people who are neuro diversion or have autism. They can't sit still either. Why? Because their brain needs information and their brain is getting information from the vestibular system. So think about it.

Say your kid's moving their head around a lot or can't sit still, that's what's calming them down. Without that information, their brain literally has no idea where they are in space and is panicking. So rather than telling your kid to sit still, I would say, I want you to move as fast as you can. Let's move.

Let's do this. Let them move. Keep in mind, I understand you might be tired. Your kid is annoying you. You just want them to be quiet. I get that. That's why I don't have kids. You'll have to figure out that solution. What I'm telling you is you are basically taking away their strategy, and I have a rule I add.

I never subtract. I don't take away people's strategies to be balanced or to feel safe. And I use balance guys, when people talk about brain safety, the best way to improve safety in the brain is balance through integration of these three systems. Most of us guys, our three systems, are fighting each other, not because they wanna fight, they're just trying to figure shit out, help our brain feel safe and know how to create a better motor map of what we need to do.

So rather than taking somebody's strategy, maybe. Give them something else to do. Lemme give you an example. I worked with a young man who has cp. He's constantly looking around the room. He's constantly switching subjects or can't stay on task. Well, it's hard for him to focus. He needs a lot of sensory information from his eyes.

Okay, so it's like if you are Taylor Swift's bodyguard, they like, I saw a clip on Instagram. I don't know why this is fresh in my mind, but her bodyguard literally follows her around stage and they are constantly looking for threats. So if you have someone in your life who is, eyes are always all over the place moving around, they are constantly looking for threats.

So rather than giving them gay stabilization exercises, I might be like, look over here. Move your body towards what you're looking at, look over there, then move your body. So asking them to move their eye specifically so that their body can adapt. I'll use my laser pointer. I'll tell them to find their la, the laser pointer, run over to it, touch it.

Or I'll say, I'll put the laser pointer on a wall and I want them to turn their entire body so they're facing the laser pointer for this young man. I used a head-mounted laser and I told him too. Move the laser pointer around and let his body follow. When I had him do his roll-ups or cat cow, I didn't cue him how to move the body.

I told him, get that laser pointer from here to there. I don't care how you do it. And it took him a minute and he figured it out. And he did the most beautiful cat cow. Why? Because he was letting his visual and vestibular system guide him, not his proprioception, which is greatly affected because he has ce, cerebral palsy, and high levels of spasticity.

Spasticity affects proprioception. Okay, so going back to where your head is in space, do you know where your head is in space and how are you determining it? Are you closing your eyes and tilting your head in different directions? To activate your vestibular canals. Are you keeping your eyes open and moving your head around specific targets?

Are you touching your head? Okay, what if everybody right now, make an al with your hand, touch your chin, any your ear, or behind your ear on your ear skull. Just touch two spots on your head, one on the jaw, one on the head, and I want you to rotate your body right to left. Do you notice anything? When I shift to the right, my jaw gets closer to the back of my head.

I shift my jaw, excuse me. When I turn to the left, my jaw also shifts to the right. That is a lovely symptom of my concussion, where I got concussed in the back corner of my left head twice. Okay? But when I put my hand there, that might bring attention. So I'm using a proprioceptive cue. And I'm turning my head and seeing, can I do that rotation without my jaw shifting kind of hard when I'm talking.

Okay. So by just doing that exercise, I improved my proprioception using a touch base strategy. So my brain felt when I was moving, things that I wasn't trying to move. Finding those movement errors leads me to question two. Mm-hmm. When you close your eyes, do you feel like you're on a boat? You can try this right now.

Record yourself on your phone. Okay? Stand up. You can have your arms out. Okay, this, this is a test they do at the neurologist's office. Or just close your eyes and just stand there. Watch yourself in the video. Video yourself from the side. Are you swaying or are you locked in? If you are locked in, that is telling me your brain is getting enough information from your proprioception and your vestibular system, when you close your eyes, as soon as your brain feels you move, it corrects you.

Now, I cannot tell. This is why I hate when they say it's proprioceptive assessment because you cannot separate proprioception. Vestibular because when your eyes are closed. If your body's swaying, there is going to be movement in your head. Was it your vestibular system that righted you or was it your proprioception?

Okay. Now what's tricky about this is every time I move my head, proprioception is going to be a factor whether I move my head or don't. So you can't really separate proprioception and vestibular. Okay, I'm trying to work on a research study. We just don't have the technology to separate those two yet.

But what I was thinking about is, does it really matter? Maybe you try proprioceptive cue and if it doesn't make a difference lead and get them to focus on vestibular, so it's really a 50 50 chance. If we're wrong, we just learn something. So I'm okay with being wrong. That's me now. What if when you closed your eyes, you were swaying all over the place?

You might've felt dis, maybe you didn't feel disoriented, you might've felt like you stood still. Well, that's telling me that either your visual or your, excuse me, vestibular or proprioception. Was not feeling those nuances. Dare I say, neither of them were. So this person, I might actually have to move both of them bringing attention to both of them and then see which makes the biggest difference.

Now, you can use this in your movement sessions even easier. When you give a client an exercise, do they close their eyes or do they open 'em? Oftentimes when people close their eyes think they have enough proprioception. And vestibular information to do the movement. So you have a challenge. You need to integrate their visual system because people don't walk around with their eyes closed.

Right. You ever do that sometimes where you have to close your eyes to focus on what you feel? I get it. I have to do that sometimes. 'cause my eyes can be a disruptor. Okay. Meaning that the sensory information in my eyes are getting are disrupting. Actual the good information coming in from proprioception and vestibular.

So a client who closes their eyes, I'm not gonna force them to open. I might use a specific visual target for them so their eyes know what to specifically look at. I need to make sure I can integrate the visual with what they're feeling, proprioceptive or vestibular. That is critical. Now, if it's the opposite, if clients are terrified to close their eyes or they don't want, that's telling me they are relying on their visual system.

They need a visual strategy. They might need to use peripheral vision. They need a visual representation of where their body is to help stabilize and mobilize it to change proprioception. So clients that need their eyes open know they're relying on their eyes probably too much. These are often clients I see sometimes their symptoms get worse when they're sleeping and their eyes are closed because when they go to roll over their body, overreacts, say they have spasticity, their spasticity could increase, their nerve pain, could increase, their shoulder pain could increase because the body doesn't have enough strategies with the eyes closed in that position.

Okay, so question one and question two are so related. How can we improve? Our ability to know where our head is in space. Can we first isolate variables? Can we maybe use a visual strategy, a proprioceptive strategy or vestibular strategy? Can we also understand that we can't fully isolate variables because all three systems are getting information at all times.

Unless we're severing nerves to the muscles and tendons, we can't remove proprioceptive sensory information. Even if you have neuropathy, even if you have a neurological condition like ms, you are still getting sensory information. It might not be good sensory information, but it's still something. And when it comes to your eyes, guys, this, when it comes to your eyes, guys, something you need to realize is what we see isn't the only sensory information our eyes are getting.

Our eyes are taking in so much information and our brain is processing that so we see a clearer picture. Maybe you're going, my brain is not processing that. Okay, well, how can we give our brain less information? Maybe make the visual feel smaller to then make it bigger. Maybe isolate one eye at a time. A lot of people have double vision.

Oi talk about bad sensory information to the brain. Your brain doesn't know which one is correct, so it's going to make an educated guess based off past experience and other current sensory information. So patch one, eye work on one eye at a time. Then working on integrating both eyes together based off a proprioceptive strategy, not a visual strategy.

Okay? If your client has double vision and you wanna improve balance. You need to figure out, I'm asking you right now, how are you going to use the other systems to support vi's, okay, so let's go back to question one. How is, how are you or your client determining where their head is in space? They probably don't know.

Nobody's ever asked them. Number two, do they need to open or close their eyes? Are they relying on their visual system or is their visual system a disruptor? This needs to be addressed. And question three, do you actually wanna improve your balance?

If you want to improve your balance, you have to work on those three systems and integrate them. So if you don't wanna do eye exercises, if you don't wanna do vestibular based movement. You are only relying on proprioception and overriding your proprioception with information that might not be accurate and it might not be integrating with other of the other two neurological systems.

So I'm okay if you don't wanna improve your balance, but please don't say you're doing balance training if you are not including those three systems standing on a bosu. While that is all great, that is really working. Your ankle's ability to stabilize in an uneven surface, love that. But how is that helping your visual and vestibular system?

It's only affecting your proprioception based off that surface. I would prefer clients to be on uneven surfaces like, um. Like those, like kind of rock pads or, um, on the grass tilted, because in real life, the ground doesn't move like a bosu. So if our clients are trying to improve their balance for walking and stuff like that, the floor is your best tool.

However, I don't love to just use flat floor. I like flat floor, cold floors, heated floors, towels under it, shoes on, shoes off. I am going to challenge my client's proprioception that their brain and body can respond no matter how that foot touches the ground. I need them to have good proprioception when their shoes are on or off because they're gonna do both.

Okay? And yes, we are dense with proprio receptors, uh, mechanical receptors on the bottom of our feet, but a lot of my clients who don't feel that they have no sensation, no awareness. So I use different spots of their feet. I'll have them wear their shoes and they can feel the tongue of their shoe or the laces of the shoe or the side of the shoe.

How I'm using the shoe is using pressure against the skin, against the muscles to trigger a different motor response, to help the brain shift their proprioception. Now, if we're gonna do the bosu, I'm fine with that, but what's the visual and vestibular strategy? What if you gave someone a specific strategy and ask them to move diagonally up, down, and then stay right in line with that visual strategy?

Don't get above or below it while they're doing their exercise. Maybe use a vestibular. I love using my martinis where I'll ask a client to kind of spill a martini or I'll have them point in the direction they're moving their head, and then I'm gonna ask them to keep their head in that configuration as they do the exercise.

So you heard me. I have them move their head in a unique pattern, and then I ask them to hold that pattern. Maybe they turn and tilt their head to the left while they're doing a squat, because what I want them to do is to maintain that head position as they go up and down. I don't want them to shift their head around because I'm looking for, you know, spinal stability.

And it depends on the depth of the squat. There's gonna be some lumbar mobility, whatever. It depends on my goal of the movement. Right. But if I can get them to move other parts of their body and not their head, that's gonna be critical. I might tell my client, rather than say they over rotate their head in rotation, I'll say to my client, get your head in line with your nipples.

Then look to the right and rotate. They're like, oh my God, I could rotate further. Well, yeah. When you over rotate your head, your neck proprioceptively is at its end range of motion. The brain is feeling that tension. So that's a red light. So the brain's like. We're at our end range also because when you overturn your head, you see over here.

So your brain thinks you rotated that far. Um, I did not rotate that far. So keeping your head in line with your nipples is going to let other parts of your spine rotate more. But maybe I wanna rotate my head more. So I might have my client touch their pelvis and ribs and say, I want you to turn your head without shifting your ribs to the right and left of your pelvis.

Okay. The goals are endless. You have to create the goal. What do you actually want their head to be doing during the exercise? And then you've gotta figure out a sensory strategy to make sure the head is actually doing what you're asking. Is there a visual system helping, or is it disrupting the movement?

And how can you layer proprioceptive, visual and vestibular Or just start here guys, you only need two of those systems to be functioning, to be balanced. This is why blind people don't fall. Sure they do fall, but not on the regular. They've got amazing proprioception and vestibular system. Okay, so think can you do a sensory stack, a proprioceptive touch base cue.

With a visual or vestibular cue. So both those systems go. Okay. Alright. I co-sign this rather than them thinking this is straight. Okay. I am tilting my head every time I'm doing a squat. I need to make sure that the motor output matches the motor map that we designed. If it doesn't, I need to give them sensory input to get their cerebellum to activate.

Okay, so enough of these silly cerebellum assessments. It's not actually assessing the cerebellum. It's assessing something that the cerebellum does, but other parts of the brain also do. What I'm looking at is, can I identify what sensory input helps the cerebellum activate to create another motor pathway?

That is what's critical. That's what leads to neuroplasticity and better balance. So to wrap a bow around today. If you want to improve balance, I want you to think about where you're at is in space. What is it doing? How is it moving in the relationship to the rest of your body? Is it moving with it or against it?

I don't care. Do both just make sure it's happening. Number two, are your eyes disrupting your balance or really dictating your balance? Are you only balanced with your eyes open, or are you better balanced with your eyes closed? That will dictate how we address the visual system because when you're walking in, in the real world, your eyes are gonna be open.

I want you to not just rely on them, because if you have ocular migraines or any visual disturbances, you are going to feel less balanced. Cataracts, you name it. But if your eyes are a disruptor, you could have everything online and your eyes could be making your brain feel less balanced. And body feel loss balance.

Okay, and last but not least, do you wanna do the work it takes to improve balance? It doesn't have to be that hard. Maybe every time you brush your teeth, you look in the mirror, find something behind you, and I want you to then take your tongue and clean your teeth without moving your head. So see that if you're looking at me, me on YouTube, I've got a painting behind me, I'm gonna clean my teeth with my tongue without my head getting closer.

I might do calf raises, lifting and lowering my heels in my bathroom. My head's gonna be going up and down with my body, but I'm gonna make sure it doesn't get closer or further away to the painting next to me. Okay, I might do a vestibular ocular reflex. I might look at a visual target and turn my head without changing the pressure at my feet.

I'm gonna do these little things throughout my day to make sure that my brain and body know where I am at all times. And if you are going through a different phase of your life, whether it's menopause, whether it's uh, puberty, whether your kids are having a growth spurt, understand that proprioception is always affected through different phases of life.

So this is also why a lot of people, women in menopause get vertigo. And it is not because of faulty vestibular system. They always love to blame the inner ear. Oftentimes the vestibular system is the only functioning system, and it's like a little overwhelmed. When you're going through menopause, depending on your cycle puberty, this happens to men and boys as well as their bodies change our brain.

The sensory information from our muscles, tendons, joints change throughout a lifetime. So we need to train our system to respond to what our body is sensing or feeling. Now, we might need more or less proprioceptive information, okay? So we never blame one system. We look to integrate them and hopefully have some fun along the way.

If you need help improving your balance, I'm gonna put a resource down there where you can find a neuro studio trained teacher that can help. All our level three teachers are very comfortable doing Zoom sessions. Uh, there also might be a teacher near you if you're a teacher interested in more about the sensory integration and wanna actually improve your client's balance with less work, more fun.

I will put our course where you can learn more about that as well. So thank you guys so much. Um, I'm gonna do another episode about balance, uh, because people had a lot of questions, but I wanted to introduce this on a bigger level to get you guys thinking. And please let me know what questions you have after this episode so I can make adjustments for future.

Thanks so much guys, and have a great and balanced day. 

​