We all recognise the benefits of regular aerobic or cardiovascular exercise to support our heart and lung health. Being active is also good for our social and mental health. And strength training promotes strong bones and muscles.

But as we age, we also need to train our balance to avoid falls.

Around one in three people aged 65 and over have a fall each year.

Falls are a common cause of disability and loss of independence in older age and can lead to an older person moving from living independently into living in a residential aged care facility. More than 6,000 older Australians die each year from falls.

But many falls are preventable. So exercise that targets balance and strength is crucial.

How much do we need to do?

International guidelines recommend all older people exercise to prevent falls, even if they’ve never fallen. Prevention is far better than cure.

Other guidelines recommend people aged 65 and over do “functional balance and strength training” on three or more days a week, to improve their ability to do day-to-day activities, stay independent, and prevent falls.

Since balance starts to decline at around age 50, it’s even better to start training balance before the age of 65.

In order to increase our muscle strength, we need to progressively lift heavier weights. Similarly, to boost our balance, we need to practise activities that progressively challenge it. This improves our ability to stay steady in difficult situations and avoid falling.

Functional training means doing a physical activity that imitates everyday activities, such as standing up out of a chair, or stepping onto a step.

When you practise the everyday activities necessary for living independently, you improve your ability to perform them. This reduces the likelihood of falling when doing those activities, and therefore helps you maintain your independence for longer.

What exercises can you do?

The best exercises to challenge our balance system and reduce the risk of falling are performed while standing, rather than seated.

For example, you can stand with your feet close together or on one leg (if it’s safe to do so) while also performing controlled upper-body movements, such as leaning and reaching. This is a functional balance exercise and it can be made progressively more challenging as your balance improves.

Here are some exercises you can practise at home:

Sit to stand

Practise standing up from a seated position ten times every hour or so. See if you can do it without using your arms for support. To increase the balance challenge, place a cushion under the feet.

Heel-raises

Rise up onto your toes and hold the position for a few seconds. Hold on to a bench or wall for support if you need to but gradually remove the support as your balance improves. To increase the balance challenge, try doing this with your eyes closed.

Heel-toe walking

Practise walking along an imaginary line, with one foot placed in front of the other. Hold on to a bench or wall for support if you need to but gradually remove the support as your balance improves.

Stepping in different directions

Practise quickly stepping forwards, sideways and backwards. Being able to move our feet quickly can help avoid a fall if you trip on something. If you are able, more challenging activities include stepping up or jumping onto a box.

Squats and lunges

Squats and lunges improve balance and leg strength. Add some hand weights to increase the challenge.

These examples and others can be found on the Safe Exercise at Home website.

Make it regular – and tailor it to your needs

It’s important that balance challenging exercises are performed regularly, at least three times per week. The benefits of exercise are lost if you stop doing them, so ongoing practice is important.

People of all abilities can safely undertake balance training exercise, however extra guidance and support is recommended for people who have physical limitations, are frail, or who are at a higher risk of falls.

For younger or fitter people, agility activities such as rapid stepping, dancing and running are likely to improve co-ordination and balance too.

So next time you are carrying out your exercise routine, ask yourself: what am I doing to improve my balance? Investing in balance training now can help you avoid falls, and lead to greater independence in older age.

Anne Tiedemann, Professor of Physical Activity and Health, University of Sydney; Cathie Sherrington, Professor, Institute for Musculoskeletal Health, School of Public Health, University of Sydney, and Geraldine Wallbank, Study Manager, PhD Candidate, Physiotherapist, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A migraine attack is not just a “bad headache”.

Migraine is a debilitating neurological condition which can cause nausea, vomiting, and sensitivity to light or sound, in addition to severe headaches.

Migraine affects roughly five million Australians, but few people understand the different stages of a migraine attack.

Knowing the four distinct phases can help you recognise the symptoms and manage pain at each stage.

Phase 1: Premonitory

The first phase of migraine development is the “premonitory” or “prodrome” phase. It functions like a warning period which begins 24 to 48 hours before a migraine attack fully sets in.

The premonitory phase has a lot to do with the hypothalamus. The hypothalamus is the part of the brain which regulates key functions such as body temperature, appetite, mood and sleep.

When a person experiences a migraine attack, their hypothalamus becomes abnormally activated. The hypothalamus is connected to other parts of the brain with different functions, so this abnormal activation can also disrupt how those parts function.

This can lead to symptoms such as poor concentration, food cravings, irritability and insomnia. If you notice these early signs, you’re more likely to “catch” the start of a migraine attack and be able to treat it early.

Phase 2: Aura

The second phase of a migraine attack is called “aura”. Aura refers to various neurological symptoms which affect your vision, speech or ability to feel sensations. Visual auras, which mainly affect your vision, are the most common kind.

Visual aura symptoms can include seeing flashing lights, swirling shapes or blind spots. A sensory aura can lead to numbness or tingling in your face or limbs. In severe cases, people may even have trouble speaking.

Research suggests a process called cortical spreading depression contributes to aura symptoms. During this process, a wave of electrical activity spreads very slowly through the brain and can impact how certain brain regions function.

Only 30% of people experience migraine with aura.

Phase 3: Headache

The third phase of a migraine attack is the headache. This is when people typically experience a throbbing or pulsating headache, alongside other symptoms like nausea and sensitivity to light and sound.

This phase usually lasts between four and 72 hours if untreated.

When different brain networks become activated during a migraine attack, other symptoms can develop in addition to headache.

When the medulla or “vomit centre” of the brain is abnormally activated, it can lead to nausea and vomiting.

The trigeminal nerve, the nerve which allows you to feel sensations on your face, can also become abnormally activated. This causes the release of chemicals which may be perceived by the brain as pain.

One of these chemicals is a protein called calcitonin gene-related peptide (CGRP). Some injectable types of migraine medication block this protein to reduce pain.

Phase 4: Postdrome

The fourth and final phase is the “postdrome”. It is also known as the “migraine hangover”.

During this recovery phase, your brain is working hard to return to its normal functioning. That is why you may feel even more fatigued or have difficulty concentrating after a migraine attack.

So, how can I manage a migraine attack?

It helps to know the symptoms and stages of migraine development.

If you have predictable symptoms, particularly during the premonitory phase, it’s best to carry pain medications or anti-nausea tablets with you. That way you can treat early symptoms as soon as they arise. It can also be a sign to rest, ideally before the headache phase sets in.

In the aura phase, taking migraine-specific pain medications such as triptans, aspirin or anti-inflammatory pain killers may stop the headache phase from starting.

If you have more than four migraine attacks each month, you may also consider taking preventive medications. These are usually daily tablets which help control the baseline level of head pain you experience. Injectable options are also available.

Finally, don’t ignore the postdrome phase. If you push yourself too hard during this recovery period, you may experience overlapping migraine attacks. This is when one migraine attack starts before the last one resolves itself. Overlapping migraine attacks are much harder to treat.

You may also experience other symptoms related to the migraine attack. These can include dizziness, neck pain, or ringing in the ears. If you have any of these additional symptoms, you should consult your neurologist to check they are not caused by a more serious underlying condition.

And if you are a woman who experiences migraine with aura, speak to your doctor before starting hormone-based contraception. This is because you may need different treatment than someone who does not experience aura symptoms.

By understanding the different phases and symptoms of migraine, you will be better equipped to tackle any future attacks that come.

Lakshini Gunasekera, PhD Candidate in Neurology, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.