Balance Function in the Amateur to Elite Boxer

New Technology for Performance Enhancement of the Balance System

By Brian K. Werner, MPT, Nationally Certified Vestibular Specialist

Have you ever been asked by your trainer to shake your head or perform spins in place vigorously and then continue to spar with the sense of dizziness? Do you remember when you were hit and felt that sense of imbalance and dizziness - did you suffer from it after a fight? This is your equilibrium or balance system, and in 80 % of boxers a key component that can be injured is the vestibular system. The vestibular system, which is a group of fine sensors encased in bone in each of you inner ears, along with your visual system and receptors found in your joints, muscle, and ligaments (called the somatosensory system) makes up the balance of your eyes and body.

In particular, the vestibular system is what we call your internal balance reference, which means that the other two sensory systems (vision and somatosensory) use it as a guide or template for your overall balance function. When it is injured or not working correctly, you may feel a sense of off-balance (dysequilibrium) and possibly dizziness when you are fighting and perhaps after a fight. Other problems you might complain of are fatigue, decreased performance, visual blurring, and/or decreased mental processing. The great thing is that the vestibular system, along with the visual and somatosensory systems, can be trained to improve your balance performance, and can be incorporated into your existing training program for boxing. The key is understanding how injured it is, and this is where some unique specialists come in to play.

Originally designed to assist NASA astronauts tolerate the micro-gravity of space and for military fighter pilots to endure the high demands of piloting a high performance jet, vestibular retraining therapy (VRT) is a form of specific exercises, usually designed by physical therapists or physicians, that increase the functional performance and endurance of your balance system (this is your eye and postural stability), with particular emphasis on the vestibular system. The vestibular system, along with your vision and the joint receptors, is like the front-end alignment on your car with your brain at the steering wheel. When you hit the potholes and bumps on the road and/or your tire pressure is off (this is the hits from sparring and during fights and the total fights overall), the front end will start to drift to the right or left, and it will be harder for your brain to maintain hold of the steering wheel (decreased endurance).

A great test to determine if the front end is off is to perform a marching test - also called a Fukuda test. Try to stand in place with your eyes closed and march 60 good-sized marches on a level firm surface without any noise or visual distractions (I have had boxers listen for my voice or use a bright light to try to stay in place). At 60 open your eyes and see where you are. Many times, a balance dysfunction will cause you to drift forwards and to the right or left. I have seen some boxers and patients drift forward six or seven feet - I have even seen a guy turn 360 degrees in a circle without him even knowing it. This is a gross measurement of your balance function, and an abnormal response may mean some VRT is needed to get your alignment healthy and strong.

At the clinic in Las Vegas, NV, we are using three pieces of space-age technology to measure the balance system, with particular emphasis on the vestibular response: video-oculography (VOG), the EquiTest system (computerized dynamic posturography), and the VORTEQ system. Each of these tests objectively measures the function of your balance system - two through eye stability (VOG and VORTEQ) and the other through postural stability of your body (EquiTest). Visually, if you can maintain eye stability when your head is moving, you can see your opponent more clearly and avoid his/her punches and counter with clear vision. For a fighter pilot or NASA astronaut, it is life and death situation if they cannot see the instrument panel in front of them - this is really no different for the professional boxer. VOG and VORTEQ measure your eye stability through an infrared video camera and report two objective measurements: (1) the strength (called gain) of your eye response and (2) the timing/reflex (called phase) of your eyes to your head at different frequencies of horizontally and vertically. If a specific head frequency is abnormal on the test, the therapist can give you and your trainer a customized program of exercises to improve your values, thus improving your eye stability.

Standing balance is measured with the EquiTest system, which was originally designed for the NASA space program to measure balance in astronauts, as they commonly get dysequilibrium coming back from space and this can be devastating to their career. While only anecdotal, we are speculating that improved balance organization measurements with the EquiTest can mean increased punch power and improve endurance during the fight as the fighter is not "fighting" his/her balance. The test also measures what we call "motor latency/timing" similar to the phase and the gross strength in you leg muscles separately. A lag in your motor timing functionally means a delay in your push-off for your punch leg and also means a delay in your quickness to avoid your opponent. Like the VORTEQ and VOG, a customized program can be developed with your trainer to focus on your deficits and improve your performance.

For more information on the use of this technology for performance enhancement in boxing, call Brian K. Werner, MPT at 702-880-1515 at the Werner Institute of Balance and Dizziness, Inc.

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