Movement Is a Team Effort
Understanding Movement and Balance with CIDP
When people think about improving their balance, they often think about making their muscles stronger.
Strength is certainly important.
But after working with people living with neurological conditions, including CIDP, for many years, I've observed that balance is far more complicated than strength alone. CIDP can affect muscle strength, sensation and fatigue, all of which can influence the way we move and balance
In fact, one of the most important ideas I share with my patients is this:
Movement is a team effort.
Every time you stand up, reach for a cup of tea, walk across the room or step onto uneven ground, your body relies on many different systems working together.
Your muscles produce movement.
Your eyes help you understand where you are in space.
Your inner ears detect movement and changes in head position.
The sensation from your feet tells your brain what surface you're standing on.
Your spine helps position your body efficiently.
Your brain constantly receives all of this information, processes it, and decides how your body should respond.
And then there's confidence.
Confidence changes how we move.
If you've experienced a fall or several near misses, it's completely understandable to become more cautious. Many people begin taking shorter steps, moving more slowly, stiffening their bodies or avoiding certain activities altogether.
These are very normal responses.
However, over time they can reduce the amount of movement your brain experiences, giving it fewer opportunities to adapt and respond.
Balance isn't just about muscles
Imagine trying to bake a cake.
If you forget the flour, it won't work.
If you forget the eggs, it won't work.
If you leave out the baking powder, it won't work.
Movement is very similar.
Strong muscles alone don't guarantee good balance.
Likewise, excellent sensation won't overcome significant weakness.
It's the combination of all these systems working together that allows us to move confidently.
This is why I rarely look at one body part in isolation.
Instead, I ask:
· Which systems are working well?
· Which systems need more support?
· How can we use the stronger systems to assist the weaker ones?
When one system changes
One of the encouraging things about the nervous system is that it is adaptable.
If one system isn't providing as much information or support as it once did, rehabilitation can explore ways to make better use of the systems that are working well, while also addressing the areas that have been affected.
For example:
If sensation in the feet has changed, we might explore ways to improve body awareness and balance strategies, while making effective use of visual information.
If weakness develops around the ankles, we may improve stability by strengthening the hips and trunk.
If fatigue makes standing difficult, we may initially complete exercises in sitting or lying before gradually progressing to standing activities and we pace exercise.
Rather than asking, "What can't this person do?", I prefer to ask,
"What systems can we build upon?"
Exercise should reflect the way the body works
This philosophy also changes the way I prescribe exercise.Rather than relying on one exercise or one piece of equipment, I like using simple movements that challenge different aspects of the movement system.
Sometimes we're strengthening. Sometimes we're improving body awareness. Sometimes we're encouraging better spinal movement.
Sometimes we're rebuilding confidence. Often we're doing several of these at the same time.
That's one of the reasons I enjoy using simple equipment such as resistance bands, small balls and fabric loops in addition to Clinical Pilates Equipment.
They're inexpensive, easy to use at home and allow us to target many different movement qualities without always needing a room full of equipment.
Fatigue is part of the picture too
For someone living with CIDP, fatigue can change how the whole movement system performs. An exercise or activity that feels manageable at one point in the day may feel very different later.
That's why I don't just look at what someone can do during an exercise session. I'm also interested in how their body responds afterwards.
How do they feel a few hours later? That evening? The next morning? Understanding that response can help guide the amount and intensity of exercise next time.
The goal isn't perfect movement
People often ask me,
"What exercise is best for CIDP?"
There isn't one.
There isn't one “best” exercise for CIDP. The right exercise is one that's appropriate for your body, your goals and how you're responding today.
Your nervous system may respond differently from someone else's.
Your fatigue may vary from one day to the next.
Your balance may change depending on sleep, stress or illness.
Good rehabilitation recognises that.
It's flexible.
It adapts.
It progresses gradually.
And it respects what your nervous system is telling you.
A different way of thinking about rehabilitation
It's about helping the whole movement system work together more effectively.
When we understand movement as a team effort, exercise becomes much more than strengthening. It becomes an opportunity to work on the different systems that contribute to movement and balance , strength, sensation, mobility, coordination and confidence.
It can also help improve the quality of information your brain receives, the efficiency of your movement, and your confidence in what your body can do.
For someone living with CIDP, the goal isn't perfect movement. It's finding the right challenge, at the right time, for your body.
For me, that's where rehabilitation becomes truly meaningful.
Key Takeaways
· Movement relies on many body systems working together.
· Balance is about much more than muscle strength.
· Rehabilitation should target the whole movement system, not just one body part.
· If one body system is affected, the others can often be strengthened to provide greater support.
· The best exercise program is one that reflects how your nervous system responds and progresses at a pace that's right for you.