A Deep Dive: 🎧Achieve Balance Course-Module One: Finding Your Why

A Deep Dive into the Believe in Balance Course

5 Surprising Truths About Regaining Your Balance (and Independence) In the United States, we are navigating a silent but devastating epidemic. Currently, one in four adults over the age of 65 falls every year. The clinical data is sobering: 50% of those who fall experience a lasting decrease in mobility and a loss of independence, while 25% of those who suffer a hip fracture die within six months. This is no longer just a personal or familial tragedy; it is a national economic crisis. The cost of falls in the U.S. is currently estimated at over $80 billion annually—a figure projected to surge to $100 billion within the next five years. As a physical therapy specialist, I see the “paralyzing” fear of falling as the primary obstacle to recovery. Reclaiming your life requires more than simple leg exercises; it requires a systematic neuromuscular recalibration. The ultimate hurdle I see in my clinical practice is not the physical injury itself, but learning to “believe in balance” again. To prevent becoming a statistic in this hundred-billion-dollar crisis, we must shift our perspective from passive aging to active system maintenance. 1-The “Paralyzing” Downward Spiral is Optional A fall often triggers a “downward spiral” that is as metabolic as it is psychological. When an individual loses confidence in their stability, they instinctively restrict their movement. This self-imposed inactivity leads to a rapid loss of mobility, strength, energy, and independence. This loss of energy creates a feedback loop: the less you move, the less capacity you have to move, which ironically increases the risk of the very fall you are trying to avoid. This psychological barrier is the first clinical hurdle to recovery. Breaking the cycle requires shifting the mindset from a state of paralysis to one of proactive conditioning. As highlighted in my Believe in Balance [https://knowstroke.substack.com/p/closure-after-stroke-book] guidebook: “Whether you think you can’t or think you can, YOU are right.” Recognizing that this spiral is optional—and that mobility confidence is a rebuildable resource—is the essential first step in reclaiming a life of independence. Achieve Balance with SmartMovesPT is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. 2-You Can Slash Fall Risk by 40% Without a Gym There is a persistent myth that reducing fall risk requires high-intensity gym routines or specialized equipment. However, the most effective tool in our clinical arsenal is the Otago Exercise Program. Developed in New Zealand and based on extensive research, this home-based strengthening and balance retraining pathway has been proven to reduce falls by 35% to 40% among sedentary older adults. I’m an Otago certified provider and I build my course around the evidence based therapeutic exercises in this program. The program is so effective that it is now a coordinated clinical standard promoted by the CDC, the Patient-Centered Outcomes Research Institute (PCORI), and the Administration for Community Living. The power of Otago lies in its precision. Rather than general “leg days,” it focuses on research-driven movements performed in the home environment, such as: * Front Knee Strengthening (Quadriceps) * Back Knee Strengthening (Hamstrings) * Standing Calf Raises * Tandem Walking (Heel-to-Toe) Achieving a major medical outcome does not require a gym membership; it requires a consistent, evidence-based pathway tailored to your current functional level. 3-Balance is a Multi-System “Check-Engine Light” In physical therapy, we view balance not as a single faculty, but as a “check-engine light” for the body’s integrated systems. To address this, the CDC developed the STEADI (Stopping Elderly Accidents, Deaths & Injuries) algorithm—a coordinated clinical tool designed to screen and intervene before a catastrophe occurs. A decline in balance is often a symptom of underlying issues across multiple systems: * Vision and Inner Ear Health: Disturbances in how you process spatial orientation. * Medication Side Effects: Prescriptions that may cause light-headedness or fatigue. * Nutrition: Specifically, how diet impacts “muscle resilience” and “balance performance.” * Postural Hypotension: Sudden blood pressure drops when standing. Clinical screenings using the STEADI algorithm utilize three primary functional tests: the Timed Up & Go (TUG), the 30-Second Chair Stand, and the 4 Stage Balance Test. By using these tools, we move the conversation away from the inevitability of “getting older” and toward proactive system maintenance. 4-The Power of the “Exercise Snack” For those grappling with high fall anxiety, a 60-minute workout can feel like an insurmountable mountain. This is why we utilize “exercise snacks”—or mobility breaks—which serve as the essential foundation for beginning to move. These are gentle, short-duration movements that can be performed several times per day as tolerated to reduce muscle tension and relieve stress. The primary snacks include: * Active Neck Rotations: To maintain cervical mobility and spatial awareness. * Seated or Standing Cat-Cow: For spinal flexibility and core engagement. * Cervical Retraction (Chin Tucks): To correct posture and head positioning. * Active Trunk Rotation: To maintain the spine’s ability to rotate safely during daily tasks. These snacks are more sustainable because they integrate into the natural flow of your day. By snacking on movement, you maintain a baseline of mobility that keeps your neuromuscular system primed for more complex challenges. 5-Hacking Your Own Recovery is Possible at Any Age Balance is not a fixed trait; it is a plastic, modifiable skill. I learned this firsthand following a stroke that robbed me of my stability. My recovery was not a linear path of clinical perfection; I had to “hack” my way back through determination, trial, error, and—importantly—many falls along the way. My experience proves that even for a specialist, falling is sometimes part of the process of learning to believe in balance again. To measure this “hacking” progress objectively, I use the 30-Second Chair Stand specifically to measure lower body strength and the Timed Up & Go (TUG) to assess dynamic mobility. These tests provide a clear baseline of your current risk and tangible evidence of your neuroplastic gains. And as far as the 4 Stage Balance, it’s a series of progressive static hold positions in narrow base stances that will challenge even those that think their balance is in check. As a quick litmus test right now, how long can you stand on one foot? Now try the other and be ready to hold on, your balance response here or lack of might be and immediate ‘check-engine’ light you should explore further. “The 100 billion dollar rehab question is, how does someone who has had a fall and has lost mobility confidence believe in their balance again?” The answer is found in treating balance as a skill to be practiced, measured, and reclaimed, regardless of your age or history. A Forward-Looking Pathway to Believe in Balance Again Independence is not permanently lost the moment a fall occurs. Through structured, evidence-based pathways like the Otago program and my “Believe in Balance” philosophy, the road to reclaiming your mobility is clearly mapped. By addressing the psychological barriers of the downward spiral, utilizing “exercise snacks” as a foundation, and monitoring your body’s “check-engine light,” you can move from passive aging to active system maintenance. Are you ready to look at your own “check-engine light” and take the first step toward reclaiming your mobility? Also available with purchase of my book Closure After Stroke This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit achievebalance.substack.com/subscribe [https://achievebalance.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_2]

A Deeper Dive: 🎧Achieve Balance Course-Module Two: Know Your Numbers

If you missed module one on audio please start my course here: https://open.substack.com/pub/achievebalance/p/a-deep-dive-achieve-balance-course [https://open.substack.com/pub/achievebalance/p/a-deep-dive-achieve-balance-course?r=lr4mj&utm_campaign=post-expanded-share&utm_medium=web] This will be a paid subscriber benefit when this updated course launches this month and adds to my educational Achieve Course Academy. If you are already enrolled in my Believe in Balance course [https://open.substack.com/pub/achievebalance/p/announcement-believe-in-balance-course] you’ll also receive audio access to the next Know Your Numbers module with action toolkits when it goes live in Substack. Resources for my Course: This new course was developed from my book Body in Balance [https://physicaltherapycoach.com] which I beta tested over the last 2 years with my health coaching and PT clients over on SmartMovesPT [https://smartmovespt.com/]. I’m now bringing it to a larger platform and audience here on Substack while keeping up with the times, including deep dives , new video explainer shorts and a new slide deck and audio education modules like the one you can listen to in this episode. Enjoy! About this episode: Know Your Numbers We often navigate our health by “feel.” We glance in the mirror, check the number on the scale, and if nothing hurts, we assume the internal machinery is humming along in perfect harmony. However, there is a yawning chasm between the absence of disease and the presence of true health. Beneath the surface, your body is constantly generating a stream of data—hidden metrics that tell the real story of your biological age, long before symptoms ever emerge. Most people are currently operating from an invisible baseline, guessing at their health rather than measuring it. We rely on outdated standards, much like the researchers of the 1940s. When the famous Framingham Heart Study launched, the researchers actually included a budget line for ashtrays in their offices; they were so “pre-knowledge” that they didn’t yet realize smoking was the very thing driving the heart disease they were studying. Today, we are in a similar state of ignorance regarding our own biomarkers, often waiting for a clinical crisis to act. To bridge this gap, we must move beyond the frailty of “Willpower” and embrace “Skill Power.” Skill Power is the proactive application of data to behavior. By identifying the specific metrics that drive your health—your “Lead Dominos”—you can stop guessing and start managing your longevity with the precision of a scientist. The “Lead Domino”: Why Sleep Controls Your Biomarkers In the hierarchy of health, we tend to view sleep as a luxury to be sacrificed for productivity. However, as synthesis from experts like Andrew Huberman and David Dansereau suggests, sleep is actually the “Lead Domino.” When sleep is ineffective, it doesn’t just make you tired; it causes every other biomarker—from blood pressure to glucose regulation—to tumble in its wake. Prioritizing sleep is a strategic foundation for recovery. It is the period when the brain clears metabolic waste and the body modulates systemic inflammation. If you are struggling to manage your cholesterol or stick to a fitness plan, the root cause is rarely a lack of discipline; it is usually a lack of rest. Without sleep, the rest of your health markers are built on shifting sand. “Sleep is the leading factor for recovery and controlling inflammation. If sleep tumbles, everything behind that falls—whether you are managing blood pressure, blood glucose, or an exercise plan.” The 80% Blind Spot: The Silent Rise of Prediabetes Metabolic dysfunction is the great silent epidemic of our time. According to the CDC, 1 in 3 U.S. adults is currently prediabetic, yet a staggering 80% of them are completely unaware of it. This “blind spot” exists because high glucose doesn’t always hurt—at least, not at first. While it silently damages vital organs, nerves, and blood vessels, the individual feels “fine.” The threshold for prediabetes is a fasting blood glucose level between 100 and 125 mg/dl, with anything 126 mg/dl or higher classified as Type 2 diabetes. This condition is driven by insulin resistance, where cells lose their ability to process sugar efficiently. Regular monitoring is the only way to unmask this silent killer before the damage becomes irreversible. “The danger of high glucose is the impact it has on all your vital organs, your blood vessels, and your nerves. It is one of the top numbers to know.” Your “Movement Age”: The 5-Year Penalty Longevity is not just about internal chemistry; it is about how you move through your environment. Using the “Smart Movement Screen,” we can calculate your “Movement Age” by evaluating three fundamental patterns: the overhead reach squat, the inline lunge, and the high hurdle step. These movements test whether your muscles are balanced and fit. The scoring is binary: you either perform the movement correctly without pain (a “1”) or you “funk” it. For every point you score below a perfect 10, you must add five years to your chronological age to find your biological movement age. If a 40-year-old scores a 6, they are moving with the structural limitations of a 60-year-old. Our modern “high-tech habits”—the 150 times a day we check our smartphones—are prematurely aging our spines and creating a “body out of balance.” Thanks for reading Achieve Balance with SmartMovesPT! This post is public so feel free to share it. The Independence Metric: Gait Speed and 1.6 MPH Perhaps the most startling biomarker for independence is your gait speed. Clinical research identifies walking speed as a primary predictor of fall risk and long-term autonomy. The critical threshold is 1.6 miles per hour. When your gait speed drops below this level, walking is no longer “automatic.” The 1.6 MPH Threshold: Why Your Walking Speed is a Better Longevity Predictor Than Your Scale This has visceral real-world consequences. For instance, intersection lights are timed based on the assumption that a pedestrian can maintain a specific speed; fall below 1.6 mph, and you literally lose the ability to navigate your community safely. This decline is often driven by a slowing Resting Metabolic Rate (RMR) caused by the loss of muscle mass. To combat this, we must maintain our “internal furnace.” I experienced the power of this firsthand after running the Boston Marathon; when I measured my RMR on a metabolic cart the next day, my energy burn was 1,500 calories higher than predicted. This “after-burn” effect is the reward for intense activity and strength training, which protects both your metabolic rate and your gait speed as you age. The Fiber Gap and the “3 F’s” Strategy Nutrition is the primary tool for modulating inflammation, which Hippocrates famously noted begins in the gut. We can simplify this through the “3 F’s”: Fluids, Fiber, and Fats. The Standard American Diet (SAD) is notoriously fiber-deficient, with most adults consuming less than 10g per day. To provide your microbiome with a proper defense, you need to target 25 to 50g of fiber. This must be paired with precision hydration—0.5 oz of water per pound of body weight—and healthy fats. Specifically, you should aim for 3 grams of Omega-3s daily from sources like fish, flax, or chia seeds. These three pillars work in tandem to regulate your gut health and prevent the systemic inflammation that leads to chronic disease. Achieve Balance with SmartMovesPT is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Beyond LDL: The Evolution of Heart Health For decades, we were told that as long as our Total Cholesterol was under 200 mg/dL, we were “safe.” Modern science has moved past these historical, oversimplified metrics. While the ratio of HDL (”good”) to LDL (”bad”) matters, proactive “health hackers” are now looking deeper. The measurement of ApoB (Apolipoprotein B) is emerging as a far more accurate predictor of cardiovascular risk than LDL alone, as it directly measures the particles that cause plaque buildup. Furthermore, if you have a family history of heart disease, you should not wait for a standard panel to flag a problem. Pushing for advanced testing, such as a calcium score, provides a definitive look at arterial health that a simple blood test might miss. Your Next Steps: From Awareness to Achievement Action creates momentum. The transition from “guessing” to “knowing” is the single most important shift you can make for your longevity. Whether it is the “5-year penalty” on your movement screen or the 1.6 mph gait speed threshold, these numbers are not just data—they are the roadmap to your future independence. You cannot manage what you do not measure. By identifying your specific “Lead Domino”—whether that is fixing your sleep hygiene, hitting your 3g Omega-3 target, or increasing your fiber—you trigger a chain reaction that brings your body back into balance. Which Lead Domino will you address first? Stay tuned here for the next module on gut health and if you need a coach to help you get started message me! Did You Know? These course toolkits from Achieve Balance will also be released within the resources of my new book, Closure After Stroke [https://amzn.to/4wUi2Y5]! Currently #1 in prerelease orders on Amazon! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit achievebalance.substack.com/subscribe [https://achievebalance.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_2]

A Deep Dive: 🎧Achieve Balance Course-Module One: Finding Your Why

As I get ready to roll out my Achieve Balance Course to Substack, I wanted to offer an 🎧 audio overview, or new deep Ai dive into Module One: Finding Your Why. This will be a paid subscriber benefit when this updated course launches later this week and adds to my educational Achieve Course Academy. If you are already enrolled in my Believe in Balance course [https://open.substack.com/pub/achievebalance/p/announcement-believe-in-balance-course] you’ll also receive access to the first new Finding Your Why module with action toolkits when it drops later this week. This new course was developed from my book Body in Balance and I beta tested it over the last 2 years with my health coaching and PT clients over on SmartMovesPT [https://smartmovespt.com]. I’m now bringing it to a larger platform and audience here on Substack while keeping up with the times, including deep dives , new video explainer shorts and a new slide deck and audio education modules like the one you can listen to in this episode. Enjoy! Achieve Balance with SmartMovesPT is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. About this episode: Finding You Why Connecting with your “Why” means identifying your core motivation for wanting to improve your health and achieve your wellness goals. It is the underlying reason that makes you interested in taking charge of your health, and identifying it serves as a powerful reminder to keep you moving forward when working toward your goals. When you connect with your “Why,” you are taking time to determine what specifically drives you, which can be categorized into the two types of motivation we discussed earlier: * Extrinsic motivation: Being driven by external rewards or avoiding negative consequences. * Intrinsic motivation: Engaging in an activity because it is personally fun or rewarding. Understanding your personal “Why” helps you assess your current stage of behavior change and formulate SMART goals with clear milestones and rewards. While external factors might help you get started, discovering a positive, intrinsically motivated “Why” is crucial; research shows that development-based motivators are much more effective at keeping you actively engaged in long-term behavior change. Listen to this episode to learn how David applied these science based lessons from his book to optimize his own nutrition and physical recovery from stroke. Learn More Resources: David’s Body in Balance Book [https://physicaltherapycoach.com/] https://physicaltherapycoach.com/ Believe in Balance Course [https://open.substack.com/pub/achievebalance/p/announcement-believe-in-balance-course] https://achievebalance.substack.com/p/announcement-believe-in-balance-course [https://achievebalance.substack.com/p/announcement-believe-in-balance-course] Subscribe to Achieve Balance on Substack [https://achievebalance.substack.com/] Next Up in Module Two: Know Your Numbers This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit achievebalance.substack.com/subscribe [https://achievebalance.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_2]

Beyond the Burn: 5 Surprising Truths About Finding Your Body’s True Balance

Welcome to Episode 22 of the Believe in Balance Podcast About this episode: Discard the guesswork that leads to the inevitable burnout of most health journeys. Many well-intentioned people start with high energy only to lose steam weeks later because they lack a sustainable blueprint or a powerful enough ‘Why’ to provide their True North. Achieve Balance with SmartMovesPT is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber to access our courses If you are joining me for the first time here, I’m David Dansereau, MSPT, a Physical Therapist and Nutritionist, Author of Body in Balance [https://www.smartmovespt.com/david-dansereau] and I’ve developed my “Achieve Balance” philosophy, coaching mindset and courses to replace this uncertainty with a strategic approach to wellness. This podcast episode reveals the impactful takeaways from some of my writing and my course curriculum that will shift your perspective from temporary fixes to long-term equilibrium. Ready to get started? Tune in to this episode here or on Apple, Spotify and now streaming on YouTube! Show resources and mentions: Host David Dansereau biosketch and company profile: https://www.smartmovespt.com/david-dansereau [https://www.smartmovespt.com/david-dansereau] Body in Balance Book: https://physicaltherapycoach.com [https://physicaltherapycoach.com] Subscribe for Achieve Balance and Believe in Balance Course Updates: https://achievebalance.substack.com/ [https://achievebalance.substack.com/] This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit achievebalance.substack.com/subscribe [https://achievebalance.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_2]

Google's FitBit Air For Rehab and Recovery?

Thank you for tuning in, watching and listening to Episode 21 of the Believe in Balance Podcast, now on Apple, Spotify, Substack and more! Disclosure: I had a patient need to reschedule so I wanted to jump in to Substack Studio to take some time to inform you of this upcoming new product release from Google with their Fitbit Air (now Google owned). I have no financial disclosures to report with Google. About this episode: This episode reviews on video and audio Google’s latest upcoming product release in wearable tech and I share why I believe it is important for rehab and recovery or simply as an new affordable way to help you or a loved on take charge of your mobility and health monitoring. Important Note and Author Disclaimer: While the Fitbit Air is an excellent proactive partner for tracking overall health, always consult with your neurologist, cardiologist, or physical therapist before starting new post-stroke exercise routines. Episode Resources and Mentions: Based on my latest article on Substack: FitBit Air: [https://open.substack.com/pub/knowstroke/p/fitbit-air-a-possible-game-changer] A Possible Game Changer for Stroke Survivors Seeking Affordable Wearable Tech for Recovery Insights and Health Monitoring Breakout Moment for Stroke [https://open.substack.com/pub/knowstroke/p/when-will-stroke-care-finally-get]? Reimagining Stroke Recovery Through Performance Metrics [https://open.substack.com/pub/knowstroke/p/reimagining-stroke-recovery-through] FitBit Air Measurement Data Quick Review for Reference on Biometric Data Mentioned in this Episode: * Heart Rate: 24/7 continuous heart rate tracking, including heart rate zones during workouts. * Heart Rhythm (AFib): Background detection for irregular heart rhythms that may indicate atrial fibrillation (AFib). * Heart Rate Variability (HRV): Tracks the variation in time between each heartbeat to help measure stress and training recovery. * Blood Oxygen (SpO2): Uses red and infrared sensors to estimate your blood oxygen saturation levels while you sleep. * Skin Temperature: Tracks your wrist’s nightly skin temperature variations. * Breathing Rate: Monitors your average breaths per minute while resting. * Sleep Analytics: Details your sleep duration and segments your rest into light, deep, and REM sleep stages. * Motion & Activity: Built-in 3-axis accelerometer and gyroscope to track daily steps, distance, active minutes, calories burned, and automatic workout detection. Chime In! What Are You Measuring? This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit achievebalance.substack.com/subscribe [https://achievebalance.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_2]