Falls occur when your center of gravity moves away from an invisible line that runs from your midsection to your feet. Once your tummy and lower spine move outside this center – your core — you're at a higher risk for falling. If you have any curvature of your spine, you’re at a greater risk because your midsection is not in alignment with the rest of your body.

But having a straight spine doesn’t ensure you won’t fall. Whenever you reach for something on a high shelf, or carry a bag of groceries, you may be off-center. If someone bumps into you or you trip on a curb while you’re leaning forward, you’re more likely to fall. And if you have weak leg muscles, your balance can also be unstable.

When exercise isn't enough
Researchers at the Mayo Clinic know this. They tried to improve the balance in older women whose spines were curved from osteoporosis. So they made a two-pound weighted back brace to keep these women’s torsos aligned above their feet. The women wore this support for four weeks and did specific daily exercises. The result was less back pain and better balance, but their leg muscles were no stronger.

Here's why I predict the benefits from this treatment will be short-lived.

A weighted back support may help your alignment while you’re wearing it. But when you take it off, your body will try to return to its original position. Home exercises may strengthen your long back muscles, but they don't recruit the small, deep muscles that support them.

In addition, wearing a weighted back support is uncomfortable. You may be able to force your body into better alignment with a device like this, and everyone benefits from regular exercising. But an integrated approach that combines your mind and body will have far greater effects than a purely physical approach.

The mind/body approach reeducates your body
The Mayo Clinic study just involves physical changes, not paying attention to your breathing or posture. The exercises and brace do their work whether you pay attention or not. But when your body and mind work together, you get better results.

Most therapeutic exercises strengthen large muscles. But when you concentrate on your movements while you exercise instead of letting your mind wander, your subconscious mind steps in. You begin strengthening both your large and small muscles even when you don’t know anything about their function. Visualization re-programs your muscles to work properly. Eventually, all of your muscles work together even when you're not exercising or paying attention.

Yoga is one form of exercise that integrates the mind with the body. I’ve found another one I like even better for strength and balance. It’s called Pilates.

What is Pilates?
Pilates is a system of conditioning developed by Joseph Pilates in the 1920s. Originally a weak, sickly child, he created a series of exercises that restored his health. His exercises were the foundation for today's Pilates exercises. You can do these exercises either on a floor mat or on a piece of equipment with pulleys called the Reformer. The floor exercises are excellent and will work just fine.

Pilates exercises make you stronger, more flexible, and less likely to fall because they re-educate your body to use all of your muscles. By strengthening both your large muscles and the deep, small endurance muscles that are responsible for your strength, they take the strain off the larger muscles and give them added support. You need to add concentration and correct breathing to an exercise to recruit the small supportive muscles. Bottom line: less pain, greater range of motion, and fewer falls.

Pilates exercises are gentle and simple. And you only need to repeat each one three to five times. As you perform each exercise, concentrate on doing it with the correct form: breathing deeply and tightening your tummy. This combines the mental with the physical.

Pilates doesn't weigh you down, isn't painful, and has permanent effects. Re-alignment, strength, and balance occur when you concentrate on your movements and breathe properly as you exercise. Eventually, your body takes over and "remembers" how to stand, move, or perform an exercise without falling or getting hurt. By being conscious of your form and breath while you exercise, you create a result that’s similar to the weighted back support and exercises — without the need to walk around with weights strapped on your back, or doing exercises that just target larger muscles.

Many exercises are called "Pilates"
Pilates is the name given to a type of exercise with characteristics stemming from Joseph Pilates’ work. Not all Pilates exercises are the same. They can vary greatly from teacher to teacher. I've researched the subject for you and found resources that my personal Pilates teacher, Kathleen Langermann, and I think would best help people over 50.

You can learn Pilates from a video or DVD. Be sure to get one that's appropriate for those of us over 50. The two I suggest are: Pilates for Beginners (VHS and DVD) and Easy Pilates (DVD only). Pilates for Beginners shows basic fundamentals you need before doing the exercises, then teaches Pilates. Easy Pilates concentrates on the proper form and has easy-to-follow routines. Both are available from Gaiam (877-989-6321) and at most Barnes & Noble and Borders bookstores, Target, Amazon.com, and many health food stores.

My experience I've been doing Pilates exercises — both on a mat and on the Reformer — for over a year, and I'm excited about the changes in my body. My body is more stable than ever. When I paddle my kayak, I have greater strength and endurance. I don't injure myself easily. I stand and sit straighter because my body reminds me that it feels most natural when it's in better alignment. And after more than 40 years, my chronic low back pain is gone.

Exercising used to be a chore that I fit into my schedule when I could. Pilates has changed this. I'm convinced that a mind/body approach to exercising will give you better results than wearing a back brace or doing other exercises.

Siler, Brooke. The Pilates Body, Broadway Books, 2000.

Sinaki, et al. "Significant reduction in risk of falls and back pain in ostoporotic-kyphotic women through a spinal proprioceptive extension exercise dynamic (SPEED) program," Mayo Clinic Proceedings, July 2005.