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What you need to know about balance

You have likely seen that popular commercial “Help, I have fallen but I cannot get up.” This commercial may seem a little dramatic, but it is not!  Falls are no laughing matter; they are a serious health concern!

According to the CDC, falls are the leading cause of fatal and non-fatal injury for adults ages 65 years and older in the U.S. today.  Alarmingly, one in four older adults report falling every year.

If you are an older adult and you have not fallen, you likely know someone who has. Even if the fall does not result in an injury, one fall can lead to a fear of falling.  This fear can lead to a dangerous sequence of events. Fear of falling can cause a person to stop or decrease activities such as walking, which can lead to deconditioning and weakness that in turn will increase the risk for a fall. So, every fall, injury or not, needs to be taken seriously. 

Not surprising, poor balance is a leading cause of falling.

Being older does increase your risk for falling. This is because as we age we often have some declines in strength, vision, flexibility, hearing, and stamina. Our ability to maintain balance requires a complex interaction of multiple systems that must be able to work together.

1. Visual system

2. Vestibular system

3. Somato-Sensory system

4 .Motor system

We rely on our brain to coordinate all these systems to help you maintain your balance.

Many people falsely assume that poor balance is an inevitable part of aging. It is not! Many of these changes are due to deconditioning, rather than simple aging. The good news is there are steps you can take to improve your balance. Balance can be improved with the right training!

Because the ability to maintain an upright position is dependent on multiple systems working together it is not easy to make an exercise program to target balance. Unfortunately, one or two basic exercises will not work, instead you need consider the following principles:

Mix it up!

You may have heard that trying to stand on one leg is a good way to improve your balance.  The truth is, that particular exercise will improve your ability to stand on one leg, but what happens in the real world when you turn quickly, reach out of your base of support, step on an acorn, or walk on grass uphill?  Your balance exercises need to address all types of challenges.  So, the more variety with your exercise the better improvement in your balance should be.


To improve your balance, you must do exercises that make you feel like you are about to lose your balance.  If you are doing your exercise feeling steady and secure, then you are NOT improving your balance!  You need to be working, wobbling, and struggling a bit, so your neurological system will work to improve.  

Eyes and Ears

Your visual and vestibular system (your inner ear) have to coordinate and work together to maintain balance.  A quick turn of the head while walking can easily lead to a loss of balance.  Balance exercise should contain challenges including turning the head and closing the eyes.  By closing your eyes, you are simulating poorly lit environments such as walking in the dark. 

Static and Dynamic Challenges

You need to be able to balance while you stand in one place as well as when you are walking or moving.

As you challenge your balance you should try activities where you stand in one place in a narrow base of support as well as challenges where you are moving, walking, sidestepping.  

Static balance exercises 

Stand at the kitchen counter in a heel to toe position.

Add challenges such as reaching over head, turning your head side to side, closing your eyes, or tossing a ball.

Dynamic balance exercises 

Walk or sidestep while turning your head right and left, tossing a ball, stepping over objects, walking on uneven surfaces or grass. 

If you have had a fall or you are concerned about your balance you may consider a visit to your physical therapist. There are physical therapists who specialize in the treatment of older adults, they are experts in balance and fall prevention. A physical therapist will perform a detailed assessment and design an individualized program specifically for you. 

Be pro-active! Do not settle for poor balance!  With the right exercise you can improve your balance and prevent falls!

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