Finding the right balance

Falls and loss of balance are often viewed as an inevitable part of the ageing process. Some of the main reasons for this include weakening muscles and stiffening joints, sensory and balance problems, vision difficulties and side effects of medication. One in four people aged over 60 have at least one fall per year, and this increases to one in three over 65. If we do fall, this can have serious consequences, particularly if our bone density is low. Falls often result in injuries such as fractures, cuts or head injuries. Even when there is no serious injury, falls lead to a loss of confidence to the point where people avoid activities they previously enjoyed.

There are many ways to help reduce the incidence of falls as we age. Today we’re going to discuss improving balance.

Understanding the importance of balance:

Our sense of balance comes from many different systems working together to create stability of our body. The three components of balance comprise of the visual system, vestibular system (located in the inner ear) and our proprioceptive system (feeling, and knowing where our body is in space). Our brain integrates and processes all the information from these three systems to help us maintain our balance or sense of equilibrium. When you start to have problems with your balance, one or more of the above systems might be affected.

What factors cause balance problems in the elderly?

Factors that can impair balance control include pain, vision problems, muscle weakness, sensory changes, vestibular issues, cognitive impairment, some prescribed medications and fear of falling. Moreover, age-related degeneration and a variety of diseases/comorbidities, more common with older age, can afflict all functions and systems involved in stability and control.

What problems can occur if balance is not maintained in the elderly:

Balance issues in elderly people is a serious problem. Falls are a leading cause of hospital admissions, the majority of which lead to hip fractures. One of the most detrimental aspects of balance issues in elderly people is that they can enter a cycle of deterioration—being unsteady makes them refrain from physical activity, which contributes to functional decline that cause the lack of stability.

Treatment of loss of balance in the elderly:

There are multiple ways in which we can improve balance. The most efficient and effective ones are increasing physical activity, strengthening exercises, stretching exercises and balance exercises.This can also improve your bone density and reduce the risk of injury if you do fall. 

It is important to make sure the environment and the surroundings are safe to perform these exercises for example near a bench top or wall for support.

Exercise to improve your strength and balance 

Static stance with altering base of support or vision

  • Start with feet apart, eyes open and holding on to a bench for support. You can then bring your feet together and practice taking your hands off the support to see whether you are able to maintain balance with a narrowed base of support

  • Secondly you can keep a wider stance and close your eyes. Taking away your vision will challenge your balance and stability

  • If these have both been easy to perform, you can stand with a narrowed base of support and close your eyes. Ensure you are near something to grab on to in case you lose your balance.

  • Try stand in each position for at least 30 seconds.


Marching legs

  • Standing, lift one knee up towards your hip. Gradually lower to the ground and lift the other leg up. Alternate each leg 20 times. This is a dynamic stability exercise and a good way to practice balancing on one leg at a time. It will help with climbing stairs and getting in and out of cars and buses. It also improves the pattern of walking and prevent tripping by clearing the foot from the ground.

Single leg standing balance

  • Just like you did with exercise #2, you’re going to lift one leg up in the air. This time however you’re going to practice maintaining stability on each leg for a longer period of time. Hold for up to 30 seconds. Repeat on the other side

Heel to Toe/Tandem stance

  • Try standing with one foot directly in front of the other. If this is easy you could progress to walking up/down a corridor with a heel-toe gait.

Heel raises

  • Rise up on the your toes, hold 5-10 seconds and return to standing.

Dynamic balance with Toe Taps

  • In single leg standing- lift one leg up and tap up on to a step on out in front/ to the side of your body. This will improve your stability in single leg stance while working on manouvering obstacles/ pertubations. It will help improve stability on steps, paths, and uneven surfaces.

Sit to Stand

  • Try stand up from a chair with as little arm support as required. This will help maintain/ build strength in your glutes and thigh muscles as well as improve your stability in a functional actvity.

Standing balance with upper body perturbations

  • You can choose your standing position (wide/ narrow/ single leg), and then practice lifting arms up and down, throwing a soft ball against a wall, passing a ball around your torso.

Try these exercises daily and your will notice your balance will start to improve. Your confidence will boost and your risk of falling will reduce. If these exercises are too easy, read through previous blogs on higher level balance exercises.


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