Written by Ashley Gelhaus

If there was one thing you have probably heard about aging, it is that when you age, you are more prone to falls and that you need to be really careful. I am here to tell you that as much as it is important to be cautious, I don’t want you living in fear of going out and doing the things you love to do with your loved ones (as I am sure you don’t either). This blog is here to help you have that freedom! This blog will talk about the prevalence of falls in older adults, the fact that imbalance is one large predictor of fall risk, why balance is important, and finally we will look at the 13 best exercises that you can engage as part of what we call balance training to improve your balance and reduce your risk of falls! Continue reading to figure out how to do just that!

Fall Risk in Older Adults

I am sure it is no surprise to you when I tell you that one of the leading causes of injuries in the aging population is… drum roll please… Falls! You guessed it.To support my claim though, here are some statistics. Over 33% of adults over the age of 65 fall at least once a year. Of those that fall, 50% will have recurrent fall. Those with other neurological disorders such as Parkinson’s disease, are at even higher risk.1 As one continues to age, the rate of falls can increase up to 60%.2 On top of that, it may surprise you that older adults who are in a nursing home or some type of older adult living home experience falls even more often than those not in an assisted care center.2Why is this important though? Well, injurious falls can lead to severe fractures and injuries! This is of important concern for the aging adult because as one ages they natural lose bone density and muscle mass that protect individuals when they are younger from getting serious injury. Due to the natural decrease in bone and muscle mass, older adults are more prone to get an injury from falling and it will take them a lot longer to recover from this injury, if they fully recover.2,3 I don’t want to say all of this to scare you, but to help you and your loved ones prepare and take measures to prevent this from happening and to help you determine the best action steps you can take to protect yourselves from falls and injury.

Importance of Balance in Older Adults

Now, you may be thinking, “that this all sounds great but how do we take an active step to prevent falls if the natural aging process makes it harder and harder?”The most important thing you can do to prevent falls is to engage in balance training! Balance training consists of certain exercises that target muscles that assist in maintaining upright posture and equilibrium resulting in muscle growth, increased strength, and improved balance to help prevent imbalance and therefore prevent falls. Research has shown that a tailored balance and resistance training program can improve intrinsic fall risk factors including muscle strength, power, and balance performance. Exercise programs that challenge your balance and are frequent were seen to reduce fall risk by 16%!!

Recommendations for Balance Training

1)Exercise should be ongoing and enough to be effective.

The greatest improvement in balance has been shown with training over a period of 11-12 weeks with about 3 sessions a week, each lasting about 30-45 minutes. Continual, extended exercise is the best way to train your muscles and body to improve your balance. Consistency is Key!

2) Exercise needs to provide a moderate to high challenge to one’s balance. Exercises should aim to challenge balance in 3 ways:

a. Reduce Base of Support

b. Changing position of Center of Gravity

c. Reduce need for upper limb support (such as holding on for support)

3)You can take group based classes such as Tai Chi or utilize a home based program.

4)Inclusion of Strength Training May Benefit One’s Balance.

Reduced muscle strength is an important risk factor for falls. Therefore, maintaining and increasing muscle strength by overloading the muscles may help with fall prevention.

13 Best Exercises to Improve Your Balance

These exercises start off with more beginner exercises and move up to more advanced options. Wherever you are at is okay! Each exercise also offers certain progressions to make it more difficult or certain modifications to make it a little easier. Do what is best for your body.

Make sure to talk to your physician or personal trainer before starting any exercise program to ensure and always do exercises safely with a chair or something to hold onto nearby.

  1. Tandem Stance
    1. Stand one foot directly in front of the other and hold for 30 seconds to 1 minute or as long as you can. Repeat with other foot in front.
    2. Progression: eyes closed, stand on foam pad/folded towel
    3. Modification: stand feet slightly apart or hold onto something next to you, just have fingertips touching
  2. Stork stance
    1. Stand on one foot and kick the other foot behind you and hold this position for 30 seconds to 1 minute or as long as you can. Repeat for both feet.
    2. Progression: eyes closed, stand on foam pad/ folded towel
    3. Modification: have toe of lifted foot just touching the ground, hold onto something, have fingertips touching the bar
  3. Stork Stance with bicep curl
    1. Stand on one foot and kick the other foot behind you.
    2. In each hand hold two small dumbbells or cans if at home.
    3. Complete 15 bicep curls and then repeat on the other leg.
    4. Modification: touch toe slightly on floor behind you for more balance
  4. Tandem stance with torso twist
    1. Stand one foot directly in front of the other, holding hands/some type of weight directly in front of you. Slowly twist from one side to the other. Complete 20 rotations and then switch with the other foot in front.
    2. Progression: add weights or hold something that is weighted
    3. Modification: have feet slightly spread apart
  5. Tandem stance with cross body punches alternating sides
    1. Stand with one foot directly in front of the other. Punch arms alternately across body for 20 punches and then repeat with the other foot in front
    2. Progression: add weights for punches
    3. Modification: have feet slightly spread apart
  6. March and hold leg at top for 5 seconds
    1. Either march in place or walk across the room but as you march and pick one leg up hold it up for 5 seconds before setting it back down and picking up the other foot. Take your time!
    2. Modification: do alongside a wall so there is something to hold onto at all times
  7. Single arm overhead press with something weighted
    1. Stand feet firmly planted under you about shoulder width apart. With a weight in one hand at shoulder height, palm facing out, slowly extend your arm above your head, pressing the weight upward and then bring back down. Repeat 15 times and then switch arms.
    2. Focus on keeping core nice and tight and posture upright.
  8. Shoulder Press in Lunge Stance
    1. Step one leg back and pull knee down into lunge stance. Legs should be making 90 degree angles. Have small weights in each hand at shoulder level. Stay down in lunge position while pressing both arms up at the same time above your head. Repeat 10 times before coming out of lunge position and repeating with the other leg in front.
  9. Hip Flexion, Abduction, Extension each leg
    1. Firmly plant one foot on the ground and with the other leg pick up into a march position (flexion), bring it back down to center, swing leg straight out to the side (abduction), bring back down to center, and then extend leg straight back trying to keep leg as straight as possible (extension) and then bring back to center.
    2. Try to accomplish without holding onto anything to practice balance.
    3. Repeat 10 times on each leg
    4. Modification: hold onto something
  10. Alternating Forward Stepping Lunges
    1. Start with feet firmly planted under you about shoulder width apart. Alternate stepping one foot forward and dropping into a lunge position with legs at 90 degrees. Repeat for 10 times each leg.
    2. Progression: add torso twist when lunge forward
      1. When lunge forward, twist to the opposite side of the leg that stepped forward and alternate legs.
    3. Progression: hold weights when go into torso twist
      1. Hold weight chest height directly in front of you and continue as described previously
  11.  Single Leg Squat
    1. Plant one foot firmly on the ground beneath you, have the other leg slightly bent or straight out in front of you. Slowly sink down into squat position (doesn’t have to be really deep) and come back up. Repeat 10 times and then switch to other leg.
  12. Side lunge into Stork Stance
    1. Start with both legs firmly planted beneath you, shoulder length apart. Take one leg out to the side into a side lunge. When you come back, push off of leg and pull it into a stork stance and repeat. Complete 10-15 repetitions on each side.
    2. Progression: use weights for cross body chop (starting at knee in side lunge and coming up into shoulder press as come into stork)
  13. Single Leg Deadlift
    1. Start with one leg firmly planted on the ground beneath you and the other bent up behind you. Slowly bend over and slightly bend knee while sticking lifted leg out behind you. Stop when hand comes to knee level and then rise back up. Repeat 10-15 times on each leg.
    2. Start no weights
    3. Progression: add weights to opposite arm of leg on the ground
    4. Modification: hold on to something with opposite hand

Benefits of Being Balanced

Having good balance allows one to enjoy all the daily activities they would need and want to do! Having good balance improves ease of movement in any activity and helps to prevent injury, especially in the older population. The more you actively work towards improving strength and balance, the longer you will be able to enjoy activities like going for a walk, bending over to pick something up, playing with your grandkids, and more without carrying around a cane or walker or worrying about your chances of falling and injuring yourself.