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You May Feel Fit, But What About Your Balance?

Dr. Rein Tideiksaar - February 22, 2016 11:08 AM

Elders who exercise on a regular basis often feel that they’re safe from falling. But according to a new report, being fit may not be enough to avoid falls. Even if elders are physically active, their balance may still be inadequate to avoid a fall. There appears to be little relationship between how many hours an elder spends exercising and how well they do on balance tasks. In order to reduce fall risk, elders need to specifically work on their balance.

Test Your Own Balance

Do you think that your balance is OK? Try these simple maneuvers and find out:

•    Walk along a straight line, touching heel to toe with each step.
•    Walk figure eights in a similar fashion.
•    Stand on one leg.
•    Turn completely around in a full circle. Pause. Then turn a full circle in the other direction.
•    Stand up from a chair. Try not to use chair arms or hands for support.
•    Close your eyes and stand still for 10 seconds.
•    Place feet together and stand still without holding on.
•    Pick up an object from the floor from a standing position.
If you lose your balance while attempting these maneuvers or are unable to do the maneuvers, your balance may need some fine-tuning. Talk to your doctor; he or she will do further tests to evaluate your balance and risk of falling.

Why is My Balance Poor?

As we age, one’s ability to balance declines. There is no single reason for this, but weakening eyesight and muscles, and physical changes in the brain, all play a role.

Balance requires the coordination of vision, the inner ear, and sensations through the feet and legs. Muscles must be strong, flexible, and work in a coordinated fashion to help stop the body from falling. With age, muscle mass and strength in the hips and legs decreases, mobility in the ankles, knees and hips is reduced, and reflexes and reaction times are slower, leading to the reduced ability to “catch” oneself when falling.

But poor balance can also be related to other factors, such as certain health conditions and medications prescribed that can make individuals dizzy. In fact, a decline in balance can be an important indicator of health problems.  Also, having a fear of falling may can increase the risk of poor balance. Persons with a fear of falling, typically restrict their mobility and become more sedentary. As a result, this lead to weak leg muscles and poor balance.

Good Balance Requires Exercise

Exercise is the key to better balance. The best balance exercises for any individual are based on the person’s health conditions and balance inadequacies. This discussion needs to occur between the elder and their family doctor, who might also ask a physical therapist for additional exercise advice.

Here are some recommendations of balance exercises from the National Institute of Health’s Senior Health Program.

Standing On One Foot

•    Stand on one foot behind a sturdy chair, holding on for balance.
•    Hold position for up to 10 seconds.
•    As balance improves, increase the number of repetitions.

Click here to watch how this is done.

Walking Heel to Toe

•    Place the heel of one foot just in front of the toes of the other foot. The heel and toes should touch or almost touch.
•    Take a step. Put your heel just in front of the toe of your other foot.
•    Take between 15 and 20 steps in the same manner

Click here to watch how this is done.

Balance Walk

•    Raise arms to sides, shoulder height.
•    Choose a spot ahead to focus on to keep you steady as you walk.  
•    Walk in a straight line with one foot in front of the other.
•    As you walk, lift your back leg. Pause for 1 second before stepping forward.

Click here to watch how this is done

Back Leg Raises (strengthens buttocks and lower back)

•    Stand behind a sturdy chair, holding on for balance.
•    Slowly lift one leg straight back without bending the knee.
•    Keep leg you are standing on slightly bent. Hold position for 1 second.

Click here to watch how this is done

Side Leg Raises (strengthens hips, thighs, and buttocks)

•    Stand behind a sturdy chair with feet slightly apart, holding on for balance.
•    Slowly lift one leg out to the side.
•    Keep leg you are standing on slightly bent. Hold position for 1 second.

Click here to watch how this is done

Movement Exercises for Balance

Exercise regimes promoting balance and muscle strength, such as tai chi and yoga, can also help lower the risk of falls. 

Tai Chi

Tai chi is an ancient Chinese form of exercise. It involves a series of movements performed in a slow, focused manner and accompanied by deep breathing. The benefits of Tai Chi include:

•    Improved balance and stability by strengthening ankles and knees.
•    Improved lower body and leg strength.
•    Enhanced mental capacity and concentration.
•    Reduced anxiety and stress.


Yoga is an Eastern medicine that includes postures, meditation, and breathing performed to address known fall risk factors:

•    Poor balance
•    Impaired mobility
•    Reduced strength and flexibility

Yoga helps improve balance by increasing the mobility and flexibility of the hip and ankle joints. Also, the mind-body interaction of yoga is likely to help manage anxiety related to fear of falling. 

Tai Chi and yoga group classes are offered at local fitness centers or senior centers. As well there are numerous videos and books about tai chi and yoga for rental or purchase.

More Benefits

Beyond better balance, the benefits of balance training include:

•    Better coordination and faster reaction time. This helps keep individuals keep upright if they start to fall by putting out an arm quickly to grab something stable.
•    Stronger muscles This can buffer the impact of a fall, providing some protection to bones and joints.
•    Stronger bones. Strong bones are more resistant to fractures.
•    Better brain function. Clearer thinking may help avoid situations that increase the risk of falling.

Rein Tideiksaar Ph.D., PA-C (or Dr. Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, N.J., a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. Check out Dr. Rein’s professional profile on LinkedIn: If you have any questions about preventing falls, please feel free to email Dr. Rein at

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