We all need balance in our lives. Literally. But having good balance is more complex than you may realize.
It involves the integration of various sensory and motor systems, including: vision (to perceive direction and motion), the vestibular system in the inner ear (which monitors motion and provides orientation clues, such as which way is up) and what’s called “proprioception” (the ability to sense where your body is in space). To stay steady, you also need good muscle strength and reaction time.
If any of these systems are not functioning properly, you can lose your balance even while just walking or standing up. In fact, about one in three people over age 65 (not living in nursing homes) fall at least once a year—and 10 to 15 percent of these falls result in serious injury, according to a 2008 Australian paper. Falls, of course, are a major cause of fractures, which increase as people get older.
Older people often have poor balance due to loss of muscle strength and joint flexibility, as well as reduced vision and reaction time. And the risk of inner ear dysfunction, which can throw you off balance, increases with age.
Lack of exercise, alcohol, obesity, neuropathy (nerve damage) in the lower legs, certain drugs or medical conditions, even wearing the wrong eyeglasses, can also interfere with balance, at any age.
From tai chi to cobblestones
Exercise—such as brisk walking, running and strength training—helps improve balance. Any activity that increases strength, especially in your lower limbs, as well as agility, is worthwhile. Even golf, aquatic exercise, interactive dance video games, and Feldenkrais (a movement therapy) have been shown to help.
In particular, you may want to try tai chi. Studies have documented its ability to improve balance and decrease falls in both healthy and ill people.
Originally a Chinese martial art, this ancient practice involves slow, balanced, low-impact movements done in sequences; it builds confidence, coordination, muscle strength and all-around fitness. Classes are often available at health clubs and adult education centers. The International Taoist Tai Chi Society can help you find instructors and classes in your area.
Below are some other good things you can do for your balance. The equipment needed is available at sporting-goods stores or online; gyms and physical therapy offices may also sell it.
Before you start: If you have serious balance problems, it’s a good idea to begin with a trainer at a gym or a physical therapist. At home, be sure to have someone “spot” you or at least have something to hold onto so you don’t fall.
Balance on a board: Also called wobble or rocker boards, balance boards are wooden or plastic devices that sit on a short base that acts as a fulcrum. By shifting your weight from side to side or front to back, you try to balance without rocking too much. For more of a challenge, do it with your eyes closed. Boards cost about $20 to $60 (or more, for a "professional" one).
Have a ball: Made of vinyl and filled with air, a large exercise ball (also called a stability ball or physioball) is another handy helper for improving balance. At home, be sure you have plenty of room so you don’t tumble onto a piece of furniture. The balls come in different sizes (based on your height); most cost about $15 to $30.
Walk on cobblestones: Chinese tradition holds that walking on uneven paths is good for balance. A study at the Oregon Research Institute gave support to the practice. It found that healthy but sedentary older adults significantly improved their balance by walking on special cobblestone mats.
Aim for half an hour of cobblestone walking two or three times a week, in addition to regular walking and strengthening exercise. If you have no cobblestone paths in your neighborhood, you can buy long walking mats like those used in the study for about $50.
Try a mini-trampoline: Training on a mini-trampoline for 14 weeks increased balance in a study published in the Journal of Electromyography and Kinesiology in 2011. After participating in the program, older people were better able to regain their footing in a forward fall experiment—an ability that can help prevent a serious injury in real life.
If you are very unsteady on your feet, though, this may not be a good choice. Mini-trampolines cost about $40 to $80; some have handrails.
Bottom line: If you are over 60, ask your doctor to check your sense of balance. There are many ways to improve your balance and thus reduce the risk of falls. Find what you like but also mix it up.
Another thing to consider for fall prevention is a vitamin D supplement. Studies suggest that adequate vitamin D reduces the risk of falls by increasing muscle strength in the legs. The recommended daily intake is 600 IU up to age 70 and 800 IU for those older, but we recommend 800 to 1,000 IU a day for most people. People who are deficient may need higher doses.
Also see New Tricks for Old Bones about exercise for bone health.
Originally published November 2011; updated September 2017.
Published September 21, 2017