How to Improve Balance as You Get Older

Many people notice changes in their balance as they get older. You may feel less confident: • walking on uneven ground • turning quickly • using stairs • stepping off a kerb • walking in busy places • standing on one leg Sometimes this happens gradually. Other times, confidence changes after a fall or period of illness. The important thing is that balance is not simply something you either have or do not have. Balance can often improve with appropriate exercise, particularly when training also addresses leg strength, stepping ability and confidence.

Why does balance change with age?

Balance depends on several systems working together. These include: • vision • sensation from the feet and joints • the inner ear • muscle strength • coordination • reaction speed • confidence Changes in any of these can affect how steady you feel. This is why balance problems can have many different causes. Does muscle weakness affect balance? Yes. Strong legs help you control your body when standing and moving. They are also important when you need to react quickly. For example, if you trip, your muscles need to produce enough force to take a quick recovery step. If strength has reduced, it can be harder to respond. That is one reason strength training is often included alongside balance exercises. Can poor balance be caused by not exercising enough? Reduced activity can contribute. If you gradually become less active, you may lose: • strength • endurance • confidence • balance challenge This can create a cycle: less activity → reduced strength → poorer balance → reduced confidence → even less activity. Exercise can help interrupt that cycle. What exercises improve balance? There is no single best balance exercise. The right exercise depends on your current ability. Examples may include: • standing with feet closer together • tandem standing • weight shifting • stepping • turning • reaching • supported single-leg balance • walking in different directions The exercise should challenge you enough to create adaptation without being unnecessarily unsafe. Why does stance width matter? Standing with your feet wide apart gives you a large base of support. That usually makes balance easier. As the feet move closer together, the base of support becomes smaller and your body has to work harder to stay controlled. This provides a simple way to progress balance exercises. For example: wide stance → feet together → semi-tandem → tandem stance → single-leg work where appropriate. What is tandem standing? Tandem standing means placing one foot directly in front of the other, similar to standing on a tightrope. This reduces your base of support and can challenge balance. It should be performed near a stable support if needed. You do not need to remove all hand support immediately. Can standing on one leg improve balance? Single-leg balance can be useful, but it is not the right starting point for everybody. If you are very unsteady, begin with easier positions. You might progress through: • feet together • staggered stance • tandem stance • supported single-leg balance The challenge should match your ability. Why is stepping practice important? Balance is not only about standing still. When you lose balance in real life, you often need to take a step. Practising stepping can therefore be useful. Examples include: • forward stepping • sideways stepping • backward stepping • stepping over small objects • changing direction These exercises challenge both balance and coordination. Can turning be trained? Yes. Turning is a common situation where people feel unsteady. You can practise: • slow turns • turning in both directions • changing direction while walking • turning around an object Start slowly and use support if needed. Why do I feel less steady when I turn quickly? Turning requires the body to change direction while maintaining balance. This can be harder if there is: • reduced strength • slower reaction time • poor coordination • dizziness • reduced confidence If turning repeatedly causes dizziness rather than simply unsteadiness, further assessment may be appropriate. Can leg strength improve balance? Yes. Strength exercises commonly used alongside balance training include: • sit-to-stands • squats • calf raises • step-ups • hip strengthening These exercises improve the physical capacity needed for everyday movement. For example, stronger legs can help with: • stairs • getting out of a chair • recovering from a stumble • stepping onto a kerb Why are sit-to-stands useful? Sit-to-stand trains several important muscles at once. It can also provide information about functional strength. If you need both hands and a lot of effort to stand from a chair, that may suggest leg strength needs attention. The exercise can be progressed by: • reducing hand support • using a lower chair • increasing repetitions • adding weight Why are calf raises useful? The calf muscles help control the ankle and contribute to walking and balance. Calf raises can be performed using a stable support. As strength improves, you may progress by: • reducing hand support • increasing repetitions • adding resistance Can walking improve balance? Walking helps, but it may not be enough by itself. Most everyday walking happens on relatively predictable surfaces. Balance training often needs more specific challenges such as: • narrower stance • turning • stepping • reaching • reduced hand support Walking is still valuable for general mobility and endurance.

What about walking on uneven ground?

Uneven ground requires more balance than a flat indoor surface. Progress gradually. You might begin with: • flat outdoor paths then move towards: • gentle slopes • grass • uneven pavements if appropriate. Use a walking aid where needed. Safety matters more than trying to remove support quickly. Can a walking stick improve balance? Yes, for some people. A walking stick can increase confidence and provide an additional point of contact with the ground. However, it should be: • the correct height • used appropriately • held on the correct side for the individual's needs A physiotherapist can review whether your current walking aid is suitable. Is using a walking stick a bad thing? No. The aim is independence. If a walking stick allows you to: • walk further • feel safer • go outside • reduce falls risk • stay active then it may be helpful. The goal is not necessarily to remove every aid. It is to use the most appropriate level of support. Can fear of falling make balance worse? Yes. Fear can change how you move. You may: • take shorter steps • walk more slowly • avoid turning • hold onto furniture • stop going outside This can reduce activity and contribute to further weakness. A gradual exercise programme can help rebuild confidence. What if I have fallen before? A fall should prompt you to think about why it happened. Possible factors include: • strength • balance • vision • medication • dizziness • environmental hazards • neurological conditions Physiotherapy can assess physical function, but other medical review may also be needed. Repeated falls should not simply be accepted as normal ageing. What if I feel dizzy? Dizziness is different from simply feeling unsteady. It can have many causes. These include: • inner-ear problems • blood-pressure changes • medication • medical conditions If dizziness is new, severe or unexplained, seek medical advice. If it is associated with neurological symptoms, urgent assessment may be required. Why do I feel dizzy when I stand up? Some people experience a drop in blood pressure when moving from sitting or lying to standing. This can cause: • light-headedness • dizziness • blurred vision If this happens frequently or contributes to falls, discuss it with your GP or healthcare team. Do not simply treat every dizzy episode as a balance-training problem. Can balance improve after 70 or 80? Yes. Age does not stop the body responding to training. Balance and strength exercises can still be useful later in life. Progress may vary between individuals, but improvement is possible. The key is using exercises that are: • appropriate • challenging • progressive • safe How often should I practise balance exercises? Balance exercises can often be practised regularly. The exact frequency depends on: • exercise difficulty • falls risk • fatigue • medical conditions A small amount practised consistently may be more useful than a very long session once a week. Should I practise balance exercises every day? Some simple balance exercises may be suitable for frequent practice. However, not everyone should practise unsupervised. If you have: • frequent falls • severe balance problems • significant dizziness professional assessment may be appropriate before starting difficult balance exercises alone. Can I practise balance while doing other things? Sometimes. For example, you may practise a supported balance position while: • waiting for the kettle • brushing your teeth • standing at the kitchen worktop But do not create unnecessary distractions if your balance is poor. Safety comes first. How do I make balance exercises harder? Progress one thing at a time. You might: • narrow your stance • reduce hand support • increase reach • add stepping • change direction • use a more challenging surface Do not combine several major progressions at once. What if an exercise feels too easy? That may mean you have adapted. If you can complete the exercise comfortably with no real balance challenge, it may be time to progress. For example: feet together with both hands holding could progress to: feet together with one hand then: fingertip support then: no hand support where safe. What if the exercise is too hard? Make it easier. You can: • widen your stance • add hand support • shorten the duration • reduce movement Balance training should challenge you without repeatedly putting you at risk of falling. Why is consistency important? Balance and strength improve with repeated practice. Doing exercises occasionally is less likely to produce meaningful change. A realistic programme you follow consistently is better than an ambitious programme you stop after one week. Should I join a balance class? A structured strength and balance class can be useful because it provides: • regular routine • supervision • exercise progression • social interaction • confidence Exercises can also be adapted to different ability levels. For people who are nervous about exercising alone, a group can provide additional support. When should I seek medical advice for balance problems? Seek medical assessment if balance has: • suddenly deteriorated • been associated with neurological symptoms • been accompanied by severe dizziness • resulted in repeated unexplained falls New facial weakness, speech problems, severe dizziness or sudden loss of coordination require urgent assessment. Balance problems have many causes, and not all of them are treated with exercise alone. The main message Balance is trainable. Improving it usually involves more than simply standing still. A good programme often combines: • strength • stepping • turning • balance challenge • walking • confidence The exercises should gradually become more challenging as you improve. Looking for a strength and balance class near Bexley or Dartford? Tom Morgan Physio Solutions runs a weekly physiotherapist-led Strength & Balance Group at St Barnabas Church in Joydens Wood, close to Bexley, Dartford, Sidcup and Crayford. The class focuses on practical strength, balance and mobility exercises to help improve confidence and independence.

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*This article provides general information and does not replace individual physiotherapy or medical assessment. Sudden or unexplained changes in balance, repeated falls or significant dizziness may require medical assessment.*