"Doug, why is my balance getting worse and why am I  falling?"

That is a question that is asked of me many times during the week. On one hand, it is a hard question to answer, and on the other hand it is really quite simple.

What I mean by that is, it is well known why our balance decreases as we age but it is more difficult to individually address a seniors particular situation.

For example, have you ever lost your footing on wet or icy pavement causing you to fling your arms in the air and sending your heart into high gear?  

If you have then you know how frightening loosing your balance can be.

Ordinarily we take our balance for granted but it is an important and vital part of our daily life.

As many as 28% to 45% of elders fall each year.

Though our balance will decline as we age, balance activities, elderly balance exercises and elderly balance training can limit the loss or actually improve our performance.

Here are some things that may be involved with your balance problems:

• Your vision may decrease which can lead to falls due to not seeing clearly.
  

• Your hips and legs can become weaker making it harder to walk.
  

• We can develop poor posture or have spinal degeneration making it harder to stand erect.
  

• Our ability to lift our feet decreases and we can stumble.
  

• It takes longer to react when something is in our way causing us to fall. 

• Many drugs interact causing dizziness or decrease balance.
  

• Low blood pressure can lead to light-headedness increasing our risk of falls.
  

That is why beginning a fitness program for elderly and seniors which incorporates strength training, endurance training and balance training is essential in maintaining and promoting good balance.

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Well then, how does our balance work?

Our balance system is truly amazing!

When we rise from a chair, climb stairs and walk outside on uneven terrain there is cooperation between the brain, nervous system, muscles and bones which help keep us from falling.

Our body can do this by way of three systems. 

• Visual cues come from our eyes and tell us all sorts of information about our environment. Our eyes help us see and prepare for potential dangers and obstacles which can prevent falls.

• Internal spatial orientation tells us where our arms and legs are positioned in space. For example, if you close your eyes and then lift your arm and wave it about your head, you know where your arm is because of this inner sense of feedback.

• The inner ear also contains a fluid-filled semicircular canal which gives us important information on the position of our head and its movement in space in relation to gravity.
  
  This is why we get seasick or car sick when there is a lot of head movement and ground movement.

When all these systems are working together automatically with our musculoskeletal system we can stay active and independent, preventing falls and improving your elderly balance.

You can keep or regain your balance

Here is the light at the end of the tunnel. I especially like working with the elderly and seniors on balance simply because it is a skill that many of us can keep during our adult life.  

Though there are often many factors involved with decreased balance as we age, a lot of this decline is simply due to our inactivity.

This can usually be improved with training. This training will involve improving your overall upper and lower body strength along with challenging your balance system daily with activities that require you to use the three systems I spoke of above.

When I talk to seniors about balance, I use the example of the tennis players posture. If you play tennis you know that there is a server and a receiver. Think of how the receiver stands. Feet wide apart, knees and hips flexed, upper body leaning forward.

Put a walker in front of him or her and they would look like a frail older person! No disrespect meant for tennis players or frail older persons...but the point is that they are finding the safest most balanced position in which to receive the ball. That is usually also our choice as we age...finding the safest most balanced position.

Unfortunately, when we make this choice, our balance system is not challenged and our brain begins to become lazy. "Well, Bill just doesn't need all that balance anymore."

Have you ever watched womens gymnastics on the TV? How can a 16 year old young woman, jump onto a 4 inch wide beam way up in the air and do a hand stand or flip? Do you think any 16 year old young women could do that or is there a little practicing involved?

Right. Like anything else in life it is about practice. There is a saying you may have heard but I put it in a different way. "Practice makes PER...MANENT". If you are practicing something wrong, it will be permanently wrong. So begin to practice balancing the right way.

Some amazing results have happened  with daily focused work on elderly balance activities.

Get out of bed with more confidence, walk around the garage and back yard with improved stability.

Follow These Elderly Balance Exercise Safety Guidelines

• These exercises are intended for normal imbalance and unsteadiness in seniors as they age due to inactivity and disuse.
  
  
• Make sure you check with your doctor if you suspect a more serious balance problem involving vertigo, ear infections, Meniere's disease, chronic dizziness or drug interactions.

• If you are working with a senior with poor balance or the frail elderly, make sure they are closely supervised at all times. 

• Progress to the next exercise when the preceding one can be done safely or if you have enough assistance.

• Be aware of your posture. Try to maintain your weight over your ankles.

• Avoid fast movements including quick turns or changes in position.

• Use a chair as a place to not only perform seated exercise but also to hold on to while standing. Hold on with your finger, one hand or two hands.

  One Finger

  One Hand

  Two Hands

• Always get up slowly when rising from a chair.

• Don't close your eyes when exercising or standing at your chair.

• If you are taking medications, ask your doctor if there are any side effects which may cause light-headedness or decreased balance.

What you will need to begin balance training in your home

	1. Armless chair.
	2. Smooth bottom shoes that won't catch on the carpet.
	3. A counter to hold which will allow  8 to 10 feet of walking.
	4. Soft items to step over. Slippers and small plush toys work great.
	5. (Optional) A roll of masking tape. Blue painters tape works great and is easier to remove from carpet and floor.
	6. (Optional) A sheet of  paper or paperback book to read.
	7. (Optional) One pound ankle and wrist weights.
	8. YOU!

Balancing exercises are challenging!

Don't try these exercises alone if you are uncomfortable about these exercises or are unsure of your ability to complete them.  

Start slowly with the first exercise until you become used to the new experience of stressing your balance system. 

It is not a race to the finish. You may be comfortable only performing the first few balance exercises and not be comfortable doing the moving and walking exercises. That is ok.

Never do something that you are nervous about by yourself.

Much better to have a helpful, stable person around to make you more confident and secure.

Before You Start

Balancing exercises are fun but they can also be challenging. Make sure you have a stable family member on hand when you begin to practice these exercises. 

You will be more confident in performing the exercises and having a helping hand to hold will allow you to better focus on maintaining your balance as you get used to the exercises.

Let's get started! 

I have made 12 balance exercise videos for you to view below.  The exercises below are a sampling of some basic balance exercises we use in Physical Therapy.

The exercises progress in difficulty from beginning to end. If you use a cane or walking is difficult, make sure someone is with you for support.

Remember, elderly and senior balance training can be a fun activity but will only show benefits if it is done regularly with the correct focus.

Practice two or more of these exercises for 10 minutes every day.

So get a stable family member, your chair, place it in a clear spot in your living room. Put on your smooth bottom shoes and let's begin.

Watch These Balance Exercise Videos

1. Single limb stance: 
   
   • A great place to begin with fall prevention in the elderly is with the simplest standing balance exercise. Hold on to a chair and balance on one leg. 
   • This is a great place to begin to feel your center of gravity over your ankles. This is your goal, maintaining your center over your ankles.
   • Try a few seconds balancing on each foot. Work up to a minute if you can. Then begin to hold on with one hand, then one finger and finally try to let go completely.
   
   
2. Eye tracking:
   
   • Move on to the other exercises for balance with static standing exercises as you gain confidence including this exercise which targets your vision and vestibular system.
   • This exercise can sometimes make you dizzy. If this happens, stop the exercise. Try it again with smaller head movements next time.
   • Gradually you will learn to do it correctly.
   
   
3. Clock reach:
   
   • Make sure to hold on to a chair when attempting this exercise to prevent falls in the elderly. Don't reach back too far if you have pain in your shoulder.
   • (Use your one pound wrist weight here to increase your workout.)
   
   
4. Staggered stance:
   
   • Also hold on to a chair when trying this exercise for elderly balance problems. Let go of the chair for a few seconds at a time if you feel comfortable.  
   
   
5. Single limb with arm:
   
   • Look up from your feet when balancing and pick a spot at eye level in front of you to improve falls in elderly. Lift your chest and bring your shoulders back.
   • Breathe in through your nose and out through your mouth
   
   
6. Balancing wand:
   
   • This is a fun exercise and easy to do. Use a cane, broom or even an umbrella.  Don't have too much fun with these balance exercises for elderly!
   
   
7. Knee marching:
   
   • Try this one next to a counter so you can hold on when performing knee marching. This is also a great cardio exercise and for leg muscle weakness.
   
   
8. Body circles:
   
   • This exercise for improving balance can be a little tricky. Keep a chair nearby if you are uncomfortable without one.  Make sure your knees and hips are kept straight when you circle.
   
   
9. Heel to toe:
   
   • The moving exercises are the most difficult. Only try this balance exercise when you have become good at the preceding exercises.
   • (If you have masking or painters tape, place an 8 to 12 foot piece in a straight line on the carpet or floor. This will allow you to maintain a straighter line when performing the walking exercises.)
   
   
10. Grapevine:
    
    • Seniors who dance will be more familiar with these balance exercises. Try it in your kitchen holding on to the counter.
    • Walk several steps in one direction, turn around and walk back. Continue for several minutes. Gradually hold on less and less until you can take a few steps without holding on.
    • It may take a while, but keep practicing...you'll get it sooner or later!


11. Stepping:
    
    • This series of stepping exercises for falls and the elderly are very challenging. You may have a stable family member demonstrate these for you first.
    
    
12. Dynamic walking:
    
    • Try these exercises to improve balance only when you feel confident and have a helper in the home. 
    • Give them a try when you are stronger and more sure of yourself. These exercises are great to do with someone else.
    • Holding hands with a stable family member will make these exercises easier and safer. (This is where you may use your pad of paper or a small book when walking.)

Do you like these exercises? Did you know you can download the exercises along with a 4 week exercise program?.