Derek Burnett
Derek Burnett is a Contributing Writer at Bottom Line Personal, where he writes frequently on health and wellness. He is also a contributing editor with Reader’s Digest magazine.
When we were kids, having a good sense of balance was associated with everyday activities like riding a bicycle or skateboard. But as older adults, we ask much less of our sense of balance. A good sense of balance comes to mean taking the stairs with ease, walking over uneven ground without worry, and dancing with abandon. As we age, our vestibular (balance) systems naturally decline, and we look to our sense of balance not to perform remarkable feats but to allow us to navigate our daily lives without fear of falling.
Despite the natural diminishment of balance that comes with age, there’s plenty we can do not only to slow the decline but, to a certain extent, reverse it. And it’s worth doing. One in four adults over age 64 will suffer a fall this year, and a fall-related injury or its aftermath kills an American every 19 minutes. You undoubtedly have known an older person who took a fall and was never the same afterward…which is why dedicating a few minutes a day to balance exercises is a good idea.
When most of us hear the phrase, “improve your balance,” we immediately picture some form of exercise designed to fine-tune our athletic ability. While exercises are very important to maintaining proper balance, there are also a few things you can and should do before you lace up your sneakers.
There are literally thousands of prescription drugs that can cause balance issues, and older adults taking multiple drugs at a time are at particular risk of balance-related side effects. Do a thorough inventory of your prescriptions and ask your physician or pharmacist if any drugs…or drug combinations…on your list could be causing balance problems. It may be possible to make substitutions to lower your risk of falls.
Keep a list such as this one to help organize and understand your drugs and their interactions:
Eyesight. Vision is a crucial component of your vestibular system. You know that’s true if you’ve ever tried standing on one leg with your eyes closed. The messages fired off from the vestibular organs in the inner ear are constantly checked against visual information to keep us upright. Make sure to check your vision regularly, keep your eyewear prescriptions up to date, and use your glasses or contacts any time you’re moving around.
Hearing. As noted, the key vestibular organs are located in the inner ear. A paper in Archives of Internal Medicine found that someone whose hearing acuity has dropped from normal to “mild hearing loss” has triple the odds of having fallen in the previous year. Be sure to stay on top of any hearing issues by getting your hearing checked regularly and corrected if necessary.
Adjusting the inner ear. “Realigning your crystals” is a real thing that works to correct some balance issues. Your “crystals,” scientifically known as otoconia or canaliths, are tiny bits of calcium carbonate that move around inside your inner ear in response to head movement, generating balance-related signals that get sent to the brain via the nervous system. In some people with a balance condition called benign paroxysmal positional vertigo (BPPV), one or more of those crystals has slid out of place and entered a semicircular canal where it does not belong. A canalith repositioning procedure (CRP), also known as the Epley Maneuver, can put the crystals back where they belong and clear up vertigo symptoms in just five or 10 minutes. Completely non-invasive and about 80 percent effective, it consists entirely of holding the head in a particular tilted position for a brief period of time.
The Epley Maneuver is best done under a doctor’s care, both to increase the chances of efficacy and to help avoid injury, especially to the neck. It can be done at home as needed, but you should have a physician take you through it first at least once so you know what to do.
The best way to maintain your sense of balance is to keep moving. While there certainly are exercises specifically designed to help with balance, the truth is that any kind of movement is going to help. That’s because we rely on our sense of balance to do literally any form of exercise…so spend as much time as possible on your feet. Regular walking for exercise is one of the best things you can do for your balance. In fact, a study published in Geriatrics & Gerontology International found that for older adults, regular walking for exercise was better for preventing falls than dedicated balance training.
Good balance doesn’t just stem from healthy vestibular organs in the inner ear. It also comes from having strong muscles and being flexible. In addition to performing aerobic exercise, make sure you’re doing at least two sessions per week of resistance (strength) training that cover all of your major muscle groups, including your core. After you perform your aerobic exercise, warm down with stretching to keep your muscles and tendons supple and flexible.
Certain types of exercise are especially good for balance. Tai chi has been shown to help older people improve balance and prevent falls. Although there is insufficient evidence that yoga specifically reduces falls, it has been shown to benefit balance in older adults as well as to improve their fear of falling. And in a 2020 meta-analysis covering 29 randomized clinical trials, dance-based activities reduced the rate of falls in older patients by 31 percent.
Following are some suggested balance-specific exercises you can perform at home. If you’re already suffering from balance problems, discuss this list with your doctor to decide which ones it would be safe for you to do.
Find a large room or hallway with lots of space in a straight line. Picture a tightrope extending straight ahead of you and imagine you’re an acrobat in a circus. With one foot on the “rope,” place the other carefully ahead of it, heel of the forward foot against the toe of the rear foot. Take 20 such steps, avoiding looking down, while keeping your back straight. After 20 steps, turn around and take 20 steps back to the starting point. Do the exercise two or three times per day.
In a chair, sit flat-footed with your hands by your side (you can also do this standing up holding onto a chair). Slowly raise one hand over your head like a student flagging a teacher’s attention. With the hand still in the air, lift the opposite foot off the ground a few inches. Count to 10, then lower both hand and foot. Switch sides. Do three repetitions. Once 10 seconds becomes too easy, see how long you can hold the position.
Stand at the bottom of a set of stairs (or even a single step) with your feet together. Holding the banister if necessary, step up onto the first stair with your right foot, place your left foot beside it, then step back down to the floor with the left foot, then right. Do this 10 times, then repeat it with the feet switched (that is, now leading with the left foot, not the right).
Stand near a secure object for support. Feet parallel at shoulder width. Rise on your toes and hold for 10 seconds. Return to the starting position and repeat the movement. Work up to 8–10 reps, 2–3 sets.
