Balance Exercises for Seniors
Balance exercises for seniors are an essential part of an osteoporosis exercise program. They should include fall prevention exercises that reduce your risk of a fall. But even if you have not achieved that senior status, balance exercises for seniors will keep you active and mobile as you age and more confident.
In this section, I will cover balance exercises for seniors and fall prevention exercises, and provide a fall prevention checklist. Links will be provided to other pages on my blog that go into specific balance and fall prevention issues in more detail. These guidelines are a part of my Health Guides series.
Table of Contents
- Balance and Fall Prevention Exercises for Seniors
- Balance and Fall Prevention Resources
- Balance and Fall Prevention and Elderly
- Four Ways to Improve Balance for Seniors
- Physical Therapy Fall Prevention and Balance Training
- Fall Prevention Checklist • 25 Ways to Prevent a Fall
Welcome to the Guide to Balance Exercises for Seniors. This guide is going to provide you with an overview of all the essential elements of balance and fall prevention.
Some of you are asking, “What exactly is balance and what are balance exercises for seniors?” Unfortunately, we don’t often realize that we’re using balance on a day-to-day basis — until we start to lose it.
Some of my clients will say to me, “I was invited to a cottage. I was walking on the uneven ground and I really felt uneasy, unsure of myself, unsure of my stepping.”
Or they’re out and they’re coming in at a later hour than they are used to, and it’s a little bit darker, and all of a sudden their footing doesn’t feel secure or sure.
Or take something as simple as putting on pants. All of a sudden they realize, “I’m sure I used to do it always standing on one foot.” But now they have to lean back against the door frame or against the bed to be able to put the pants on, because they were feeling uneasy and unsteady on that foot.
This is a key point: your ability to keep your balance can change over time without you noticing it until is too late and you experience a fall.
Unfortunately many people die as a result of a fall. It might not be the actual fall that kills them, but the outcome of a fall. The fracture, the resultant head injury, those kind of things that can change your life instantaneously like this.
This guide provides you with insight into how to maintain your balance and prevent falls and will provide a number of balance exercises for seniors.
Here are several Balance Exercises for Seniors that you can incorporate into your balance and fall prevention exercise program.
2.1 Single Leg Balance Exercises for Older Adults
The Single Leg Stance is one of a number of single leg balance exercises for older adults for the Exercise for Better Bones program. It is in the Beginner Level section. It can be safely practiced by people of all ages and is a great balance and fall prevention exercise.
2.2 Single Leg Reach
The single leg reach is another balance exercise in the Exercise for Better Bones program. It is more advanced than the Single Leg Stance and is in the Athletic Level section. It can be safely practiced by people of all ages and is a great balance and fall prevention exercise.
2.3 Dynamic Standing Balance Exercises for Elderly
In the article listed below, we cover a number of dynamic standing balance exercises for elderly that allow them to improve their balance. These are recommended balance exercises for seniors.
2.4 Balance Ball Exercises
These balance ball exercises are for people who want to improve (and challenge) their balance and fall prevention skills but should only be attempted by people comfortable with using the Physio ball. These progressive balance ball exercises are in the Exercise for Better Bones program and are balance exercises for seniors.
2.5 Tai Chi for Osteoporosis
Tai Chi is a popular fall prevention activity and includes a number of balance exercises for seniors. In this article I demonstrate a basic Tai Chi for osteoporosis routine that will improve your balance and fall prevention skills.
2.6 How to Use a Rocker Board to Improve Your Balance
Maybe you want to incorporate some equipment to challenge you during your balance and mobility exercises. In this blog post I cover how to use a rocker board to improve balance.
2.7 How to Improve Reaction Time in Seniors
We all know that we need to practice balance and mobility exercises for balance and fall prevention. But how will you respond if you lose you balance (even after practicing diligently)? This is why you should work on improving your reaction time. In this blog post I show some fun ways to improve reaction time in seniors.
I have a number of educational resources available for clients and health professionals specifically developed for people with osteoporosis.
3.1 Exercise for Better Bones Osteoporosis Exercise Program
I have a book dedicated to osteoporosis exercise — Exercise for Better Bones. The book includes a number of balance exercises for seniors as well as strength, weight bearing, flexibility and other exercises.
The book is available in print and Kindle format on Amazon. I strongly encourage anyone who want to improve their bone health through exercise to purchase this book. It is a great resource.
I have developed four exercise levels and the one you choose depends on your activity level and fracture risk.
I provide the tools in the book to help you choose the osteoporosis exercise program best for you.
A twelve week exercise program is ready for you that includes strength training, cardiovascular, flexibility, balance, and posture improvement.
3.2 Exercise for Osteoporosis — Free Course
Another great resource I make available to my clients and visitors to this website is a free, five day email course called Exercise for Osteoporosis.
After you provide your email address, you will receive five consecutive online educational videos on your bone health — one lesson each day. You can look at the videos at anytime.
I cover important topics related to osteoporosis exercise including stop the stoop (how to avoid the hunched posture associated with osteoporosis), key components of an osteoporosis exercise program, key principles of bone building and exercises you should avoid.
3.3 Working with Clients with Osteoporosis — Free Course
If you are a health professional, I encourage you to take my free online course, Working with Clients with Osteoporosis. This five day email course includes a daily video lecture on how to safely and effectively treat clients with osteoporosis, osteopenia or low bone density.
During the video lectures, I cover important topics related to osteoporosis including bone density and bone quality, exercise and osteoporosis, nutrition, pharmaceutical intervention, and the implications for your professional practice.
3.4 Stronger Bones, Stronger Body Video Workout
Each of the video sessions challenges different parts of your body and will improve your balance, strength, flexibility and confidence. Safe and proper form and posture is encouraged throughout the whole exercise series. There are a number of balance exercises for seniors.
Stronger Bones, Stronger Body is a great standalone workout exercise program and a super complement to the Exercise for Better Bones Program.
3.5 Yoga and Osteoporosis
I am the author of a book dedicated to yoga and osteoporosis, Yoga for Better Bones. The second edition of Yoga for Better Bones is available on Amazon and was written for yoga practitioners and teachers who want to continue an active yoga practice but do so safely — especially as it relates to their bone health.
3.6 Core Strength and Balance
A stronger core will improve your balance (as well as deliver other substantial health benefits). That is why I wrote Strengthen Your Core and prepared an extensive video series to accompany the book.
The Strengthen Your Core program uses Plank and Side Plank poses to improve posture and balance, enhance performance, and strengthen from head to toe. Strengthen your Core is available on Amazon in both Kindle and print format. All of the educational videos are available for free on this site.
Today I am going to talk about balance and fall prevention. Specifically I am going to address seniors and how weakness, their balance, and the usage of prescription drugs play an important role in their balance and fall prevention.
This winter I read Being Mortal by Atul Gawande. When Dr. Gawande looks at aging and some of the consequences of aging, he brings up three points that basically are a prescription for guaranteeing that you will have 100% risk of falling in the next year. Those three things are:
- Poor balance.
- Taking more than four prescription medications.
If you or any of your loved ones are experiencing poor balance, know that they are not as strong as they should be, and/or are taking more than four prescription medications, then I highly recommend that you make some changes in one or all of those areas because individuals who did not have any of those three factors only had a 12% of falling in the next year.
In other words, you can potentially reduce your risk of a fall from 100% to 12% by improving your balance, strengthening your muscles especially of your lower body, and talking to your pharmacist, and your family physician, see if all those prescription medications are necessary. Make sure that their side effects don’t cause you to be further at risk for falling.
I hope those points are helpful for you and for those that you love. Here are several additional variables that are important to balance and fall prevention.
4.1 Good Vision and Balance
We know that good vision and having the appropriate eye wear is essential.
4.2 Vertigo and Balance
We know that the inner ear plays an important role in our balance. Those of you who’ve suffered from vertigo know that all of a sudden your balance can change instantaneously if your inner ear is affected.
4.3 Joint and Muscle Receptors
Your little joint and muscle receptors play a key role in balance and fall prevention. Have you ever been to yoga class and asked to stand on one foot? All of a sudden you realize, “Wow, when I tried it on the other foot, it’s so different. It’s so much harder.” This difference between the stability in the two feet could be the result of an injury that happened 20 years ago but because you never rehabilitated that ankle or that knee, the little receptors that are so important to balance and stability never had a chance to build up.
4.4 Strength and Flexibility
As I mentioned above, your overall strength, especially the strength in your lower body, and the strength in your core can affect your balance and mobility. In addition, flexibility around your joints, especially the joints of the ankle and the hip play a critical role in balance in seniors.
4.5 Balance and Fall Prevention Interplay
It is important that you be aware of the interplay of all of the variables listed above (vision, vertigo, joint and muscle receptors, strength, flexibility) when it comes to balance and fall prevention. If these variables are tuned and ready, then when you lose your balance, you can stop the fall with your foot, for example. This is much better than trying to stop the fall with your foot you are not fast enough to get the foot out. Even if you are not fast enough on you feet, if you have built up your strength, your hands can be the next line of defence.
Sadly for some, because they not fast enough and not strong enough, their face or their head becomes the point of contact on the fall.
Today I want to talk about four ways to improve balance for seniors.
- The positioning of your feet.
- The surface that you’re standing on.
- What you’re doing with your head and your eyes.
- What you’re doing with you arms through your balance work.
Let’s cover each of those points in detail so that you know simple ways, just with the things that you have at home, that you can help yourself to boost your balance.
5.1 Improve Balance for Seniors: Foot Position
The first thing to keep in mind is to choose a foot position that will make you successful. (Please follow the demonstration in the video above.)
I want you to feel like you have good balance. You are holding a position that you can successfully balance and you don’t feel like, “Oh my gosh, I keep having to grab that chair. I keep having to grab the wall.”
You want to be able to hold a strong position, focus on your breath, and focus on your alignment and your posture.
All the while, you’re feeling, “Wow, you know this is working. I could feel the little muscles in my feet and in my ankles, and I could feel my hip muscles working to hold me, to help me keep that posture and that balancing.”
All the while you are feeling just a little bit more challenged — but not threatened. For example you do not feel, “Oh my goodness, my whole nervous system feels like I’m going to collapse and fall over, and this is very threatening.” Do not push yourself a little bit too hard so that your body doesn’t feel comfortable.
- Be patient with yourself. With little adjustments to each of these positions, you’ll be able to progressively boost your balance.
- Lets start with the first thing, the foot position.
- Your foot position, the ultimate challenge position will be standing on one foot.
- But before that, you can start with your feet in a nice long, staggered step position.
- If you just took a step and held that, that would be a comfortable widest position I’d encourage you to start in.
- Then you would gradually start to bring your feet together so that then your feet are in position, so that they’re standing on a line.
- They would then come closer and closer together.
- Ultimately, you’re then standing on one foot. You may never (depending on arthritis or hip pathology or your strength) get to the single leg stance.
- But there’s so much you can gain from still working with both feet on the ground.
That covers how to improve balance for seniors with your foot position.
5.2 Improve Balance for Seniors: The Surface You Are Standing On
Second point is the surface you’re standing on. In your house, you’ll have carpet surfaces. You’ll have hardwood. You’ll have linoleum. Each one feels different under your feet.
If your lucky enough to live somewhere where its nice and warm, you might be able to you know go into the yard, work on grass, all of those types of things.
5.3 Improve Balance for Seniors: Your Head and Eyes
The third point to consider is what you’re doing with your head and your eyes. When you balance, you’ll notice that fixating on one point really makes things so much easier. But it doesn’t encourage the other systems in your body to work harder.
As we get older, we tend to focus too much with our eyes for balancing. Therefore, our little joint and muscle receptors get lazy.
- Progress from something you are comfortable with.
- Focus on one point and then gradually turn your head to the right and left.
- The faster you start to turn your head, the harder it’s going to be.
- The wider the angle that you turn your head or look up and down, the harder it’s going to be.
These are all variables that you can tweak when working on your balance.
5.4 Improve Balance for Seniors: Arm Position
Finally, the fourth point to consider is your arm position. Ever notice that tightrope walkers will extend their arms and carry a stick while walking the tightrope? That is because distributing their weight creates a ballast effect and helps them keep their balance over a narrow walkway.
In real day-to-day life, you do not have this type of balance support. On a given day you might be carrying groceries or you might be going up to your car with car keys. In this case you should practice keeping your with a reduced arm support.
With time, as you get comfortable in challenging yourself, you can start to bring your arms in, off the height of the chairs, still in a safe position but maybe bringing your arms to be crossed in front of you. Or doing other things with your arms such as just tossing a little ball, a soft ball, in front of you, those kind of things.
Hopefully, these tips will help you boost your balance and keep you safe. To review, the four points are foot position, the surface you’re standing on, what you’re doing with your head and your eyes, and what you are doing with your arms. Combining all of those things will keep you challenged for quite a while. These activities supplement your balance exercises for seniors.
This presentation on Physical Therapy Fall Prevention and Balance training is a continuing education update for Physical Therapists and Physiotherapists who deal with clients challenged to maintain their balance.
First on my agenda was to update my fall prevention material. That’s what I’d like to run through with those of you who have taken my Level One and Level Two courses, so let me share the following with you.
Some of the strategies that I am going to be covering in this year’s courses that I have not spoken to you of in the past was the Medication Check, Footwear (shoes for elderly to prevent falls), Vision, and specific Balance Strategies.
6.1 Medication Check
On the Medication Check, this is something that came to my attention the last time that I went to the pharmacy, which was just last week. Picking out some things, I went, “Wow! That’s very interesting.”
The Province of Ontario is now instituting a Meds Check, which is a private pharmacy consultation that the pharmacist gives you up to 30 minutes once a year. It’s covered by OHIP.
So for any Ontarian who has a chronic condition or taking three or four medications, and we all know that that’s one of the things that people at risk for falls is the number of medications that they’re on, you may want to make a recommendation to your clients to bring their OHIP card, all current medication containers that they are taking, including vitamins and herbal supplements. They can either go online to book or contact their local pharmacist.
The other items under “Balance” come from a Fall Prevention Workshop that was held in Ottawa this past June. It was probably one of the better lectures that I attended this year. It was sponsored partly by the City of Toronto, Shoppers Drug Mart, and a lot of the presenters came from COTA. It was very, very good, and I want to carry through some of the highlights of the talk.
6.2 Shoes for Elderly to Prevent Falls
First and foremost was Footwear and Fall Risk, specifically shoes for elderly to prevent falls. Some of the studies showing that walking indoors, whether barefoot or in socks, as well as wearing high-heel shoes, either in or outdoors — I don’t know why anybody would care to do that indoors — that wearing that type of footwear has been shown to increase the risk of falls, especially in older people. Hence, we should recommend that the elderly avoid shoes with elevated heels or soft soles.
During the winter months more and more of our seniors spend most of the day indoors. As a result they tend to walk around in slippers that are very soft-soled. That is going to put them at further risk for falls.
What are the recommended shoes for elderly to prevent falls? For optimal dynamic stability when walking on even or uneven surfaces:
- They should look for standard laced shoes.
- They should look for shoes that have low collars.
- The sole be of standard hardness, whether they have a good tread or not.
6.3 Fall Prevention Vision Strategies
Next on the agenda is the Vision Strategies for Fall Prevention. There’s a very interesting researcher, Stephen Lord, out of Australia, who is spending a lot of time looking at this. He has shown that recommending cataract surgery, when it is appropriate, will help maximize vision and hence help with fall prevention. A lot of our seniors have not gone for regular eye check-ups. Hence, correct prescriptions and updated glasses is also another important category for vision strategy.
Multifocal glasses. This is really interesting, because multifocal glasses have become the “in” thing, but what has also been found is that they’re impairing distance contrast sensitivity and depth perception in the lower visual field.
This means, on a practical basis, that older people that are wearing multifocal glasses, or bifocal or trifocal glasses, have a harder time to detect environmental hazards. This is going to show up where they’re more likely to fall, whether outside their homes or walking up or down stairs. Multifocal or bifocals should be replaced with single vision, or distance lenses, for outdoor use, especially when using public transportation, stair-negotiating, or walking in an unfamiliar environment. Those are some really good tips that I got out of reading Stephen Lord’s paper.
6.4 Physical Therapy Fall Prevention
Lastly was Balance Strategies. It was very interesting to listen to Sandra McKay talk about physical therapy fall prevention and the “change-in-support” balance recovery reactions that they’re studying. These are reactions that are either stepping strategies or reaching movement strategies that people adopt. These are replacing what we used to consider or think about training individuals for hip strategies or ankle strategies. In studying how people respond to significant changes in perturbations, they’re finding that the change-in-support balance-recovery reactions is really the direction we need to be moving in.
Keeping this in mind, and the fact that we know that age-related decreases in neural, sensory, and musculoskeletal system contributes to specific aspects of change-in-support strategies, we have to pay particular importance for the prevention of hip fractures. This brings to light the evidence showing restricted control in lateral stability.
6.5 Fall Prevention Activities for Seniors
With my clients, I’ve started trying to elicit more lateral stepping strategies. In doing so, I want to show you a couple of videos that we took using Miss McClaren, who is 93 years old, God bless her, and a very willing participant in all of my work with her.
I’m going to show you a video where she is doing some lateral stepping when we first initiated it back in the fall, and then some recent work that we did with her just last week showing her rate of improvement.
Now, at 93, just asking her to step laterally is sometime is a surprise onto itself. A lot of the studies are saying that you need to do it in a spontaneous manner, so that you’re not having too much cortical involvement in pre-planning. Fortunately, Miss McClaren forgets often, from time to time, what we’ve done in the past, but her body tends not to forget. Hence, she’ll see great improvement.
This initial video was taken in October. This was not the first time that I had Miss McClaren do the crossover, but it was still at a point where she forgot from time to time that we had practiced the crossovers. I would review how to do the step.
As she was sitting on her bed, I would let her visually see what I was going to ask of her to do, knowing that it had been quite a few years, actually, since she had done any crossover work. She hadn’t been dancing through her 80s or anything like that, so she found it quite challenging.
The forward crossovers were easier for her than the backward crossovers. Because of her anxiety, I worked in front of her bed initially, because she knew at least she had a safe landing if she was going to lose her balance. Initially, we had actually just scanned the perimeter of her bed in the first few weeks. What you’re seeing now is, again, sort of a month into having had some opportunities to practice this. This was what I felt was actually very good success on her part and good improvement.
You’ll notice that she is without solid shoes on that one. She’s still without solid shoes here. She tends to wear shoes that are very soft-soled. As with most seniors, they’re quite resistant to changing their footwear. Look how smooth she is here, and she’s a lot more comfortable doing this lateral stepping away from her bed, out in the open hallway.
This is three months into the occasional side-stepping that we do. I don’t repeat the same balance exercises for seniors with her every time. I try to mix things up, have her do four-square stepping, having her do change in directions, head turns, these kinds of things.
This grapevine stepping is combining both the forward and the backward sidestepping. Unlike the studies where Dr. McKay and associates had done some great perturbation-based training, where they used sophisticated platforms, unfortunately, most of us don’t have access to these sophisticated platforms, so we are as creative as we can be with our training, but still with great results.
Aside from balance exercises for seniors, there are many things that you can do to prevent a fall. Below is a fall prevention checklist with a series of 25 questions and suggested actions to reduce your risk of a fall.
Check each of the 25 items in the fall prevention checklist to see if you are at risk of a fall.
7.1 Do you currently experience slips, trips, near falls or falls?
Have an assessment from your primary care physician and/or physical therapist (physiotherapist) to help you determine the cause of your slips, trips and falls.
7.2 Do you have difficulty keeping your balance?
Begin a balance training program suited to you that includes balance exercises for seniors.
7.3 Do you experience episodes of dizzy?
Have an assessment by your doctor to determine the cause of your dizziness. Dizziness caused by benign positional vertigo (BPV) can be easily treated. You should seek out a physical therapist (physiotherapist) trained in vestibular rehabilitation.
7.4 Do you have foot problems?
See a physical therapist (physiotherapist) trained in foot conditions, a podiatrist or a certified pedorthist to have your feet looked after. These practitioners will be able to recommended orthotics or shoes for elderly to prevent falls that are best suited to your feet.
7.5 Do you have weak muscles?
Begin the strength training program that is suited to you.
7.6 Do you have stiff muscles/joints?
Begin the flexibility exercises that address your tight areas.
7.7 Do you have incontinence or have to rush to the bathroom?
Contact your doctor to determine the cause of your incontinence. You may benefit from training with a physical therapist (physiotherapist) trained in urinary incontinence problems.
7.8 Do you have vision problems?
Speak with an eye doctor to ensure you are doing all you can to optimize your vision. You should also always keep your home well lit.
7.9 Do you have hearing difficulties?
Speak with an audiologist to ensure you are doing all you can to optimize your hearing.
7.10 Do you have difficulty sleeping?
After you have ruled out possible medical problems with your primary care physician, you can try any of the following suggestions:
- try to avoid napping during the day
- limit your caffeine intake
- expose yourself to bright light or sunshine soon after waking
- exercise early in the day and have your iron level checked
7.11 Do you suffer from a chronic illness such as arthritis or heart disease?
Work with your primary care physician to ensure that your illness is managed as best as possible.
7.12 Do you walk in places that are uneven, slippery or icy?
When walking on uneven, slippery or icy surfaces ensure you have the appropriate footwear and step with caution. If possible, walk with a sturdy friend that you can rely on for extra support. Consider an alternative route or avoid uneven paths or icy weather. Improve your balance and fall prevention with balance exercises for seniors.
7.13 Do you take three or more medications?
Be sure to keep a list of all your medications whenever you are speaking with your primary care physician or pharmacist.
Both the type and number of medications your on could increase your risk for a fall. Antidepressants, psychotropics and sedatives/hypnotic drugs increase your risk of falling far more than other medication. Be sure to take extra caution if you are on any of these.
7.14 Do you have loose carpet, throw rugs, slippery/highly-polished floors, cords/wires/toys, have cluttered furnishing or any other obstructions on the floor?
A throw rug is not worth the fall that it may cause you. Replace all loose rugs with rubber-backed carpets that stay where you put them. Instruct your children/grandchildren to pick up any toys when they are finished with them. Ensure that you have uncluttered walkways, hallways and rooms. None of the “stuff” that is cluttering your house is worth the cost of a fall!
7.15 Do you have unstable chairs and/or beds that are too high or too low?
Do an inventory of all your furnishings that could put you at risk and if you cannot have it repaired, then get rid of it/them. Your bed height is optimal when you can sit at the edge of it and your feet touch the floor and your knees are level or slightly higher than your hip height.
7.16 Do you have dimly lit rooms or corridors?
Consider replacing your current bulbs with higher wattage bulbs (there are great energy efficient bulbs that provide a clean white light) or have more lights installed.
7.17 Do you live in a community with traffic lights that do not allow sufficient time to cross the street?
Speak to your city councillor or mayor about the traffic lights in question. If you find that they change too fast, then it is likely that many others feel the same way as well!
7.18 Do you wear high-heeled shoes or poorly fitting shoes?
Wearing high-heeled or poorly fitting shoes increase the risk of a fall. You should invest in a set of shoes that fit well and are lower to the ground.
7.19 Do you wear non-slip shoes?
Non-slip shoes can significantly improve your stability as you walk. Consider them a must!
7.20 Do you have trouble doing any of your daily chores?
You may find that after several weeks of starting the exercises suited for you that your daily chores get easier as well. If not, speak with your primary care physician about the possibility of having an occupational therapy assessment. There are hundreds of tips and tools that are available to make your life safer and more comfortable.
7.21 Do you have steps and walkways leading to your house or apartment that are not in good repair?
Your front entrance is key to our safety. Ensure that it is clear, railings are sturdy and steps are stable and not too high. You must remember that you use this space frequently.
7.22 Do you have stairs and walkways that have the potential of being covered with snow, ice or leaves?
Keep a broom, small shovel and ice melting pellets in close proximity to your front entrance. That way they’ll always be there when you need them and it will remind you to keep the area fallproof–not only for yourself but for your visitors.
7.23 Do you have stairs and walkways that do not provide good traction?
Speak to the staff at your local hardware store and ask them their recommendations based on the climate and surface your dealing with. There are many quick, low cost solutions.
7.24 Do you have a solid handrail on both sides of the railing?
If you are not comfortable with installing handrails yourself, you can contact a community agency that conducts home safety inspections and repairs. The following site will provide you with a checklist to follow for a home safety audit: www.homemods.org
7.25 Do you forget to regularly check the safety hazards around the house?
If you are not comfortable with doing this yourself, you can contact a community agency that conducts home safety inspections and repairs. The following site will provide you with a check list to follow for a home safety audit: www.homemods.org
Balance Exercises for Seniors Conclusion
This balance exercises for seniors guide includes a comprehensive coverage of balance and fall prevention strategies and concludes with a fall prevention checklist. It identifies a number of balance exercises for seniors that you can practice to improve your balance.