DrRobFitness

Balance Exercises for Seniors

Maintaining balance is one of the most important goals for seniors , as having a fall is a leading cause of death, disability, and further health complications. According to the CDC an adult over the age of 65 suffers a fall every second in the US. Each year about 36 million falls occur resulting in 32,000 deaths. One out of every five falls results in an injury, and more than 95% of falls result in a hip fracture. I have treated hundreds of clients with balance impairments and use many of these exercises to decrease their fall risk and keep them out of the hospital. I am sure they can be of benefit to you as well.

  • A fall occurs every second in the US for adults over 65
  • 36 million falls occur each year
  • 32,000 deaths are the result of falls
  • 95%- percentage of falls which result in a hip fracture

10 Balance Exercises for seniors

Here are 10 balance exercises for seniors with instructions. I have also specified who would benefit from the exercise .Someone who is elderly with two knee replacements ,more than likely, will not be able to perform the same balance activity as someone who is 65 and has not undergone any surgeries. I have classified them into Beginner, Intermediate, and Advanced.

For beginners

1. Standing with Feet Together

This is one of the easiest balance activities , and is a good one in which to begin.

Instructions:

Stand behind a steady surface that you can hold onto and steady yourself. An example of this would be behind a kitchen sink. Hold onto the sink and place your feet together so they are touching or as close together as they can be. When you are ready, drop your hands to your sides and hold for 10 seconds. Return hands to sink or stable surface and than repeat for two additional sets of 10 seconds.

To progress:

Increase time to 30 seconds up to 60 seconds. At 60 seconds you likely won’t get much more improvement by extending time and should progress to some of the exercises below.

Level: Beginner

2. Tandem Stance

This exercise is a definite step up from number one and will also work your foot and ankle musculature as an added benefit.

Instructions:

Stand behind a steady surface with hands on surface to get into position. Place one foot directly in front of your other foot so you are heel to toe. When you are comfortable,take your arms and place them at your side. Hold this position for 10 seconds. Return hands to sink or stable surface and rest until you are ready to repeat. When ready , repeat for two additional sets of 10 seconds. Repeat on the other foot for 3 sets of 10 seconds.

If too difficult: If this is too difficult and you find your self falling to the side or having trouble holding the position; place the foot that is in front a little to the side ,so it is not directly heel to toe. This will increase your base of support and make the exercise easier to perform.

To Progress:

Increase time to 30 seconds up to 60 seconds.

Level: Beginners

3. Side Steps

This is an excellent balance exercise as it improves lateral balance and our hip abductor strength. Very often we only operate in the sagittal plane , an example of this is walking straight forward. Falls often occur when an unknown perturbation or situation forces us out of our comfort zone. Working on side steps is a great activity to decrease fall risk.

Instructions:

It is best to perform this along a long counter-top if you have it. If you don’t have a long counter-top you can use a wall. Stand behind counter-top or just in front of the wall and perform side steps all the way to the end of the counter-top or wall. It is important that you keep your feet pointing straight forward when performing this activity ,and you do not cheat by turning your feet to face the direction you are side stepping. It is also important that you have good posture with your back straight and eyes looking forward. When you reach the other side, rest if needed, and than side step in the other direction. Set a timer for 2 minutes and perform until the timer is up.

To Progress:

Increase time to up to 5 minutes. A further progression would be to lift the knee up and hold for a 1 second count before side stepping. For example , if you are side-stepping to the left, lift the left knee up toward the ceiling so it is in a 90 degree angle and hold for 1 second ,before stepping out to the left. Don’t worry about lifting the right knee up. You will lift that knee up when going back to the right.

Level: Beginners

4. Marching

Marching is a great exercise to improve hip flexor strength and at the same time improve balance. During each leg lift there is a period of single leg stance which will challenge static stability.

Instructions:

Stand behind a sink or stable surface such as a sturdy chair. Place hands on the chair or sink and lift your knee up toward the ceiling. Alternate knees for a total of 10 repetitions per leg. Rest as needed and than perform an additional 2 sets for a total of 3 sets x 10 repetitions.

To Progress:

Increase to 20 repetitions. As a further progression, perform without upper extremity support with hands down at your side.

Level:Beginners

Intermediate

5. Tandem Walking

Tandem Walking on log

This is a step up in difficulty, and will begin to challenge the majority of seniors .It is in the intermediate category.

Instructions:

It is best to perform this next to a wall or counter-top, as a precautionary measure , so as to give one something to grasp if one begins to lose balance. I would also recommend that the majority start off with your hand just resting on the counter-top or grazing the wall until you are able to perform without use of hands. To perform, walk in a heel to toe pattern with the heel of the lead foot touching the front of the other foot. If you have tiles on your floor , it may be easier to use the tile lines as a straight line on which to place your feet . When you get to the end of counter-top or wall, turn back and go in the other direction. Set a timer for 2 minutes and perform until the timer is up.

To Progress:

Remove hands from counter-top or wall. You can also increase time up to 5 minutes.

Level: Intermediate

6. Single Leg stance

Person standing on one Leg

Single leg stance is one of the more challenging exercises, and a good predictor of fall risk. If you are unable to maintain single leg stance for 5 seconds on each leg your risk for falls increases.

Instructions:

Stand behind a steady surface , such as sink or sturdy chair. To get into position have your hands on sink or chair to begin. Lift one foot in the air so it is not touching the ground and also do not allow your foot to rest on your other leg or ankle. Try to stand for 10 seconds, however, if you are unable to get to the full 10 seconds , attempt to increase time per second intervals. Repeat on the opposite leg. Perform 3 sets on each leg.

To Progress:

Increase time up to 30 seconds

Level: Intermediate

7. Side Steps over small object

This is one of my favorite balance exercises to use, as it also works on coordination. Similar to side steps shown above, this exercise has the added benefit of working on hip abductor strength, which is one of the muscle groups known to weaken in older adults.

Instructions:

Place a small object on the floor such as a soda can or a tissue box. As your balance improves , you may use a taller and larger object such as a spare cardboard box. Again, perform this behind a steady chair or kitchen sink in case you need to quickly grab for balance. Side step over the object so both feet are on the other side and then repeat back to the other side. Maintain good posture with a straight back and eyes forward when performing. As with side steps above, do not allow your feet to turn , they must be pointing forward. Set a timer for 1 minute.

To Progress:

Use a taller object such as a small cardboard box. Increase time up to 3 minutes.

Level: Intermediate

8. Toe Taps

Toe taps are a great balance as well as coordination exercise. As an added bonus your glutes and core will get a workout with this exercise.

Instructions:

You can tap just utilizing the floor , however , I believe it helps to tap an object , such as a tissue box or shoe box. You can use any household object. Perform this next to a sturdy chair or kitchen counter-top. Stand tall with shoulders back and lift one foot up and tap the object in a smooth controlled manner and return that foot to the ground. Repeat 5 times on that foot and switch to the opposite foot and perform 5 times. Rest as needed, repeat for an additional 2 sets of 5 repetitions , for a total of 3 sets of 5 reps.

To Progress:

Increase reps to 10. You may also place the object further away and out to the side ,instead of directly in front, which challenges lateral stability.

Level: Intermediate

Advanced

9. Grapevines

Your significant other might be thinking you are doing some country line dancing as you perform this exercise, as it is essentially the same movement. That being said , this is one of the best balance exercises as it combines a significant amount of coordination, challenges the mind-body connection, and works the small muscles in our feet and ankles.

Instructions:

Stand behind a counter-top or next to a wall. This example describes what to do if you are performing to the left. Start with your feet shoulder width apart and take your right foot and cross it over your left foot .Your right foot will now be to the left of your left foot with your right leg obviously also crossed over your left. Now as you transfer your weight onto the right foot side step your left foot to the left. You will now be in the starting position with your feet shoulder width apart. Now , cross your right foot behind your left foot instead of in front. As before , as you transfer your weight onto your right leg take your left foot and side-step to the left. Than repeat with the right foot going in front again. Repeat this sequence until you get to the end of the wall or counter-top. Reverse directions and now your left leg will be the one doing the crossing. Set a timer and perform for 2 minutes.

To Progress:

Increase time up to 3 minutes , or increase the speed at which you perform. Perform safely and under control.

Level: Advanced

10. Eyes Closed

We rely on our vision as a way to let us know where our bodies are in space. When you take away our vision our balance goes down significantly. Falls occur more frequently in areas where there is less light. An example is when a senior gets up in the middle of the night to utilize the lavatory. By training our body to perform a balance activity with our eyes closed ,it improves the other sensory systems we use for balance- Proprioception and vestibular.

Instructions:

Stand behind a steady surface with your feet about shoulder width apart. Close your eyes and count to 10 seconds.

To progress:

There are many ways to progress this exercise as listed below.

  1. Increase time up to 1 minute
  2. Perform with feet together
  3. Perform in tandem stance (heel to toe)
  4. The most advanced would be single leg stance with eyes closed. This should only be performed by the most advanced seniors and must be accompanied by someone else for safety purposes.

Level: Advanced

Some Considerations

  • Never perform balance exercises alone as they are naturally difficult to perform.
  • Always have someone who is able bodied close by, as you perform balance exercises, in case you stumble or fall.
  • Ensure you combine balance exercises with a healthy diet that includes enough protein so your body is able to repair and build your muscles.
  • Get enough rest with a recommended 8 hours of sleep a day to allow the body to repair itself.

Disclaimer

Although I am a Doctor of Physical Therapy by profession, I am not your personal Physical Therapist nor am I a medical doctor. All content and information on this website is for informational purposes only, does not constitute medical advice and does not establish any kind of patient-client relationship by your use of this website. A patient-client relationship with you is only formed after we have expressly entered into a written agreement with you that you have signed, including our terms to represent you in a specific manner. Although we strive to provide accurate general information, the information presented here is not a substitute for any kind of professional advice, and you should not rely solely on this information. Always consult a professional in the area for your particular needs and circumstances prior to making any professional, legal, medical and financial or tax related decisions.


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Comments

2 responses to “Balance Exercises for Seniors”

  1. Samantha Avatar
    Samantha

    Do you think air ex pads are helpful for seniors? How would you incorporate them into a balance routine?

  2. Tom Avatar
    Tom

    Great ideas for seniors. I will begin these exercises at once! Thank Dr. Rob! I will share my progress.

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