• Balancing Acts

    Exercises to Help Prevent Falls

    Image for balancing exercise article Do you believe falling is increasingly inevitable as you age? It is true that more and more people fall as they get older. But did you know there are steps you can take to prevent falls?
    Impaired balance, a major risk factor for falling, often worsens with age. It may worsen because of decreased strength, agility, and flexibility, or as a result of illness, sensory impairment, or certain medications. If you have chronic pain, this can also increase your risk of falling.
    The good news is, certain exercises may improve balance and strength in people of all ages. Read on about balancing acts, which you may want to try at home to minimize falls and remain independent for as long as possible.

    Research: Paving the Way to Steadier Steps

    Studies have shown that people who perform regular exercises to improve lower body strength and balance can decrease their risk of falls and fall-related injuries. In addition, some research supports the practice of tai chi to reduce falls.

    Before Getting Started

    Keep in mind that although exercise may reduce fall-related fractures in healthy seniors, it may increase risk in seniors with functional limitations. Therefore, it is important to check with your doctor before beginning any exercise program, including the exercises listed below. Assistance during exercise, or an organized exercise program, may be necessary for some people.
    Also be aware that obstacles in the home may contribute to loss of balance and subsequent falls. For people aged 65 or older, most falls occur in or around the home. Start by removing obstacles in your home that may contribute to loss of balance. For instance:
    • Provide adequate lighting, especially at night.
    • Secure carpet and/or throw rugs to the floor or remove them.
    • Install handles near the toilet and bathtub.
    • If stairways are unavoidable, install railings on both sides of stairway.

    Strength- and Balance-Building Exercises

    After checking with your doctor, you may want to try some of these exercises at home or find out about community exercise programs. These exercises were adapted from The National Institute on Aging.
    1. Toe Stand
      1. Stand with a table or chair in front of you and hold onto it for support.
      2. Start with your feet flat on ground, shoulder-width apart.
      3. Slowly stand on your tiptoes.
      4. Hold this position for one second.
      5. Breathe in and slowly lower your heels so that they touch the floor again.
      6. Repeat 10-15 times.
      Do two sets (10-15 repetitions each) for each leg. Be sure to rest between each set.
    2. Balance Walk Exercise
      1. Raise your arms to your sides so that they are shoulder height.
      2. Focus on a spot ahead of you.
      3. With arms still raised, walk as you normally would in a straight line.
      4. When you lift your back leg make sure you bend your knee.
      5. Hold it in place for one second before taking the next step.
      Repeat for 20 steps.
    3. Knee Curl
      1. Stand with a table or chair in front of you and hold onto it for support.
      2. Start with your feet flat on ground, shoulder-width apart.
      3. Slowly bend one leg at the knee, raising foot up toward buttocks.
      4. Hold for one second. This exercise may cause cramping of the hamstring muscles at first.
      5. Slowly return to normal standing position.
      6. Repeat 10-15 times. Then do the same on the other leg.
      Do two sets (10-15 repetitions each) for each leg.
    4. Standing on One Foot
      1. Stand with a table or chair in front of you and hold onto it for support.
      2. Start with your feet flat on ground, shoulder-width apart.
      3. Stand on one foot behind the table or chair.
      4. Hold this position for 10 seconds.
      5. Slowly lower leg down. Rest.
      6. Repeat 10-15 times.
      7. Repeat with other leg
      Do two sets (10-15 repetitions each) for each leg.
    5. Heel-to-Toe Exercise
      1. Place the heel of one foot in front of the toes of the other foot. Heel and toes should touch.
      2. Focus on a spot ahead of you.
      3. Take a step, keeping heel and toes touching with every step.
      Repeat for 20 steps.
    6. Side Leg Raise Exercise
      1. Stand with a table or chair in front of you and hold onto it for support.
      2. Slowly lift one leg out to the side until foot is off the ground. Keep your back and both legs straight and keep your toes pointed forward.
      3. Hold for 1 second.
      4. Slowly lower leg back to normal standing position. Pause.
      5. Repeat 10-15 times.
      6. Repeat with other leg.
      Do two sets of 10-15 repetitions for each leg, alternating legs.

    Increasing the Challenge

    As your balance improves, you may want to increase the difficulty of these exercises by making the following modifications:
    1. Hold onto the table or chair with one hand instead of two.
    2. Progress to holding the table or chair with one fingertip.
    3. Then use no hands.

    Other Exercises to Build Balance

    • Take daily walks. Be sure to wear comfortable, non-slip shoes that fit you well.
    • If you can, take extra trips up and down the stairs, holding on to the railings for safety. This will help strengthen hips and thighs.
    • If you are unable to handle stairs well, try repeatedly getting up from a sitting position in a chair. This also strengthens hips and thighs. Grip the arms of the chair if needed. Or, do not use your hands for a more difficult work out. Soft, low chairs are harder to get out of.


    Centers for Disease Control and Prevention http://www.cdc.gov

    National Institute on Aging http://www.nia.nih.gov


    Canada Safety Council http://www.safety-council.org

    Health Canada http://www.hc-sc.gc.ca


    Exercise & Physical Activity: Your Everyday Guide from the National Institute on Aging. National Institute on Aging website. Available at: http://www.nia.nih.gov/sites/default/files/exercise%5Fguide.pdf. Updated June 14, 2012. Accessed July 25, 2013.

    Falls in the elderly. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 8, 2013. Accessed July 25, 2013.

    Judge JO, Lindsey C, Underwood M, et al. Balance improvements in older women: effects of exercise training. Physical Therapy. 1993;73:254-265.

    National Center for Injury Prevention and Control. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/injury/index.html. Updated July 19, 2013. Accessed July 25, 2013.

    Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59(1):148-157.

    Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients: a preplanned meta-analysis of the FICSIT trials. JAMA. 1995;273:1341-1347.

    Rubenstein LZ, Josephson KR, Trueblood PR, et al. Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men. J of Gerontology Series A-Biological Sciences & Medical Sciences. 2000;55:M317-M321.

    Samelson EJ, Zhang Y, Kiel DP, et al. Effect of birth cohort on risk of hip fracture; age-specific incidence rates in the Framingham Study. Amer J Public Health. 2002;92:858-862.

    Taggart HM. Effects of tai chi exercise on balance, functional mobility, and fear of falling among older women. Applied Nursing Research. 2002;15:235-242.

    Wolf SL, Barnhart HX, Kutner NG, et al. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J of Amer Geri Soc. 1996;44:489-497.

    12/11/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Leveille SG, Jones RN, Kiely DK, et al. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA. 2009;302(20):2214-2221.

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