Balance: the exercise most people skip, and five ways to practise it

Ask someone in their fifties whether they exercise and they will tell you about walking or the gym. Ask whether they practise balance and you get a blank look. Balance is not something we think of as trainable. It is just there, until one day it is not quite. For the full picture, start with our complete starting guide.

Why it matters

The numbers are not subtle. The CDC reports that “more than one out of four older people falls each year, but less than half tell their doctor”, and that “falling once doubles your chances of falling again”. In the US alone, falls in older people lead to “about 4.5 million emergency department visits” a year. Globally, the World Health Organization says falls are “the second leading cause of unintentional injury deaths worldwide”, and “adults older than 60 years of age suffer the greatest number of fatal falls”.

The injury is only half of it. NHS inform, the Scottish health service’s information site, notes that after a fall people often “become less active and more cautious and withdrawn”, and may “stop doing things you enjoy, lose confidence in your abilities or feel anxious”. A fall at 70 can shrink a life at 71. That is what balance practice is really for.

The good news is in the same sources. The CDC’s message is “Falls are Preventable”, and its STEADI programme puts “keeping active and maintaining balance” at the centre of prevention. The WHO lists “gait, balance and functional training” and tai chi among the interventions that work. And every guideline for over-65s — the NHS asks for “strength, balance and flexibility on at least 2 days a week”, the WHO for balance and strength “on 3 or more days a week” — treats balance as a core part of the week.

Five ways to practise

These five are drawn from the NHS’s balance exercises. Do them near a wall, a worktop (counter) or the back of a sturdy chair, fingertips resting on it. As you improve, lighten the touch, then hover your hand next to it. Not in socks on a smooth floor: bare feet or shoes with grip.

1. The one-leg stand. Stand facing the wall, fingertips touching it. Lift one foot a few inches off the floor, hips level, soft bend in the standing knee. The NHS suggests you “hold the lift for 5 to 10 seconds and perform 3 on each side”. This one fits into any wait: the kettle, the microwave, the phone queue.

2. Heel-to-toe walk. Along a line in the floor, “place your right heel on the floor directly in front of your left toe. Then do the same with your left heel. Keep looking forward at all times.” Aim for at least five steps, fingers on the worktop, and “as you progress, move away from the wall”.

3. Sideways walking. Feet together, knees slightly bent, step sideways slowly, one foot then the other to join it. Ten steps each way. Keep your hips up as you step.

4. The simple grapevine. Cross your right foot over your left, then bring the left round to join it. Five cross-steps each way, fingers on the wall if needed. This trains the crossing-over movement that catches people on a crowded pavement (sidewalk).

5. The step-up. On the bottom stair with a hand on the banister, step up with one foot, bring the other to join it, step back down. Up to five with each leg leading, slow and controlled.

The whole set takes under five minutes. One or two of them daily is worth more than all five once a week. NHS inform’s advice for beginners is to “try each exercise 2 or 3 times and slowly increase the repetitions as you build strength and confidence”.

Tai chi

If you would rather learn balance from a person than a web page, tai chi is the obvious class. It is slow, done standing, every movement is a controlled shift of weight from one leg to the other, and nobody is competing. The WHO names tai chi specifically among the approaches that prevent falls in older people, and beginners’ classes are common in community centres, leisure centres and church halls in both the UK and the US. Yoga, pilates and many chair-based classes build balance too.

If you want balance built into a month of short daily sessions alongside gentle strength and walking, The 30-Day Restart includes it from day one.

Strength is half of balance

Balance is not only in the inner ear. Standing on one leg needs a hip and thigh strong enough to hold you there. That is why the guidelines say “strength and balance” in one breath, and why our strength training guide belongs next to this one. Sit-to-stands and calf raises are balance exercises in disguise.

When to seek help

Practise at home if you are generally steady and want to stay that way. Ask for help if:

• you have fallen in the past year, even without injury — the CDC’s first piece of advice is “talk to your doctor about fall risks and prevention”;
• you feel unsteady, dizzy or light-headed when you stand up or turn;
• you have started holding on to furniture to cross a room;
• you are on several medications (the CDC flags medication review as part of falls prevention);
• you have not had your eyes tested in a couple of years.

A GP (family doctor) can check medication, eyesight and blood pressure, and refer you to a physiotherapist (physical therapist) or a local strength-and-balance class. In the US, ask your doctor about STEADI or a falls-prevention programme. This is general information, not medical advice; if you are worried about your balance, that conversation is the first step.

This week

1. One-leg stand, ten seconds each side, fingertips on the wall, every day while the kettle boils.
2. Heel-to-toe for five steps along the kitchen floor, on two days.
3. Check the floors: loose rugs, trailing cables and a dark landing (hallway) cause falls that no practice prevents.
4. If you have fallen this year or feel unsteady, book a GP appointment and say so.