Maintaining Balance With Age

by Richard O’Boyle, Publisher
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Some people seem to have it and some people don’t. It’s that sense of coordination of body movement – what makes someone a graceful dancer or dynamic athlete and someone else a complete klutz. Good balance and coordination may seem to be bonuses in life, but the fact is, as we age good balance can be a life-saver.

Good balance is dependent on many different factors, some of them biological, and some of the capable of improvement. Balance is associated with sensory input from the eyes, the correct functioning of the balance system of the inner ear, and the sense of position and movement in the feet, legs, and arms, according to Charlotte L. Shupert, Ph.D. at the Vestibular Disorders Association.

Poor balance can be the side effect of certain medications, medical complications, or serious disorders. For example, dizziness, which can cause difficulty in balancing, can be a result of disease in the vestibular (inner ear balance) system. It can also be due to the side effects of drugs or interactions between different drugs, problems with inadequate or poorly balanced diet, trouble with blood pressure (high or low), or even hyperventilation associated with anxiety.

What is Balance?

The inner ear balance system works with the eyes, muscles and joints to maintain orientation or balance. For example, visual signals are sent to the brain about the body's position in relation to its surroundings. These signals are processed by the brain, and compared to information from the vestibular and the skeletal systems. Within the inner ear, a complex series of tubes, fluids, and sensitive hairs works to help the brain detect our body’s movement and position, including perceptions of up and down, side to side, and circular movements.

While having good balance and sense of body position is a benefit to sports performance, it is critical to preventing falls. Falls among the elderly are a leading cause of debilitating injury (such as hip fractures) and a serious risk factor for premature death. By preventing balance problems and working to improve remaining ability, seniors can improve their quality of life and reduce crippling injuries.

Balance Disorders

According to the National Institute on Deafness and Other Communication Disorders, when balance is impaired, an individual has difficulty maintaining orientation. For example, an individual may experience the "room spinning" and may not be able to walk without staggering, or may not even be able to arise. According to NIDCD, some of the symptoms a person with a balance disorder may experience are:

  • A sensation of dizziness or vertigo (spinning)
  • Falling or a feeling of falling
  • Lightheadedness or feeling woozy
  • Visual blurring
  • Disorientation

Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic. The symptoms may appear and disappear over short time periods or may last for a longer period of time. A doctor's help will be necessary to sort out these different causes and arrive at a correct diagnosis.

Improving Balance

Since good balance and body orientation (also called proprioception) depend on many factors, we have many alternatives to try to improve balance. For example, a regular hearing exam may detect inner ear disorders that may be treatable; or a thorough review of medications and ailments can reduce the likelihood of unwelcome side effects that affect balance.

“Because balance in standing and walking is at least partly a skill that can be learned and is dependent on good general physical condition, sound nutritional and health habits, including regular exercise like walking or playing sports can go a long way toward preventing balance trouble,” Shupert says.

Seniors can improve their overall health and fitness, and specifically balance, by participating in low-impact sports, such as aerobics, yoga, tai chi, pilates, or water aerobics. Other more active sports such as tennis, biking, walking, weight training, or bowling can also improve balance by strengthening muscles and joints and improving posture. An activity such as ballroom dancing requires both good body awareness and hand-eye coordination so it can exercise balance skills as well.

Before beginning a program you should have a complete history and physical, including a review of you medications, a musculoskeletal check for any abnormalities and blood tests to determine cholesterol and glucose levels, advises Constance Serafin, M.Ed., FNP who teaches at New York’s Pace University. “You owe yourself a good history and physical, even if not starting an exercise program,” Serafin says.

The ancient Chinese martial art of tai chi has gained interest in the last few years as a preventative to falls that often lead to broken bones in the frail elderly. Researchers think that the emphasis on swaying and other choreographed movements may help individuals to improve their balance, enhance blood circulation, and ease the pain of arthritis. As an aerobic exercise, it has the added benefit of increasing muscle strength and tone. Other Far-Eastern exercise programs such as yoga and pilates use similar techniques to synchronize breathing and body movements, and therefore improve balance.

Specific Exercises for Improving Balance

Any exercise program should build gradually to avoid burnout, boredom, or injuries. Most studies have shown that exercise properly done presents a low risk of serious injury. Serafin says, “You need to have the proper equipment and use the correct "form".” At least initially, it is a good idea to work with an experienced instructor to learn the proper basics of any sport or exercise routine such as weight lifting, yoga, pilates, or tai chi. Classes for all skill levels are increasingly offered at health clubs, senior centers, and local recreation centers. “Correct form” also means, for example, buying a walking shoe for a walking program and walking on a flat surface.

The American Senior Fitness Association and the Ohio State University Extension recommend knee lifts as an exercise to improve balance. Attempt to lift the knee as high as the hip using a secure object to assist in maintaining balance in the beginning. As you grow stronger, decrease the tendency to lean on a support, and try holding the leg up for 3 seconds or longer. It is important to never close the eyes while performing standing stretch and relaxation activities due to difficulties maintaining balance, cautions Lisa Gibson from OSU.

OSU and ASFA also recommend calf stretches, toe-tapping, point and flex exercises, leg lifts to the side and exercises which bend and straighten the knee. The sit-to-stand exercise is highly specific; when necessary, use the chair for support when standing and again when returning to a sitting position. Try to gradually decrease use of the arms as the legs get stronger.

Gerard Kerins, M.D., a physician at the University of Connecticut Health Center in Farmington, recommends the following exercises that can be done at home:

  • While holding onto a wall, chair or the kitchen sink, raise yourself up and down on tiptoes, repeatedly. As your strength improves, go higher up on your toes and eventually try it on one foot at a time. This exercise strengthens the calf muscles.
  • Lean your back against a wall with your heels placed seven to eight inches away from the wall. Lift the toes of both feet off the ground as high as possible. This exercise strengthens the shin muscles.
  • Take extra trips up and down the stairs. Hold onto the banister with one hand and press the other hand against the wall for safety. This strengthens your hips and thighs.
  • If you're wary of stairs, you can strengthen the same muscles by getting up out of a chair repeatedly. Grip the arms of the chair if you need to, but you'll get more benefit from the exercise if you don't push with your hands.

While you can expect to see gradual improvement in health, well-being, fitness, and balance, you will also see improved self-image (as you shed some extra pounds) and probably more friends (as you get to know fellow exercise enthusiasts).

Related Articles:

- Tai Chi for Health and Fitness
- Walking Tips for Seniors
- Too Good to be True? Preventing Health Frauds and Scams
- Exercising Care
- Proper Nutrition 40+


 - “Balance in the Elderly” by Charlotte L. Shupert, Ph.D.
 - “The Aging Vestibular System” by Charlotte L. Shupert, Ph.D.
 - “Balance Disorders” National Institute on Deafness and Other Communication Disorders
 - Vestibular Disorders Association
 - “Improve Balance: Prevent Falls” Ohio State University Extension
 - “Keep Your Balance: Exercises Can Improve Balance, Help Elderly Reduce Falls” University of Connecticut Health Center

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