Balance Exercises For Older Adults

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Balance training helps lower the risk of falling for seniors. This is critical for those with osteoporosis or osteopenia since bone fractures are more likely.

Disclaimer: If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Well Guide contain information from peer-reviewed research, medical societies and governmental agencies; however, these articles are not a substitute for professional medical advice, diagnosis, or treatment.

As we age, the simple task of navigating obstacles and staying upright can become more difficult. Balance exercises are an essential part of an exercise program for older adults, but they are especially important for anyone who has been diagnosed with osteopenia or osteoporosis. This is because people with either of these conditions have weakened bones and are therefore more prone to fractures, especially if they fall.

Balance exercises can involve props and equipment, or they can be performed without any equipment in the comfort of your own home. By challenging the different systems involved in helping you maintain your balance, you can improve overall safety and agility and prevent falls, which for someone with either of these bone conditions, is more important than ever.

Effects of Bone Diseases

Balance deficits can occur for several reasons. For one, a forward rounded posture (which is common in those with a bone disease) can impact your balance. This is because your center of gravity shifts forward, which can throw off your equilibrium. In addition, those with osteopenia tend to have weaker muscles. Weakness in the core and legs can lead to balance problems and increase the risk of falling.

Lastly, osteopenia and osteoporosis are diseases marked by weak bones. Therefore, potential falls are more serious since they can lead more easily to bone breaks (fractures). Some fractures, such as those in the hip, often require surgery to fix and can lead to a cascade of health and mobility issues that impact one’s quality of life.

Aspects of Balance Training

Balance training is different from strength training, in that it requires more than just making your muscles stronger. Your visual, vestibular (inner ear) and musculoskeletal systems all work together to maintain your body in an upright and balanced position.

Your brain relies on seeing the world around you in order to stay upright. Your vestibular system senses where your body is in space and how it moves about. Your musculoskeletal system works to move and keep the body in an upright position when presented with different situations.

Issues with vision or the vestibular systems can negatively affect balance. It is important to address these systems with a doctor if you find yourself dizzy or losing your balance often.

As far as the musculoskeletal system goes, good balance requires both good postural alignment and good overall strength. This means strong muscles in the upper back, shoulders and core, as well as strong hips and ankles to help you stay steady on your feet.

Other Types of Exercise You Need

It is also worth noting that the best way to help prevent falls and improve your overall bone health is to perform balance training in addition to weight-bearing exercise and strength training (Zhu et. al., 2021). Weight bearing exercises typically involve moving or holding your own body weight against gravity. Walking, and other aerobic exercises, tai chi and yoga are some examples. Strength training involves performing movements against resistance. This could also involve body weight exercises or exercises that include resistance bands or weights.

In general, physical activity is important as you age, but these three types of exercises are especially important if you have weak bones. Be sure to speak with your healthcare provider before starting a new exercise program.  

The Best Balance Exercises for Older Adults

The best exercises to reduce the risk of falls will involve a combination different types of balance exercises. These exercises involve minimal equipment but can be varied to make them more simple or more challenging. Doing something as simple as narrowing your stance, eliminating the use of one leg to stand on, or closing your eyes are just some examples of how to vary the difficulty of balance exercises. Below are examples that will help improve your balance and work the muscles of your legs.

Disclaimer: Balance exercises are designed to challenge your balance, but they shouldn’t feel dangerous. If you know you have low bone mineral density, it may be best to do these under the watch of a caregiver or with the instruction of a physical therapist, at least initially. If you have a history of falls, be sure to start with supervision and only attempt the simple exercises. Once you are very confident with those, you can try the more advanced ones. If you’re not sure which are safe for you, consider meeting with a physical therapist for a complete assessment.

1. Heel-Toe Walk

This exercise challenges your balance by narrowing your base of support. Think about walking on a balance beam. That would be challenging, right? This exercise mimics that, but on a level surface without the risk of falling off the beam (thankfully!).

  •  Perform this exercise near a stable countertop or hold onto a railing if needed.
  • Walk forward placing one foot in front of the other, lining up the heel of your front foot just ahead of the toes of the back foot like you are walking along a tightrope.
  • Walk the length of the surface you have nearby for balance.
  • Once you reach the end, you can turn around and walk to the beginning, or you can heel-toe walk backwards – but only if you are feeling very secure.
  • Perform this exercise for 1 minute.

2. Heel-Toe Raises

This exercise helps strengthen the muscles in the foot and lower leg, which help stabilize the ankle. This part of the body is the first line of defense when it comes to maintaining upright positioning and preventing falls.

  • Stand at a counter top or holding on to the back of a sturdy chair.
  • Keep your feet hip-width apart and back straight.
  • Raise your heels up.
  • Slowly lower back down to the ground.
  • Then lift the front part of your foot up.
  • Slowly lower back down to the ground.
  • Alternate repeating these two movements for 20-30 repetitions.
  • Try to avoid swinging your hips forward and back.
  • Maintain an upright posture the entire time.

​3. Back Leg Raises

This exercise works on the balance of one leg while strengthening the glutes of the other leg. The glute muscles play a big role in keeping the body upright.

  • Stand at a counter top or holding on to the back of a chair.
  • Keep your feet hip-width apart and back straight.
  • Balance on your left leg.
  • Then while keeping your right knee straight, reach it straight back behind you.
  • Perform this 10-20 times without resting the right foot on the ground.
  • Do the same on the opposite leg.

While doing this exercise, try to avoid arching or rounding the lower back. The only body part moving here is your leg.

4. Marching in Place

This exercise (also known as standing alternate hip flexion) works balance along with strengthening the muscles involved in walking.

  • Stand at a counter top or holding on to the back of a chair.
  • Keep your feet hip-width apart and back straight.
  • Slowly raise the right leg up so that your knee is at hip height.
  • Hold for 1-2 seconds. Then return it slowly back down.
  • Do the same with the left leg.
  • Continue to alternate between raising the right and left leg.
  • Perform 20-30 repetitions in total (10-15 reps on each side).

5. Sit-to-Stand

Sit-to-stand strengthens the legs and also gives you the stability and control needed to sit down and stand up safely.

  • Find a study chair and sit down.
  • Bring your feet shoulder-width apart and arms out in front of you.
  • Stand up tall, by getting your back straight and hips under your shoulders.
  • Then slowly sit back down.
  • Perform 8-15 repetitions.

If you need to use your arms to help stand up, then use the arms of the chair to do so. After more practice, try to use one arm and then no arms.

If this exercise is too easy, try it while holding a weight.

6. Single Leg Balance

Single Leg Balance challenges your static balance, or the balance you can maintain without moving your lower body, by having you balance on one leg at a time.

  • Stand near a countertop or a sturdy chair.
  • Slowly lift your right leg, balancing on your left.
  • Try to hold this position for 30 seconds.
  • If you feel safe, try to avoid holding onto the surface in front of you.
  • Work up to a 60 second hold on each leg without holding on.

7. Lunges

Lunges help strengthen your legs and also most directly mimics getting on and off of the floor. This skill is important as we age since many people tend to lose this ability. For safety reasons, it is crucial that you have the strength and mobility to get off the floor.

  • Start by having something nearby to hold onto. This could be a chair, countertop or railing.
  • Start with your feet hip width apart.
  • Step backwards with your right foot, placing your right toes on the ground behind you.
  • Avoid placing the right foot directly behind your left.
  • Maintain your feet hip width apart even as you step back.
  • Then bend your right knee towards the floor. Only go as far as you feel comfortable and balanced.
  • Step the right foot forward to meet the left.
  • Repeat this 10 times.
  • Then repeat on the left side.

Not sure where to start with improving strength and balance to prevent falls? Wellen's personalized fitness program for osteoporosis and osteopenia incorporates exercises to improve balance in every workout.

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1. Zhu L, Wu W, Chen M, et al. Effects of Nonpharmacological Interventions on Balance Function in Patients with Osteoporosis or Osteopenia: A Network Meta-Analysis of Randomized Controlled Trials [published correction appears in Evid Based Complement Alternat Med. 2021 Jun 5;2021:9892786]. Evid Based Complement Alternat Med. 2021;2021:6662510. doi:10.1155/2021/6662510

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