Balance And Falls

by | Dec 3, 2025 | Wellness Services

Balance And Falls

By Dylan Bartley, MSPT

Everyone knows how annoying and embarrassing falling can be. But as we age, the consequences of falling become more and more painful and costly. In fact, falls are the leading cause of death from an injury in persons over 65. 75% of emergency visits are fall-related. And 40% of hospital admissions in persons over 75 are the result of fall-related injuries. As Physical Therapists, we treat the injuries that result from these falls and help people get in better shape to help prevent further falls. And like any condition, prevention is the best medicine, so we’ll discuss some of the best exercises and steps you can take to stay on your feet.

First, however, let’s discuss a little about how our bodies achieve balance. Balance is a complex process involving the reception and integration of sensory inputs, and the planning and execution of movement, to achieve the goal of staying upright. It’s the ability to control the center of gravity over our base of support in any given sensory environment. Reflexes are rapid, automatic responses by the peripheral or central nervous system to help support our posture.

Our brains receive input from three different systems:

  1. Visual System: This helps us see things in the environment and orient us to the hazards and opportunities presented
  2. Vestibular System: These organs in the inner ear provide the brain with information about the position and motion of the head in relation to gravity. It provides information about acceleration and deceleration
  3. Proprioceptors: These are nerve endings located in joints, ligaments, muscles, and the skin and they tell us about our bodies current position in space.

So the brain takes information from all these 3 systems and calculates what needs to be done to stay upright. Of course if you don’t have the right strength and flexibility, your body still can’t always execute the necessary steps to avoid a fall. Also, if you haven’t trained your reflexes to operate in complex environments, such as an icy staircase, your sensorimotor system may still fail at preventing a fall.

The old adage, “Use it or lose it” applies here. Kids are constantly walking on narrow ledges and running around in fields with gopher holes and they do just fine most of the time because they are constantly training their sensorimotor systems. After injuries, we often develop fears of these challenging physical environments and we stick to treadmills, stationary bikes, and sidewalks. So a good exercise routine to get you tuned up to avoid falling will include getting you outside your comfort zone and doing movements that are safe, but maybe a little scary.

You’ll want to start with static movements where you are just holding a challenging position for 10 seconds or more and progress to dynamic balance exercises where you are moving. Even dancing or hiking are great options for people who don’t like structured exercises. And as always, come in for a consultation with one of our physical therapists for more guidance to customize a balance and fall prevention program that will be perfect for you. In addition to the exercises, we can help you identify environmental risk factors like hazardous electrical cords, rugs, poor lighting, or just general clutter in your home that may be just as important in keeping you safe.

Static Balance Exercises

  1. Single leg balance
    1. Start in a corner or door frame for safety
    2. Hold on with your fingertips to start and work on letting go completely
    3. Close your eyes to make it more challenging
  2. Tandem standing
    1. Start with one foot just slightly in front of the other but still a few inches apart
    2. Progress to doing it with your heel touching the toe of the other foot
  3. Standing on an unstable surface:
    1. Pillows, couch cushions
    2. Wobble or rocker boards
    3. BOSU Balance Trainer
    4. Trampoline

Dynamic Balance Exercises

  1. Tandem walking: walk heel to toe along a line
  2. Grapevine or carioca: walking sideways with a crossover stepping pattern
  1. Step-to patterns (forward and to the side).
    1. Place a piece of tape on the floor in front of you and to both sides (1-2ft away from your standing start position).
    2. Use the tape as a reference point for you to step to or past with one foot then push off the foot you stepped with to safely return to the start position.
    3. You should only step farm enough to be able to return without losing your balance, while still feeling challenged. The motion is similar to a lunge without deep bending in the knees.
    4. Use a cane or walking stick for support as needed.
  1. Single leg balance while you tap the other foot in a star pattern