Balance as you age

How to Maintain your Balance Throughout the Life Continuum

What Happens to Your Balance as You Age?

Have you ever noticed that as people age their balance tends to get worse?  Chances are you probably have an elderly family member with poor balance or know someone who walks with an assistive device such as a cane or walker.  Perhaps, you are that person who has poor balance or requires to use of a cane or walker.  There is no secret that balance worsens as you age, but what causes your balance to get worse and what can you do to maintain your balance?

What is balance?

Your balance, or ability to maintain upright, is accomplished by a complex set of sensorimotor control systems that includes sensory input from three systems.  These 3 systems include your vision (sight), vestibular (equilibrium/spatial orientation) and somatosensory (touch). 


The eyes are a set of organs involved in light sensation.  Input we receive through the eyes travels through a complex network of neurons and ends up in the brain.  With this input we can determine colors, direction and speed of surrounding objects, shape/orientation of surrounding objects, and orientation of our own body movements.  The role of the visual system is crucial to maintaining good balance because the eyes play many roles.  To test out your balance with and without vision, simply stand on one foot with your eyes open.  Try to maintain that position for 30 seconds.  Make sure that you are in a safe place and have a spotter.  Now, try to stand on that foot for 30 seconds with your eyes closed.  What did you notice?  You probably found it much more difficult to maintain balance without your visual system. Please do not attempt this test if you are prone to falls, have had falls in the past or have known balance issues.


The vestibular unit is a combination of sensory organs including the inner ear, cranial nerves, and brain.  It is responsible for detecting angular and linear acceleration and the body.  When activated, the vestibular system provides information about the motions and positions of the head and body in order to maintain equilibrium.  When not working correctly, this system can be responsible for vertigo. 


Somatosensation involves a complex network of sensory receptors throughout the body including exteroceptive (touch, pain, temperature), interoceptive (organs), and proprioceptive (muscles, joints) receptors.  This system is responsible for determining joint position in space and head positioning relative to the shoulders.  This system can be affected by neuropathy or injury to joints. 

ab roll out
Ab Roll-Outs for Core Strength

Putting It All Together

Input from these 3 systems is relayed to the brain stem where it is combined with other input from the cerebellum and cerebral cortex.  From there, a motor output is generated in order to engage muscles in an effort to maintain an upright, balanced position.

Why Does Balance Get Worse?

Loss of balance as we age is typically due to a failure of one or multiple sensory systems.  As we age, it becomes difficult to see your environment, making it hard to process visual information.  The calcium crystals inside the inner ear become brittle and can cause symptoms of vertigo.  Neuropathy can occur and proprioceptive input from the muscles and joints is slowed leading to decreased somatosensory input.  Furthermore, higher level processing of this information in the brain is slowed compared to a younger person.  This can decrease balance reactions in the elderly.  Finally, fear avoidance from previous experiences with falls or near-falls may play a role in a lack of balance or gait dysfunction.

How Can You Fix It?

It is possible to slow the deterioration of balance systems and to improve them in some cases.  Increasing whole body strength is one of the best ways to recuperate and maintain balance.  This can be done with a combination of strength training and exercises such as Tai Chi, Otago, or dancing.  Research reports that approximately 2.5 hours of strength and balance training per week can help reduce the risk for falls. Remember, strength training is not all about weight! If you continue to have balance problems or know someone who has fallen, seek the assistance of a physical therapist to address the issue right away.  A physical therapist will be able to do a formal evaluation and figure out where to concentrate the rehabilitation in order to restore optimal balance and reduce the risk for falls.

Remember, it is never too late to start training your balance.  If you know someone who keeps falling or may be at risk for falls, share this post with them and receive a free balance assessment from Transform Rehabilitation.  Feel free to post any questions in the comments section below and remember to subscribe to our mailing list to stay on top of all things Transform Rehabilitation.

In health,

Kyle Lance, PT, DPT

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