Is Losing My Balance Normal as I Get Older?
Updated: Sep 2
Noticing that you are becoming less steady on your feet can be concerning.
You might find yourself reaching for furniture when walking around the house, feeling less confident on uneven ground, struggling when you close your eyes in the shower, or noticing that you need to concentrate more when going up and down stairs.
A common question we hear as physiotherapists is:
“Is losing my balance just a normal part of getting older?”
While some of the systems responsible for balance do change as we age, progressively worsening balance should not simply be accepted as an inevitable part of getting older.
More importantly, many of the physical factors contributing to poor balance can be assessed and, in many cases, improved with appropriate exercise and rehabilitation.
At Body Fit Physiotherapy in North Adelaide, this is an important part of our approach to falls prevention: identifying why someone is becoming less steady rather than simply giving everyone the same set of balance exercises.
Why Does Balance Change as We Get Older?
Balance is much more complicated than simply being able to stand on one leg.
Your brain is constantly receiving information about your body and surroundings, processing that information and making small adjustments to keep you upright.
Several systems contribute to this.
1. Your strength
Having sufficient lower-limb strength is an important part of maintaining your balance and physical function.
Your calf muscles, quadriceps, gluteal muscles and other muscles around the hips and legs all contribute to controlling your body.
Strength also matters when your balance is unexpectedly challenged.
If you trip, stumble or move too far outside your base of support, you need to generate force quickly enough to take a step or make a correction.
Ageing can be associated with reductions in muscle mass, strength and power, particularly when we become less physically active.
This doesn't mean weakness is inevitable.
Appropriately prescribed progressive resistance training can help older adults improve strength and physical capacity.
2. Proprioception
Proprioception is your body's ability to recognise where your joints and limbs are positioned without having to look at them.
For example, when you walk across uneven ground, information from your feet, ankles, knees and other joints helps your nervous system understand how your body is positioned.
Your brain then uses this information to make constant adjustments.
Changes in sensory function with ageing can make this process more challenging for some people.
3. Your vision
Vision is another major contributor to balance.
Your eyes provide information about your surroundings, movement and your position relative to the environment.
One thing we commonly see clinically is people becoming increasingly reliant on their vision to maintain their balance.
This can become noticeable when visual information is reduced.
For example, you might feel considerably less steady:
walking through the house at night
closing your eyes in the shower
walking in poorly lit environments
moving through unfamiliar surroundings.
This doesn't necessarily mean there is something wrong with your eyesight. It may mean that your other balance systems are not contributing as effectively and you are relying more heavily on vision.
4. Your Vestibular System
Your vestibular system is located within the inner ear and provides your brain with information about head movement and orientation.
It works alongside your vision and proprioception to help maintain balance.
Problems affecting the vestibular system can contribute to dizziness, vertigo or unsteadiness.
Importantly, not every balance problem is simply a strength problem.
If dizziness or vertigo is contributing to your symptoms, this requires appropriate assessment to determine what may be causing it.
5. Your Reaction Speed and Power
Good balance isn't about never becoming unstable.
Everyone loses their balance occasionally.
What matters is your ability to recover when your balance is challenged.
Imagine catching your foot on the edge of a step.
Your body needs to recognise what has happened, react and generate enough force quickly enough to prevent a fall.
This is where strength, power, coordination and reaction speed become particularly important.
A person may have enough strength to slowly stand from a chair but still struggle to generate force quickly when they unexpectedly lose their balance.
This is one reason a comprehensive falls prevention program needs to look beyond static balance exercises alone.
When Should I Be Concerned About My Balance?
An occasional moment of unsteadiness doesn't necessarily mean you have a balance
problem.
However, changes are worth investigating if you notice that you are:
having falls or increasingly frequent near falls
regularly reaching for furniture or walls for support
becoming nervous walking outside
avoiding uneven surfaces
struggling more with stairs
feeling much less steady in the dark
finding it increasingly difficult to get up from a chair or the floor
reducing activities because you are worried about falling
becoming progressively less confident on your feet.
These changes are important because fear of falling can itself affect activity levels.
If someone becomes worried about falling, they may understandably start avoiding walking, exercise or community activities.
Unfortunately, doing less can contribute to further reductions in strength and physical capacity.
Early intervention gives us an opportunity to address these problems before they become more significant.
Can You Improve Your Balance After 70?
Yes.
Being 70, 80 or older doesn't automatically mean you are too old to improve your physical capacity.
Older adults can still respond positively to appropriately prescribed strength and balance training.
However, the exercise needs to be challenging enough to create adaptation while still being appropriate for the individual.
Simply standing with your feet together for the same amount of time every day is unlikely to address every potential contributor to poor balance.
For one person, the priority may be improving calf and hip strength.
Another person may have adequate strength but struggle when visual information is removed.
Someone else may have difficulty recovering when they unexpectedly lose their balance.
This is why individual assessment matters.
Is Walking Enough to Improve Balance?
Walking is an excellent form of physical activity and something we encourage many older adults to continue.
It can help maintain cardiovascular fitness, walking capacity, independence and general health.
However, walking alone may not provide enough stimulus to substantially improve all aspects of strength and balance.
For example, walking may not adequately challenge:
maximum lower-limb strength
muscular power
reactive balance
balance with reduced visual input
narrow-base balance
stepping reactions.
For many people, the best approach is to continue walking while adding specific strength and balance exercises.
The exact combination depends on your current capacity and what we identify during assessment.
What Are the Best Exercises to Prevent Falls?
There isn't one exercise that prevents falls for everybody.
An effective program may include exercises targeting:
Lower-limb strengthExercises designed to improve the capacity of the calves, quadriceps, hamstrings and hip muscles.
Functional strengthTasks such as sit-to-stand variations, stepping and other movements that relate to everyday activities.
Static balanceExercises that progressively alter foot position, support surface or available sensory information.
Dynamic balanceExercises that challenge balance while moving rather than only while standing still.
Reactive balanceActivities designed to improve the ability to respond when your centre of mass moves outside your base of support.
Walking capacityWhere appropriate, improving endurance and confidence with walking
may also form part of the program.
The key word is progressive.
If an exercise was challenging six months ago but is now easy, continuing exactly the same exercise may provide very little additional stimulus.
Your program needs to change as your capacity improves.
How Can Physiotherapy Help With Falls Prevention?
At Body Fit Physiotherapy, our Falls Prevention Program starts by trying to understand why you are becoming less steady.
During your initial assessment, we take a detailed history including previous falls, near misses and situations where you feel particularly unstable.
We also consider existing medical conditions, previous injuries, pain and other factors that may influence how safely you can exercise.
From there, assessment may include measurements of:
lower-limb strength
different components of balance
visual dependence
proprioceptive challenges
walking capacity
functional movement.
This gives us baseline information rather than simply guessing where the problem lies.
We can then develop an individualised exercise program targeting the areas that need improvement.
As you become stronger or more confident, the exercises can be progressively modified so that the program continues to challenge you appropriately.
What If I've Already Had a Fall?
Having experienced a fall doesn't mean another fall is inevitable.
However, it is a good reason to consider why the fall occurred and whether there are modifiable factors that can be addressed.
Falls are often multifactorial.
Physical capacity is one component, but other factors can include medications, vision, environmental hazards, footwear, medical conditions and dizziness.
This means some people may benefit from input from their GP or other health professionals alongside physiotherapy.
If a fall has resulted in significant injury, new neurological symptoms, loss of consciousness, persistent dizziness or another concerning change in your health, appropriate medical assessment should be sought.
Don't Simply Accept Worsening Balance as Part of Ageing
Ageing can change the systems we use to maintain our balance.
But there is an important difference between acknowledging these changes and assuming nothing can be done about them.
If you've noticed that you are becoming progressively less steady, having near falls or losing confidence with activities you previously managed comfortably, it may be worth investigating why.
Understanding whether strength, balance, sensory information, walking capacity or another factor is contributing gives you something specific to work on.
And in many cases, these are things that can be trained.
Falls Prevention Physiotherapy in Adelaide
Body Fit Physiotherapy provides individualised Falls Prevention Physiotherapy in North Adelaide for older adults who want to maintain their strength, mobility, confidence and independence.
Our approach is based on assessing your current physical capacity and developing a progressive program around your individual needs rather than giving everyone the same generic balance exercises.
If you or a family member has noticed a change in balance, experienced a fall or is becoming less confident on their feet, you're welcome to contact our North Adelaide clinic to find out more about our Falls Prevention Program.
Body Fit PhysiotherapyNorth Adelaide, South Australia
This article provides general information and does not replace individual medical or physiotherapy assessment.
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