Why Am I Becoming More Unsteady as I Get Older?
Updated: Sep 2
If you’ve started to notice that you feel less steady on your feet, you’re not alone. You might find yourself reaching for furniture when walking around the house, feeling less confident on uneven ground, or becoming more cautious when using stairs.
A common question we hear from older adults is:
“Why am I becoming more unsteady as I get older?”
While some changes to strength, balance and reaction time can occur with ageing, increasing unsteadiness shouldn’t simply be dismissed as an inevitable part of getting older.
Balance is a complex skill that relies on several different systems working together.
Understanding which part of that system is changing can help determine what you can do about it.
What Controls Your Balance?
Good balance isn’t controlled by one muscle or one part of your body.
Your brain is constantly receiving information from several systems and using this information to determine where your body is and how it needs to respond.
Three particularly important sensory systems are:
1. Your vision
Your eyes provide your brain with information about your surroundings and your position relative to them.
This is one reason standing with your eyes closed is considerably harder than standing with your eyes open.
As we get older, we can also become increasingly reliant on vision to maintain our balance.
This can become noticeable when walking in poor lighting, getting up during the night or moving through unfamiliar environments.
2. Your vestibular system
Your vestibular system is located within your inner ear.
It provides information about the position and movement of your head and plays an important role in maintaining balance when you move.
Your brain combines this information with signals coming from your eyes and the rest of your body.
3. Your proprioception
Proprioception is your body’s ability to recognise where it is positioned without needing to look.
Sensors within your muscles, joints and other tissues continually send information to your brain about your body's position and movement.
This becomes particularly important when the surface underneath you changes.
Walking across grass, gravel or uneven ground, for example, requires your body to continually detect small changes and respond appropriately.
Strength Is Also a Major Part of Balance
Knowing that you are losing your balance is only part of the equation.
Your body also needs sufficient strength to respond.
If you stumble, your muscles need to generate force quickly enough to reposition your body and prevent you from falling.
Strength through the legs, hips, calves and trunk can therefore play an important role in maintaining mobility and responding to unexpected changes in your balance.
This is one reason we don't look at falls prevention as simply doing more standing balance exercises.
A comprehensive program will often need to address both balance and physical capacity.
Why Might I Be Becoming More Unsteady?
There isn't one explanation that applies to everybody.
Increasing unsteadiness may be influenced by a combination of factors, including:
Reduced leg strength
Changes in vision
Changes to the vestibular system
Reduced proprioception
Slower reactions
Reduced walking capacity
Pain or previous injuries
Changes in confidence after a fall or near miss
Certain medical conditions or medications
For some people, the first indication isn't actually a fall.
It may be something much more subtle.
You might notice yourself using the handrail more often, avoiding uneven surfaces, taking smaller steps or reaching for furniture when walking around the house.
These changes can be worth paying attention to.
Is Becoming Unsteady Just a Normal Part of Ageing?
Ageing can contribute to changes in strength, sensory function and physical capacity.
However, that doesn't mean you should automatically accept deteriorating balance.
Importantly, many of the physical qualities involved in maintaining balance can be trained.
Strength can improve.
Balance can be challenged and progressed.
Walking capacity can improve.
Your ability to manage different environments can be practised.
The important part is identifying what you need to work on rather than assuming that everybody over a certain age needs the same balance exercises.
Why Generic Balance Exercises Aren't Always Enough
You may have seen exercises such as standing on one leg or walking heel-to-toe recommended for improving balance.
These exercises can certainly have a place.
However, they may not address the reason a particular person is becoming unsteady.
For example, someone whose main limitation is significant leg weakness may require a greater emphasis on progressive strengthening.
Another person may perform well when their eyes are open but struggle significantly when visual information is reduced.
Someone else may have good static balance but struggle when walking, turning or responding to changes in the environment.
These people don't necessarily need identical programs.
This is why assessment can be useful.
What Does a Physiotherapy Balance Assessment Look At?
At Body Fit Physiotherapy, our Falls Prevention Program starts by understanding what has been happening.
We want to know whether you have experienced falls or near misses, when you feel most unsteady and whether there are particular activities or environments that cause difficulty.
We also consider previous injuries, aches and pains and relevant medical conditions that may affect your ability to exercise.
From there, we can assess areas such as:
Strength: We can measure important muscle groups involved in maintaining your balance and mobility.
Balance: We can challenge your balance under different conditions to better understand which systems you rely on.
Walking capacity: Where appropriate, we can assess your walking ability and overall physical capacity.
The aim isn't simply to tell you whether your balance is "good" or "bad".
It's to identify the areas that could potentially be improved.
What Exercises Can Help Improve Balance?
The best exercises will depend on the findings from your assessment.
A program may include a combination of:
Progressive strength training
Exercises targeting important muscles around your hips, thighs and calves can help improve the physical capacity required for everyday activities.
Specific balance exercises
Balance exercises should be challenging enough to stimulate improvement while still being performed safely.
As your balance improves, exercises can be progressively modified rather than repeating
the same easy exercises indefinitely.
Sensory challenges
Exercises may sometimes alter the amount of visual or proprioceptive information available, depending on the person's abilities and what is appropriate for them.
Functional exercises
Activities such as getting out of a chair, stepping, changing direction and negotiating different surfaces may be incorporated depending on your goals.
Walking and conditioning
Improving your general exercise capacity can also form part of maintaining mobility and independence.
Is Walking Enough to Improve My Balance?
Walking is an excellent form of physical activity and we generally want older adults to continue walking where it is safe and appropriate.
However, walking alone may not provide enough stimulus to significantly improve all of the physical qualities involved in balance.
For example, normal walking may not sufficiently challenge your leg strength if you are already accustomed to doing it every day.
Similarly, walking along a predictable, flat surface doesn't necessarily challenge your balance systems in the same way as specifically designed balance exercises.
Walking can therefore be an important part of your exercise program without necessarily being the entire program.
When Should I Get My Balance Assessed?
You don't necessarily need to wait until you've had a significant fall.
Consider seeking assessment if you've noticed:
Increasing unsteadiness
Regular near misses
A recent fall
Reduced confidence when walking
Difficulty getting up from the floor
Increasing reliance on furniture or handrails
Difficulty walking on uneven surfaces
Reduced leg strength
Avoidance of activities because you're worried about falling
Earlier assessment gives you an opportunity to identify potential deficits before they cause a greater restriction in your independence.
Falls Prevention Physiotherapy in North Adelaide
At Body Fit Physiotherapy in North Adelaide, our Falls Prevention Program is designed to identify the individual factors contributing to your balance and physical capacity.
Rather than providing everyone with the same generic balance program, we assess your strength, balance and mobility and develop an exercise program around your individual findings.
Depending on your needs, this may involve physiotherapy appointments, supervised exercise or an individually prescribed home program.
Our goal is to help you build the physical capacity and confidence required to remain active and independent.
If you've noticed that you're becoming more unsteady as you get older, you don't necessarily have to wait until you have a fall before doing something about it.
Understanding why your balance is changing is a good place to start.
This article provides general information only and does not replace individual medical or physiotherapy advice. New or sudden balance problems, dizziness, neurological symptoms or unexplained falls should be appropriately medically assessed.
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