Why Am I Losing My Balance as I Get Older?
Updated: Sep 2
Noticing that your balance isn’t quite what it used to be can be unsettling.
Perhaps you feel less steady when walking on uneven ground. You might find yourself reaching for furniture around the house, struggling more when you close your eyes in the shower, or feeling less confident stepping off a curb.
For some people, the first indication is a near fall or an actual fall.
While changes in balance become more common as we get older, poor balance shouldn’t simply be dismissed as a normal part of ageing.
Balance is a complex physical skill that relies on several systems working together. Understanding which of these systems is changing can help determine what you can do to improve your balance and reduce your risk of falling.
At Body Fit Physiotherapy in North Adelaide, this is one of the key principles behind our Falls Prevention Program: rather than simply giving everyone the same balance exercises, we want to understand why an individual is becoming less steady in the first place.
Why does balance get worse with age?
There isn’t one single “balance muscle”.
Your ability to remain upright depends on your brain constantly receiving information about where your body is and then coordinating the appropriate muscular response.
Several systems contribute to this process, including:
Muscle strength
Vision
Your vestibular system or inner ear
Proprioception
Coordination and reaction time
Walking ability and general physical capacity
Changes in one or several of these areas can make maintaining your balance more difficult.
1. Loss of leg strength
One of the biggest physical changes that can occur with ageing is a gradual reduction in muscle mass, strength and power.
This matters because your legs don't just help you walk.
They also need to respond quickly when your balance is challenged.
Imagine stepping unexpectedly onto an uneven surface. Your body needs to recognise that you are becoming unstable and then generate enough force through your legs to correct your position.
If your legs aren't strong enough — or cannot generate that force quickly enough — recovering your balance becomes harder.
Leg weakness can also make everyday activities such as getting out of a chair, climbing stairs and getting up from the floor more difficult.
This is why appropriately prescribed strength training is an important component of many falls prevention programs.
2. Changes in your vision
Your eyes provide your brain with an enormous amount of information about your surroundings and your body's position within them.
As we get older, we can become increasingly reliant on this visual information to maintain our balance.
This can explain why someone may feel reasonably steady during the day but suddenly feel much less confident:
Walking at night
Moving through a dark room
Closing their eyes in the shower
Walking somewhere with poor lighting
If removing visual information makes your balance significantly worse, it may indicate that your other balance systems aren't contributing as effectively as they could.
This is one reason we assess balance under different conditions rather than simply asking someone to stand still with their eyes open.
3. Changes in your inner ear
Your vestibular system is located within your inner ear and plays an important role in balance and spatial orientation.
It helps your brain understand how your head is moving and where it is positioned.
Your vestibular system works closely with your vision and proprioception to help keep you upright.
Age-related changes to the vestibular system can contribute to reduced balance in some older adults. However, dizziness and balance problems can have many causes, so new, significant or unexplained symptoms should be appropriately assessed rather than automatically attributed to ageing.
4. Reduced proprioception
Proprioception is essentially your body's ability to recognise where it is in space without having to look.
Receptors in your muscles, joints and other tissues continuously send information to your brain about your body's position.
For example, when you're standing, you don't normally need to look at your feet to know where they are.
Changes in sensory information from the feet and lower limbs can make it harder for your brain to accurately understand your body's position.
This can become particularly noticeable when walking over uneven surfaces or when visual information is reduced.
Your vision, vestibular system and proprioception therefore work together.
If one system becomes less effective, your body may rely more heavily on the others.
5. Slower reactions
Balance isn't just about your ability to stand still.
One of the most important components of balance is your ability to react when something goes wrong.
If you trip, slip or unexpectedly lose your balance, your body has to respond quickly.
You may need to take a rapid step, move your foot into a different position or generate enough force through your legs to stop yourself falling.
As we get older, reductions in muscle power and reaction speed can make these corrections more difficult.
This is why a good balance program may need to progress beyond simply standing on one leg.
Is losing your balance a normal part of ageing?
Some changes in the systems responsible for balance are associated with ageing.
However, that doesn't mean progressively worsening balance should simply be accepted.
There is an important difference between recognising that ageing can affect balance and assuming that nothing can be done about it.
Physical inactivity can compound age-related changes.
someone begins feeling unsteady, they may naturally start avoiding activities they are worried about.
They walk less.
They stop going to certain places.
They avoid stairs or uneven surfaces.
They may stop exercising.
Unfortunately, reducing activity can contribute to further losses in strength and physical capacity, potentially making the original problem worse.
This is why identifying declining balance early can be valuable.
Is walking enough to improve my balance?
Walking is excellent exercise and we encourage older adults to remain as physically active as possible.
However, walking alone may not address all the physical components required for good balance.
For example, walking may not provide enough resistance to significantly improve leg strength in someone who is already weak.
Similarly, normal walking doesn't necessarily challenge your vestibular system, proprioception or reactive balance sufficiently to produce the adaptations you need.
For many people, the best approach is to combine regular physical activity with specific strength and balance exercises appropriate to their current ability.
What exercises are best for improving balance as you get older?
There isn't one best balance exercise for everyone.
The appropriate exercise depends on what is contributing to your balance problem.
Someone with significant leg weakness may require a greater emphasis on progressive strength training.
Someone who becomes very unstable when visual information is removed may require different balance challenges.
Another person may have good strength but struggle to react quickly enough when their balance is unexpectedly challenged.
A comprehensive program may include exercises targeting:
Calf strength
Quadriceps strength
Hip strength
Sit-to-stand ability
Different standing positions
Reduced visual input
Changes in surface
Stepping reactions
Walking and turning
Functional tasks
General cardiovascular capacity
The important word is progressive.
If an exercise is too easy, it may not provide enough stimulus for your body to adapt.
If it is too difficult, it may be unsafe or reduce your confidence.
The goal is to find the appropriate challenge and gradually progress it as your ability improves.
How does physiotherapy help with poor balance?
A physiotherapy balance assessment should help answer a more useful question than simply:
“Do I have bad balance?”
We want to know:
“What is contributing to my poor balance?”
At Body Fit Physiotherapy, our Falls Prevention assessment looks at your individual history, including previous falls, near falls, medical conditions, injuries and activities that you are finding difficult.
We can then assess areas such as your lower-limb strength, balance under different conditions and, where appropriate, your walking capacity.
This information helps us identify areas that may need greater attention within your exercise program.
The aim isn't simply to make you better at performing balance tests in the clinic.
We want improvements to translate into everyday life — whether that's walking confidently outside, using stairs, getting up from the floor, playing with grandchildren or continuing to live independently.
When should I get my balance assessed?
You don't necessarily need to wait until you've had a serious fall.
Consider seeking an assessment if you've noticed:
Increasing unsteadiness
Regular near falls
A recent fall
Needing to hold onto furniture when walking
Difficulty walking in the dark
Reduced confidence outside the home
Increasing difficulty with stairs
Difficulty getting out of a chair
Difficulty getting up from the floor
Reduced leg strength
Avoiding activities because you're worried about falling
A noticeable or sudden change in balance can also have causes that require medical assessment. New severe dizziness, fainting, weakness, numbness, changes in speech or vision, severe headache, chest symptoms or a sudden inability to walk normally should be medically assessed promptly rather than treated simply as an age-related balance problem.
Falls Prevention Physiotherapy in Adelaide
If you're asking yourself “Why am I losing my balance as I get older?”, the answer may involve several different factors rather than one simple cause.
Ageing can affect muscle strength, vision, vestibular function, proprioception and your ability to react when you become unstable.
But many physical contributors to balance can be assessed and trained.
At Body Fit Physiotherapy in North Adelaide, our Falls Prevention Program is designed to identify the areas contributing to your balance difficulties and develop an individualised strength and balance program around your needs.
The goal is not just preventing falls.
It's helping you maintain the strength, confidence and physical capacity to continue doing the things that are important to you.
If you've noticed a change in your balance or confidence, we're happy to discuss whether a
physiotherapy balance assessment may be appropriate for you.
To find out more about our falls prevention program:
References
Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. 2019;1.
Montero-Odasso M, van der Velde N, Martin FC, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing. 2022;51(9).
World Health Organization. Step Safely: Strategies for Preventing and Managing Falls Across the Life-Course. Geneva: World Health Organization; 2021.
Lesinski M, Hortobágyi T, Muehlbauer T, Gollhofer A, Granacher U. Effects of balance training on balance performance in healthy older adults: a systematic review and meta-analysis. Sports Medicine. 2015;45:1721–1738.
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