Why Is It Harder to Balance With Your Eyes Closed?

Have you ever tried standing still, closing your eyes and suddenly noticed that you begin to sway?

For many people, particularly as they get older, balance becomes considerably more difficult as soon as they can no longer use their vision.

This isn't necessarily because your eyes are the problem.

Instead, closing your eyes removes one of the important sources of information your brain uses to keep you balanced. Your body must then rely more heavily on your vestibular system (inner ear) and proprioception to work out where you are and keep you upright.

As physiotherapists, how your balance changes when your eyes are closed can therefore provide useful information about the way your balance systems are functioning.

In the video below, we demonstrate why closing your eyes can make maintaining your balance significantly more challenging.

https://youtu.be/dP6QZDeU7S8

What actually controls your balance?

Balance is much more complicated than simply having "strong legs".

Your brain is constantly receiving and processing information about your body and the environment around you. Three sensory systems play particularly important roles:

1. Your visual system

Your eyes provide your brain with information about your surroundings and your position relative to objects around you.

If you're standing in a room, for example, your brain can use walls, furniture and other stationary objects as visual reference points.

Vision can therefore provide a powerful source of information to help you remain stable.

2. Your vestibular system

Your vestibular system is located within your inner ear.

It provides your brain with information about the position and movement of your head, including changes in acceleration and direction.

This system becomes particularly important when your visual information is limited or when your head and body are moving.

3. Proprioception

Proprioception is your body's ability to sense its position and movement without having to look at it.

Receptors throughout your muscles, joints and other tissues continually provide your brain with information about where different parts of your body are positioned.

For example, you don't normally need to look at your feet to know whether they are flat on the floor.

Your brain combines information from your vision, vestibular system and somatosensory/proprioceptive system to help maintain postural control. Research examining balance in older adults similarly describes effective balance as requiring integration of these different sensory inputs.

So why does closing your eyes make balancing harder?

When you close your eyes, you haven't suddenly lost your balance.

You've removed one of the three major sources of sensory information your brain was using.

Your brain must now place greater reliance on information coming from your inner ear and your proprioceptive system.

If those systems aren't providing sufficiently accurate information — or your brain isn't integrating that information as effectively — you may notice considerably more sway or difficulty maintaining your position.

This is also why balance isn't always the same in every environment.

Someone may feel perfectly confident walking around their home during the day but feel much less stable:

• walking to the bathroom during the night

• moving around in poor lighting

• walking on grass or uneven ground

• standing on a soft or unstable surface

• turning their head while walking.

Each situation changes the quality or availability of the sensory information your brain has available.

Does balance become more reliant on vision as we get older?

It can.

Ageing can affect multiple components involved in maintaining balance, including strength, reaction time, proprioception, sensory processing and the vestibular system.

Research suggests that older adults can demonstrate greater reliance on visual information for postural control, with balance deteriorating more noticeably when vision is removed.

This is one reason someone may say:

"My balance is fine during the day, but I feel much less confident at night."

Reduced lighting removes some of the visual information they have been relying on.

From a physiotherapy perspective, this is important.

If we only assess someone's balance in a well-lit room with their eyes open, we may not be challenging the balance system enough to understand where their difficulties are coming from.

Does struggling with your eyes closed mean you're at risk of falling?

Not necessarily.

An eyes-closed balance exercise shouldn't be considered a stand-alone test that determines whether somebody will fall.

Falls are multifactorial.

Strength, walking ability, medications, medical conditions, vision, cognition, previous falls, environmental hazards and many other factors can contribute to an individual's falls risk.

Research into clinical balance testing supports using a broader assessment rather than relying on one balance condition alone.

However, if you've noticed a significant deterioration in your balance, experienced falls or near misses, or you're becoming increasingly dependent on furniture or walls for support, these changes are worth investigating.

Why a balance assessment should test more than standing on one leg

At Body Fit Physiotherapy, our approach to falls prevention is to determine why an individual is having difficulty with their balance, rather than simply giving everyone the same set of balance exercises.

During a balance and falls assessment, we can look at areas such as:

• previous falls and near misses

• lower-limb strength

• functional capacity

• walking ability

• balance under different conditions

• the influence of vision

• proprioceptive input

• vestibular contribution

• existing injuries, pain or physical limitations.

The goal is to establish where your individual deficits lie.

We can then use this information to develop an exercise program that specifically challenges the areas that need improvement.

Can you actually improve your balance?

For many people, yes.

Balance isn't simply something that inevitably disappears as you get older.

Like strength and cardiovascular fitness, aspects of balance can be challenged and trained.

A 2024 systematic review examining sensorimotor and proprioceptive exercise in older adults found improvements across several commonly used measures of balance, although the authors rated the certainty of the evidence as low to very low and highlighted the need for further high-quality research.

More broadly, the evidence supporting appropriately designed exercise for falls prevention is strong.

The World Health Organization identifies gait, balance and functional training among the interventions used to prevent falls in older people. Its falls-prevention guidance describes targeted exercise that challenges balance and develops functional lower-limb strength as an effective physical activity intervention for community-dwelling older adults.

The current Australian physical activity recommendations for people aged 65 and over also recommend:

• muscle-strengthening activities on at least 2 days per week

• functional activities targeting mobility, balance and coordination on at least 3 days per week.

The important part is making sure the exercise is appropriately challenging and progressed over time.

Should I practise standing with my eyes closed at home?

Not automatically.

Closing your eyes can make an exercise substantially more difficult because you're deliberately removing visual information.

For somebody with good balance, this may form part of an appropriately progressed balance program.

For someone who already has significant balance difficulties or a history of falls, however, simply closing their eyes and trying to "hold on" could unnecessarily increase their risk of falling.

Balance exercises should be selected according to your current ability and progressed appropriately.

Sometimes the most useful starting point isn't making an exercise harder — it's determining why your balance has deteriorated in the first place.

Balance problems are worth addressing early

You don't need to wait until you've had a serious fall before doing something about your balance.

Near misses, increasing reliance on handrails, difficulty getting up from the floor, avoiding uneven surfaces or feeling less confident in the dark can all be reasons to take a closer look at your physical capacity.

Falls are a significant health issue for older adults, and the World Health Organization identifies older age, physical inactivity, loss of balance, poor mobility and vision problems among factors associated with falls.

The encouraging part is that many of the physical factors contributing to falls can be assessed and, where appropriate, trained.

Falls Prevention Physiotherapy in Adelaide

At Body Fit Physiotherapy in North Adelaide, our Falls Prevention Program is designed to identify the individual factors affecting your balance, strength and mobility.

We begin with a detailed assessment before measuring important areas of physical capacity and challenging your balance under different conditions.

From there, we develop an individualised strength and balance program based on what we find.

The aim isn't simply to become better at a particular balance test.

It's to build the strength, balance, confidence and physical capacity you need to remain active and independent in everyday life.

If you've noticed your balance changing, have experienced a fall or near miss, or simply want to understand where your current physical capacity sits, we're happy to help.

Body Fit PhysiotherapyNorth Adelaide, South Australia

This article provides general information only and isn't intended to replace individual medical or physiotherapy advice.