Balance Training for Seniors – What You Need to Know

Many people, especially younger people, take balancing for granted, but it is actually pretty complicated. Balance is a complex coordination of muscles, joints, the brain, the eyes, and the inner ears. 

As people get older, your ability to balance declines for several reasons. The good news is that it’s possible to slow or even reverse some of this decline. Specific training for balance helps people stay active as they get older and reduces the risk of falls. Simple exercises targeting balance can make a big difference. 

The Importance of Balance Training for Seniors

Specific exercises can improve balance in older adults. Training for balance helps reverse natural declines in balance control and helps seniors stay active and safe. 

Balance Control and Stability Decline with Age 

The ability to balance decreases with age for several reasons: 

• Muscle mass decreases with age, and strength, especially in the core, is necessary to keep the body upright. 

• Tissues in the joint also weaken and stiffen with age. The joints respond to changes in movement to maintain balance. 

• Sensory factors also decline with age, including vision and hearing, which are important for taking in information that helps with balance. 

• The ability of the central nervous system to input, process, and respond to this information also decreases with age.  (1)

Balance can also be affected by specific health conditions that are more prevalent in older adults, including stroke, Parkinson’s disease, arthritis, cataracts, macular degeneration, and nerve damage. Some medications, like antidepressants, anti-anxiety medications, and blood pressure medications, impact balance too. 

Loss of muscle mass with age is a major source of disability. Check out this guide to strength training for seniors to help clients slow and reverse age-related muscle loss. 

Poor Balance Control Leads to Falls and Fear of Falls

Loss of balance with age is a serious risk factor for health problems, both mental and physical. The primary concern is that poor balance can lead to falls. A fall can obviously be dangerous, but there is another issue: fear of falls. 

Older adults often fear falling, whether they have experienced a previous fall or not. This fear has its own set of damaging consequences. It often prevents older adults from being active, which can lead to an even greater decline in physical fitness and balance. Limited physical activity also puts individuals at greater risk for certain health conditions, like diabetes, and even loneliness. (2)

The Danger of a Fall for Older Adults

Fear of falling is legitimate because the repercussions can be serious. A fall can be dangerous for anyone, but for an older adult the outcomes are often more severe. Falls can cause serious injuries, including fractures. They can result in chronic pain, disability, and even death. Overall, falls often lead to a decrease in quality of life in seniors. (3)

Exercises to Improve Balance

Studies show that a natural decline in balance begins as early as age 50. (4) Balance training early can help mitigate later health issues and accidents. Any physical activity helps maintain and improve balance. Some seniors, though, can benefit from specific exercises that build balance. 

If you are a trainer working with older clients, assess them carefully before creating a balance program. Some clients might need to start at the beginning with very basic exercises, while others can do more advanced balancing movements. These exercises begin with the easiest and become more advanced. 

Standing with Good Posture

This might seem very basic, but for anyone with severely impaired balance, it’s a good starting pose. Simply stand with good posture and maintain balance. You can start with feed wider and bring them in close, like mountain pose in yoga, as balance improves. 

Head Rotations

Neck mobility is essential for taking in sensory information and balancing. For this simple exercise, stand with feet hip-width apart and with good posture. Slowly move the head side to side and then up and down, following the motion with the eyes. 

Sit-to-Stand

A sit-to-stand exercise is like a squat but using a chair for stability. This is a safe way to strengthen the legs and core. Have your client use a chair or bench with something in front of them to grab for balance if needed. Stand from a sitting position with good squat form. Add weights as they progress. 

Try these additional exercises to help older clients build lower body strength.

Tightrope Walk

Work on balance, posture, and core strength with this simple exercise. Create or find a line on the floor. With arms extended out to the side, walk along the line, placing one foot directly in front of the other. Do this slowly, pausing on each step with one foot in the air. To progress, move the arms down to the side of the body or place them on the hips. 

Walking Head Rotations

Combine head movements with walking to improve sensory input and balance. Begin walking slowly and turn the head to the left, looking over the left shoulder. Continue five more steps, then turn the head to the right. Walk with your client to help them in case they lose balance. 

March in Place

Standing in one place, lift the left knee up toward the chest. Lower it and lift the right knee up. This slow, balanced movement improves lower body and core strength. 

Single-Leg Standing

Progress to balancing on one leg at a time. Stand with good posture and balance with feet shoulder- or hip-width apart. With balance, lift the arms out wide to each side and raise the right leg forward. Hold the pose and then repeat on the other side. 

Tree Pose

This yoga pose is a little more challenging than a basic single-leg stand. Start on both feet and lift the right foot up, turning the bottom of the foot in. Place the bottom of the right foot against the left leg. Hold the pose with hands in front of the chest or with one hand on a chair or other stable surface, if necessary. 

Walking Lunges

For stronger clients, or those who have progressed, add lunges to increase lower body and core strength. Lunges also build functional balance. When someone begins to lose balance while walking, they tend to reach one foot forward. Practicing balancing while doing walking lunges makes it easier to recover from a wobble. 

Dead Bugs

Any core strengthening exercise will help senior clients develop better balance. Dead bugs are gentle, modifiable, and safe. Lying on a mat on the back, raise arms straight up in the air. Raise the legs, creating a 90-degree angle at the hips and knees. Press the lower back into the mat. 

Slowly lower the right arm back behind the head while also extending the left leg. Repeat with the other sides. You can modify this by minimizing the movement of the arms and legs. Only move them as far as possible while still pressing the lower back into the mat. You can also keep one foot flat on the floor while the other extends. 

Make Balance Training Safe

Older clients with existing balance issues could fall and be injured while trying to improve balance. Help them stay safe as they make progress. An initial assessment of balance will help you begin with the most appropriate exercises. 

During balance training, make sure your client has something stable nearby. They should be able to easily grab this to maintain balance if they feel like they might fall. Talk to clients about how to do exercises at home so they can be safe even when you’re not supervising. 

Good balance is important at any age, but if you are a trainer working with older adults, it is essential. Add these and other exercises to a strength training routine to help your clients enjoy better health and quality of life as they age. 

The ISSA’s Certified Personal Trainer – Self-Guided Study Program is a great place to start your fitness career. With this foundational certification, you can start working and also train for specializations, like senior fitness. 

References

1. Konrad, H. R., Girardi, M., & Helfert, R. (1999). Balance and aging. The Laryngoscope, 109(9), 1454–1460. https://doi.org/10.1097/00005537-199909000-00019 

2. Delbaere, K. (2004). Fear-related avoidance of activities, falls and physical frailty. A prospective community-based Cohort Study. Age and Ageing, 33(4), 368–373. https://doi.org/10.1093/ageing/afh106 

3. Masud, T., & Morris, R. O. (2001). Epidemiology of Falls. Inspectapedia. https://inspectapedia.com/Stairs/Epidemiology-of-Falls-Masud.pdf 

4. Balance begins to decline as early as age 50. UCLA Health. (2022, May 23). https://www.uclahealth.org/news/balance-begins-to-decline-as-early-as-age-50