There are many important factors to consider when thinking about healthy aging, not the least of which is fall risk.
One in four adults over 65 falls each year, according to Centers for Disease Control data, and many of those people require hospitalization, medical attention or lifestyle changes due to injury.
“One of the biggest issues that we worry about as geriatricians in older adults is falls because they can cause a lot of injuries,” said Dr. Maureen Dale, an associate professor of geriatric medicine at the University of North Carolina at Chapel Hill School of Medicine.
Falls can cause hip fractures, vertebral fractures or worse, all of which can hugely impact day-to-day life for older adults, she added. “And so preventing falls is really important in our patients as we age, and one of the best ways to prevent falls is to make sure people have good balance.”
This is particularly important for post-menopausal women who may have low bone density, said Dr. James F. Wyss, a spine and sports medicine physiatrist at the Hospital for Special Surgery in New York.
“Lots of times, the focus on preventing a fracture is addressing bone density and strength training. But the greatest way to prevent a fracture is to prevent a fall,” Wyss said. “Sure, it’s great if you can get your bones stronger through strength training or a medication, but if you don’t fall, you’ve eliminated the risk altogether.”
Being able to balance for a few seconds is fine, but research shows that adults should be able to balance for longer. Here’s what to know.
You should be able to balance on one foot for at least 10 seconds.
“People should be able to stand on one foot for about 10 seconds and be able to hold their balance,” Dale said. “If they can’t do that, that’s worth talking to their primary care provider or physician about to think about things that they can do.”
There are often medical interventions that can improve balance, she noted.
While 10 seconds is the goal, the longer you can balance — even up to 30 seconds — the better, noted Janice McGrail, a physical therapist at Mass General Brigham’s Spaulding Rehabilitation.
Not being able to balance for 10 seconds can signal potential health issues.
Research shows that if you can’t balance for 10 seconds, you’re at a higher risk of falls, according to Wyss. And if you can’t hold your balance for five seconds, you are at an even higher fall risk.
Being unable to stay steady on one leg can also be a sign of other medical issues.
“Sometimes it’s just that people have a little bit of weakness in their leg muscles and need to work on an exercise program or a physical therapy program that focuses on strengthening those leg and core muscles that help support our balance,” Dale said.
Stability issues may be caused by medications, Dale noted. Certain vitamin deficiencies can also be the culprit, Dale added, such as a vitamin B12 deficiency.
“And then sometimes we find that people have sensory changes, so decreased sensation in their feet and legs that can impact their balance as well,” Dale noted.
Your doctor can help determine the cause of your balance issues and work with you toward a solution.
“There are a lot of things that we can do to help support and promote healthy balance in people. So that’s why the starting point really is talking to your primary care provider,” Dale explained.
There are ways to safely practice balancing at home and ways to prioritize it throughout your life.
It’s simple to start working on your balance — as long as your doctor says it’s safe to do so.
You can begin by building balance work into daily habits such as standing on one foot as you brush your teeth or as you wait for your lunch to heat up in the microwave, according to McGrail.
Depending on how steady you feel, you can also try standing with one foot in front of the other like you’re walking on balance beams.
It’s important to practice this safely so you don’t end up falling, McGrail said.
“When I’m giving someone an exercise to do at home for balance, I always tell them to stand at the kitchen counter [if you’re microwaving food] or at the sink counter if you’re brushing your teeth … so that you have something in front of you that you can hold on to if you need to,” McGrail said, adding that you should also put a chair behind you so that if you fall backwards, you “can just sit in the chair rather than ending up on the floor.”
If you aren’t ready to try standing on one foot, you can practice balancing by walking on your toes or heels throughout your house, Wyss said.
Folks who can easily balance on one leg while brushing their teeth or microwaving food can take it one step further and incorporate balance into their workout regimen, such as doing bicep curls while balancing on one foot, Wyss suggested.
“It’s 40s, 50s that I start tell people, ‘All right, start incorporating a little more balance training into your routine,’” Wyss explained.
Regular exercise three times a week is also a good way to improve and maintain your balance, according to Dale. Additionally, programs like tai chi, yoga and a physical therapy program known as Otago have been shown to also improve stability.
It’s never too late to work on your balance, McGrail stressed. As long as you’re up and moving, you can make small steps to improve it.
If you need support from a doctor or physical therapist, reach out and they can help prescribe you a safe balance-building program. Even if you’re not yet at an age where you worry much about balance, it’s still important to see your doctor regularly and manage any chronic medical issues that could contribute to balance issues down the road, Dale said.
“Making sure that we’re managing diabetes and heart disease and vascular disease are important things to keep us healthy now and to keep us healthy and well-balanced later,” Dale said.