What Can Balance Training Do for You? [Exercise Progression Video]

Balance Exercise

What do a 15-year-old soccer player and an 85-year-old bridge player have in common? They can both benefit from balance training. Bobby’s goal is to prevent another ankle sprain. Edna’s goal is to prevent another fall. Whoever you are: young or old, fit or sedentary, athlete or office worker, you can benefit from balance training.

Let’s take a look at what systems in your body contribute to balance, why balance training is so important for different groups of people, and – most importantly – how you can improve your balance with a progression of exercises…

Balance Systems

Balance is controlled mostly by 3 systems in your body: the visual system, the vestibular system, and the somatosensory system.

To be able to maintain your body’s position, respond to changes, and perceive stimulation from your environment, all three of these sensory systems work together so you don’t fall flat on your face.

Vision is your body’s main source for gathering sensory information to maintain balance1. Even subtle clues you pick up subconsciously from your periphery give you a big advantage in being able to find your bearings. This becomes obvious when you try to balance with your eyes closed – things become much more unsteady.

The vestibular system – a part of the inner ear – works together with the visual system to maintain postural control2, especially when coordinating movement with balance. When you have to alter your position, you rely mainly on your visual and vestibular systems3.

Your somatosensory system is what helps you maintain a normal, quiet standing posture. By relying on sensation and proprioception from your surroundings, the somatosensory system gains input to help your body become aware of its sense of position, movement, and balance4.

Balance Training Can Help Prevent Falls in the Elderly

We reach our peak of being able to control balance late in adolescence and can maintain this until about the age of 605.

Unfortunately, as we age, our sensory systems begin to decline6,7,8,9 and balance becomes more difficult.

Every year, 30% to 60% of elderly people fall. 10% to 20% of these falls end in serious injury or even death10.

This isn’t good. As a Physical Therapist, I’ve seen evidence that – with the right training – these numbers can decrease. A vast majority of falls are often preventable.

A recent systematic review showed that exercise programs for elderly people that include balance training can significantly reduce falls11.

To help reduce falls then, a recommendation would be to include exercises that challenge your balance at least 2 hours per week12. That’s 20 minutes per day, 6 days per week on an ongoing basis.

Balance Training Can Help Prevent Ankle Injuries In Athletes

Improved balance isn’t just for the elderly at risk for falls – young athletes are also at risk from poor balance causing ankle injuries.

I’ve played basketball my whole life. My first ankle sprain happened early in high school. Then I had my second, third, and the sprains continued throughout the next decade – in both ankles.

What I know now – that I wish I knew then – is that poor balance is associated with increased injury risk among athletes13.

It’s been shown that a balance training program will significantly reduce the risk of ankle sprains in high school soccer and basketball players14.

I also learned (the hard way) that once you sprain an ankle, it’s more likely you’ll sprain it again. Once injured, your joint’s proprioception becomes altered, making it more difficult for your brain to control the ankle and for your body to maintain control on top of the ankle.

Proprioception is your sense of the relative position of your body parts during movement.

Balance exercises can improve proprioception by training the brain to recognize the position of the body with different challenges placed on it15. This is true whether you’ve injured your ankles like me, or not16.

Test Your Balance

In case you’re wondering how your balance compares to others in your age group, the following is a list of norms for single leg stance time. The times represent the average time in seconds people within a particular age group can balance on one leg.

Give it a try.

A few rules: Keep your hands on your hips, don’t let the unsupported foot rest on your stance leg, and don’t let that foot touch the ground.

Table: Single Leg Stance – Age Matched Norms (University of Delaware)

Age in years Average time in seconds
20-29 30.0
30-39 30.0
40-49 29.7
50-59 29.4
60-69 22.5
70-79 14.2

If you try this a few times and become discouraged, there is good news: single leg stance has been shown to improve over the course of 6 months with balance training17.

I would argue, from my own experience, there can be much quicker improvements. For example, when I have someone do a single leg stance on a BOSU balance trainer for the first time, without fail, every single person wobbles to the point of embarrassment. By the end of the first session, if not the second, most people’s wobbles go away. The brain adapts quickly to new stimuli – the more you challenge it, the stronger the connections become.

Balance Training Progression Video

With all of the many benefits balance training provides, here is a short video that runs through a series of balance exercises.

Starting with the less challenging exercises and progressing to more difficult ones, I recommend you take it at your own pace.

The goal of balance training is to provide a moderate to hard challenge. If you can’t perform an exercise at a more advanced level, it wouldn’t be safe for you to keep trying it. I recommend, then, that you work on the previous level until your balance has improved.

For all of these exercises, please perform them in a safe place. I’ve found that facing a corner with a chair behind you is ideal. This way, if you fall forward or to either side, you can catch yourself against the wall with your hands. If you fall back, you can simply sit back in the chair. If you’re at a very low level of balance, you may want to have someone spot you as you exercise.

If any of the exercises cause pain or dizziness, stop and seek medical advice.

  1. Merla, J.L. & Spaulding, S.J. (1997). The balance system: Implications for occupational therapy intervention. Physical & Occupational Therapy in Geriatrics. 15(1):21-33. ↩︎
  2. Merla, J.L. & Spaulding, S.J. (1997). The balance system: Implications for occupational therapy intervention. Physical & Occupational Therapy in Geriatrics. 15(1):21-33. ↩︎
  3. Guerraz, M. & Bronstein, A.M. ( 2008) Ocular versus extraocular control of Posture and equilibrium. Clinical Neurophysiology, 38: 391-398. ↩︎
  4. Schaffer, S. & Harrison, A. ( 2007) Aging of the somatosensory system: A translation perspective. Physical Therapy, 87(2), 194-207. ↩︎
  5. Liaw, M. et al. (2008). Comparison of the static and dynamic balance performance in young, middle-aged, and elderly healthy people. Chang Gung Medical Journal. 32(3):297-304. ↩︎
  6. Poole, J. (1991). Age related changes in sensory system dynamics related to balance. Physical & Occupational Therapy in Geriatrics. 10(2):55-63. ↩︎
  7. Cohen, H. et al. (1996). Changes in sensory organization test scores. Age and Ageing. 25:39-44. ↩︎
  8. Cook A.S. & Woolacott, M. (2000). Attentional demands and postural control: the effect of sensory context. Journal of Gerontology: Medical Sciences. 55A(1): M10-M16. ↩︎
  9. Ricci, N.A. et al. (2009). Sensory interaction balance: A comparison concerning the history of falls of community-dwelling elderly. Geriatrics and Gerontology International. 9:165-171. ↩︎
  10. Rubenstein, L. (2006). Falls in older people: epidemiology, risk factors and strategies for prevention. Age Aging. 35:37-41. ↩︎
  11. Sherrington, C. et al. (2011). Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. NSW Public Health Bulletin 22(4):78-83. ↩︎
  12. Sherrington, C. et al. (2011). Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. NSW Public Health Bulletin 22(4):78-83. ↩︎
  13. McLeod, T., Armstrong, T., Miller, M., & Sauers (2009). Balance improvements in female high school basketball players after a 6 week neuromuscular training program. Journal of Sport and Rehabilitation, 18:465-481. ↩︎
  14. McGuine, T.A. & Keene, J.S. (2006). The effect of a balance training program on the risk of ankle sprains in high school athletes. The American Journal of Sports Medicine. 34(7):1103-1111. ↩︎
  15. Malliou, P. et al. ( 2004) Proprioceptive training (balance exercises) reduces lower extremity injuries in young soccer players. Journal of Back and Musculoskeletal Rehabilitation, 17:101-104. ↩︎
  16. Rozzi, S.L. et al. (1999). Balance training for persons with functionally unstable ankles. J Orthop Sports Phys Ther. 29:478-486. ↩︎
  17. Judge, J.O. et al. (1993). Balance Improvement in Older Women: Effects of Exercise Training. Phys Ther. 73(4):254-62; discussion 263-5. ↩︎
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