Why Seniors Should Improve Balance
3 million older adults are hospitalized annually for fall-related injuries (CDC, 2020).
But falling isn’t inherently dangerous…
If you’re a grandparent of a toddler, you might see your grandchild fall regularly without suffering a serious injury. Athletes also hit the ground often during their sports, usually without suffering a severe injury.
However, for older adults, falls often have severe consequences.
And one way to prevent those falls… balance!
One in every four older adults suffers a fall every year (CDC, 2020). Many of these falls lead to fractures, typically at the wrist or hip. About 95% of hip fractures are caused by falls (CDC, 2020).
The added danger of falling for older adults is due to the presence of weaker, more hollow bones. We lose bone tissue throughout adulthood. Falling can push a weaker bone over the threshold of what it can endure, leading to a fracture. The lack of activity which follows a fracture can subsequently cause a steep and fatal health decline, hence why so many older adults die following a hip fracture.
Strengthening the bones is important, but it’s not enough. There’s another key area to focus on: balance. Balance declines with age, but it can be improved (El-Khoury et al., 2013). Having sufficient balance will greatly reduce the risk of falling and, therefore, reduce the risk of suffering a severe injury..
As you read this, you might wonder, “is my balance poor?” If so, “how can I improve it?” Keep reading!
How Can I Assess My Balance?
Balance is a tricky concept when considering it’s not as obvious as strength, which can be assessed by simply moving a piece of furniture or lifting a heavy box. A simple way to assess your balance is to perform the “Single Leg Stance” or “One-Legged Stance Test” (Agility Lab, 2013). This is a test of how long you can stand on each leg. Here’s how you can perform it:
- Stand in a space where you can reach something (a counter, table, or other sturdy structure) if needed.
- Keep your eyes open and arms on your hips.
- Lift one leg off the ground and keep it elevated. Start a timer as soon as your leg leaves the ground.
- Stop the timer when the elevated leg/foot hits the ground OR when either of your hands leave your hips.(If you reach a minute, you can stop. Your balance is great and anything beyond a minute isn’t necessary to measure).
- Perform the test again, but with the other leg.
Fall risk is considered “high” when a person can’t stand for more than five seconds on a leg. If your time on either leg is short, consider re-testing every few weeks as you aim to improve your balance.
Strategies For Improving Balance
Strength Training
Strength training seems to be the closest thing to the existence of an “anti-aging” treatment. As you might expect, strength training also helps fight the age-related effects on balance. About 70% of the 107 studies analyzed in a research review showed that strength training decreased older adults’ fall rate (Cadore et al., 2014). Two studies showed that strength training’s ability to improve balance extended to those in their 80s and 90s (Cadore et al., 2014; Serra-Rexach et al., 2011).
What is it about strength training that makes it so important for balance? One reason is the impact on muscles surrounding critical standing and walking joints. When strengthening the glutes (butt), quadriceps (front thighs), and hamstrings (back of the thighs), people can more effectively control and move their bodies, even when walking in unstable areas.
Several leg exercises are key for balance. The leg press is most important due to its ability to strengthen the largest leg and hip muscles (quadriceps and glutes). Other helpful exercises are the leg curl (hamstrings), leg extension (quadriceps), hip abduction (glutes), and calf raises (the calves can improve balance through better control of the ankle joint).
Core Strength
However, it’s not just training the legs that explains strength training’s benefit for balance. Strengthening “core” muscles is also a big contributor to balance. Training deeper midsection muscles, specifically the transverse abdominis and lower back muscles, enhance stability (Kang, 2015). The midsection muscles play a big role in posture and ensuring that our body weight is evenly distributed among our legs, avoiding an excessive lean in one direction that could encourage falling (Kang, 2015).
To strengthen these midsection muscles, a few exercises are recommended. A plank or dead bug exercise can enhance the strength/endurance of the transverse abdominis. To strengthen the lower back muscles, the most effective method is to use the lower back machine. If one is not available, you can use the superman or bird dog exercise.
Balance Training
“Balance training” is an umbrella term used to describe many simple activities people can participate in to improve balance. They improve balance to a similar degree that strength training does (Zech et al., 2010). The research shows that balance training is most beneficial when performed at least 30 minutes per workout at a frequency of three sessions per week (Lesinski et al., 2015).
Balance training includes a number of activities, including the following:
- The Star Excursion Balance Test, which involves hopping on one leg.
- Standing on one leg on a hard surface.
- Standing on one leg on an unstable board.
- The Walk and Turn test, which is walking on a straight line.
Takeaways
Falling is a big concern for older adults. We lose bone strength over time, which makes us increasingly likely to fracture bones when falling. We can help avoid these issues by strengthening out bones (through strength training), but improving our balance is also critical.
Balance can be improved through a few methods: strengthening our legs, deeper abdominal and lower back muscles, and by performing walking and single-leg standing activities. When performing some or all of these, we can reverse the age-related impact on balance.