To improve your balance, you must practice a challenging balance activity. For your balance to continue to improve, you must keep upgrading to a more challenging balance activity of level.

You must look to gain the why (opportunity) and not just the how (activities) in order to have the knowledge to take control of your balance and strength.

Let’s take a look at three key areas to help you gain strength and balance, improve your ability to function, and ultimately help prevent falls.

Activities:       Your base of support is all parts of you that are in contact with the floor or something that’s holding you up. When you use your hands to support yourself, you increase your base of support. As you reduce your base of support, you increase the difficulty in balance.

Daily living:    Standing on one leg to put on your shoes, socks, pants, or even drying off after a shower.

Daily practice: While brushing your teeth, doing the dishes, or walking down the hallway

Mastery:          Tandem Stand, Tandem Walk, One-Leg Stand

Tandem Stand

This is best performed when you have access to stable support. Examples of support could be the kitchen counter, the bathroom vanity, or even a dining room table.

Instructions:
Place one foot directly in front of the other, touching heel to toe. Proceed to stand in place for a set period. Use support as needed.

Upgrading:

  • As you progress, close your eyes to challenge your balance.
  • As you progress, shift weight backward and forward.

Tandem Walk

This is best performed when you have access to stable support. Examples of support could be the kitchen counter or a dining room table. Hallways are also good as you can use the walls for support.

Instructions:
Place one foot directly in front of the other, touching heel to toe. Begin with good, upright posture and lengthen through your spine. Extend your arms out to your side. Keep your eyes on the horizon and use peripheral vision to observe the floor and space around you. Proceed to take 4 to 8 steps forward pretending you’re walking on a tight rope. Use support as needed.

Upgrading:

  • As you progress, you can cross your hands over your chest.
  • As you progress, you can add some type of weight to hold to your chest.

One-Leg Stand

This is best performed when you have access to stable support. Examples of support could be a chair, the kitchen counter, a bathroom vanity, or even a dining room table.

Instructions:

Stand on one foot for 10 seconds. Repeat as many times as desired on each leg. Use support as needed.  

Upgrading:

  • As you progress, use only one hand for support.
  • As you progress, use only one finger for support.
  • As you progress, use no hands.
  • As you progress, try closing your eyes.

Activities:       In order to have good balance, you need to be able to maintain your stability when you shift your weight as you move. If you can smoothly and safely shift your weight in either a sideways or forward or backward direction, you’ll be less likely to lose your balance.

Daily living:    When you reach for something that’s just beyond your reach, you shift your weight in one direction. For example, when you wash your hair, you shift your weight backward.

Daily practice: Brushing your hair, standing in line, or drying dishes.

Mastery:          Forward to Back and Right to Left

Forward to Back and Right to Left

This is best performed when you have access to stable support. Examples of support could be the kitchen counter or a chair.

Instructions:

Forward to Back
Stand with your feet shoulder-width apart and your arms at your side. Gently sway (lean) forward and then backward so that your weight shifts to your toes and then to your heels. Do not lift your toes or heels. Be sure that your shoulders and hips move together. Do not bend at your hips. Slowly increase how far you can sway forward and backward without taking a step. Do the toe-to-heel sway 20 times. Use support as needed. 

Right to Left

Stand with a chair in front of you and a wall behind you. If you begin to fall, you can use them for support. Stand with your feet shoulder-width apart and your arms at your side. Gently sway (lean) to the right and left so that your weight shifts from your right foot to your left foot. Do not lift your toes or heels. Be sure that your shoulders and hips move together. Do not bend at your hips. Slowly increase how far you can sway right and left without taking a step. Do the right‑to-left sway 20 times. Use support as needed.

Upgrading:

  • As you progress, you should try with your eyes closed.
  • As you progress, bring feet closer together.e

Activities:       Being able to safely and confidently step over objects is important in many situations. Stepping over objects requires one leg to work harder than the other for balance. Also, the ability to step forward and backward and right to left is necessary for stability when you shift your weight as you move.

Daily living:    Stepping over objects is part of everyday life. It’s likely that in your day-to-day activities you step over a cord, stairstep, spill on the floor, or even a threshold.

Daily practice: When stepping over thresholds

Mastery:          Stepping over Objects Forward to Back and Right to Left

Stepping over Objects Forward to Back and Right to Left

This is best performed when you have access to stable support. Examples of support could be the kitchen counter or a chair.

Instructions:

Forward to Back
Place a piece of paper or cloth on the floor. Step over the object in an exaggerated manner. You should lift your leading foot high, up, and over. The following foot needs to be lifted in an “up and over” manner. Pay attention to the foot that follows as it’s just as important as your lead foot. You should repeat this process while stepping backward. Please make sure to alternate the foot that you use to lead the step. Use support as needed.

Right to Left

Stepping over objects from right to left is performed the same was as forward and back except that it’s done right to left. Please make sure to alternate the foot that you use to lead the step. Use support as needed.

Upgrading:

  • As you progress, you should try with your eyes closed.
  • As you progress, use higher objects.

Helpful Hints to Enhance Upgrading

To improve your overall balance, you need to constantly challenge yourself. When you’re performing balance activities, think about ways to reduce the support you receive from your hands. This can be done gradually in the following ways:

Hint 1

  • Hold with two hands
  • Hold with one hand
  • Hold with fingertips, two fingers tips, one fingertip
  • Intermittent support—using support on and off or for just part of the time
  • No hand supports

Hint 2

Combining balance principles will challenge yourself. For example, when you combine the principles of reducing your base of support and shifting your weight, you’re challenging your balance limits. When you can shift your weight from foot to foot easily with your feet farther apart, you can challenge yourself by moving your feet closer together.

Hint 3

As you gain confidence, you can further challenge yourself and your balance ability by making a few small adjustments. As with all adjustments, it’s important to make them only when you understand your balance limits and do so in a safe manner. Closing your eyes makes it harder to balance. By practicing balancing with your eyes closed, you’re not just challenging yourself—you’re also preparing for situations where you find yourself in a darkened room or a poorly lit area.

Doing something else while trying to balance is another way to challenge your balance ability. Making the brain do more than one thing—such as talking to someone, carrying something, or performing a daily task—while performing balance activities is one way to challenge yourself while improving overall balance.

Additional Opportunities, Activities, and Daily Practice

Opportunity Bend Your Knees
Activity Bend knees
Daily practice Unloading the dishwasher or reaching for low items

 

Opportunity Sit to Stand
Activity Normal and low chair
Daily practice Getting out of chairs

 

Opportunity On Your Toes
Activity Toes-stand and walk

 

Daily practice Reaching for higher items or walking down the hall
Opportunity On Your Heels
Activity Heels-stand or walk
Daily practice While brushing your teeth or walking down the hall

 

Opportunity Up the Stairs
Activity Up stairs
Daily practice When using stairs for daily tasks

 

Opportunity Tighten Muscles
Activity Move ankles, bend/straighten knees, tighten and relax buttocks
Daily practice While watching TV, sitting, or playing cards

All activities and daily practice should be done with the proper level of support and at your own pace and risk.