Exercises to improve balance and prevent falls

Why balance changes as we get older — and what helps

Most of us take steady feet for granted until something changes. From around our sixties, muscle strength, reaction times and the small sensory signals from our feet and ankles begin to fade. Add a slippery path, a loose rug or a moment of distraction, and the risk of a fall rises sharply.

The encouraging news is that balance is a skill you can train. Physiotherapists working with community health and social care teams across East Anglia are clear on this point: strength and balance exercises can reduce the risk of falls by around a third, and often more for people who keep them up consistently. The key is doing a little, often, and making it part of your day rather than a one-off burst of effort.

Below are three approaches recommended again and again by local falls prevention teams — one you can do from a chair, one that builds standing confidence, and one that brings movement, breathing and company together.

Seated leg raises: a safe starting point

If standing feels uncertain, or you are recovering from illness or surgery, seated exercises are a sensible first step. They build the thigh and hip strength you rely on when standing up from a chair, getting out of a car or stepping off a kerb.

Sit towards the front of a firm, upright chair with your feet flat on the floor and your back supported.

• Straight leg raise: straighten one leg slowly in front of you, hold for three to five seconds, then lower. Aim for eight to twelve on each side.
• Knee lift: lift one knee as high as is comfortable, pause, and lower. This works the hip muscles that steady you when you turn.
• Heel and toe taps: tap your heels, then your toes, lifting the whole foot each time. These strengthen the ankles, which do much of the quiet work of balance.
• Sit to stand: when ready, stand up and sit down without using your hands, using a stable chair against a wall.

Rest between sets, breathe normally, and stop if you feel dizzy or short of breath.

Heel-to-toe stands and slow walking

Standing balance improves when you challenge it gently. Always do these near a kitchen worktop or a sturdy rail so you can steady yourself with a fingertip.

• Heel-to-toe stand: place one foot directly in front of the other, heel touching toe, and hold for ten to twenty seconds. Swap feet and repeat.
• Single-leg stand: shift your weight onto one foot and lift the other just off the floor. Build up from five seconds at a time.
• Heel-to-toe walking: take slow, deliberate steps as though on a tightrope, along a hallway or between two counters.
• Head turns: once steady, practise turning your head slowly from side to side while standing. This mimics real life and trains the inner ear.

Little and often beats long sessions. Two or three short practices a day, a few minutes each, is plenty — and far easier to fit around a cup of tea.

Tai chi: slow movement, real confidence

Tai chi is one of the few activities with strong evidence behind it for reducing falls. Its slow, controlled weight shifts train the ankles, hips and attention all at once, and the breathing settles the nerves that make us snatch at furniture when we wobble.

Many community health and social care teams in East Anglia run or signpost classes, and local physiotherapists often recommend them as a follow-on from one-to-one work. Sessions are usually held in village halls, community centres and church rooms across Norfolk, Suffolk, Cambridgeshire and the surrounding area, and plenty are seated-friendly. The social side matters as much as the movement — turning up each week keeps you consistent and makes it something to look forward to.

Getting the right support

If you have already had a fall, feel unsteady, or take medication that makes you dizzy, speak to your GP or ask about a referral to a community physiotherapist or falls prevention service. Many areas offer home assessments and can check your eyesight, footwear, medication and home hazards alongside exercise.

Contact your local council's adult social care team or a community hub if transport, class costs or simply getting out of the house are barriers. There is often help available, including seated classes, escorted transport and home visits. It is worth asking — you will not be seen as a nuisance.

Making it a daily habit

The people who benefit most are rarely the ones doing the most exercise. They are the ones still doing it six months later. A few simple habits help:

• Attach it to something you already do — leg raises while the kettle boils, heel-to-toe stands while brushing your teeth.
• Keep a note of what you did each day on the fridge or a calendar; seeing the ticks build up is surprisingly motivating.
• Find a partner — a neighbour, spouse or friend who practises alongside you, in person or by phone.
• Review your home as you get stronger: secure loose rugs, tidy trailing cables, and add a night light between bed and bathroom.
• Wear supportive, well-fitting shoes indoors as well as out, and keep up with eye tests.

Progress can feel slow, but it is real. Give it a few weeks and you may notice you are standing up from the sofa without pushing off, or crossing the garden path without watching every step. That quiet return of confidence is exactly what this work is for.