Building better balance

Philip J. Goscienski, M.D.

March 2010

When you were 10 years old you probably had no problem walking along the top of a fence or a log that had fallen across a creek. Few middle-agers would try that even if that log were lying on the ground. Do we lose our sense of balance as we grow older? Yes, but it's not due to aging.

Falls that lead to brain injury and hip fracture are leading causes of death among persons over the age of 65. About 25 percent of those who suffer a hip fracture do not survive a year. Yet like so many problems associated with aging, falls are largely preventable and maintaining youthful balance ability is a key factor.

Part of our ability to maintain balance depends on structures within the inner ear but problems with this vestibular apparatus are relatively uncommon. By far it is the loss of muscle as a result of inadequate physical activity that leads to most falls.

Gradual loss of muscle begins at about the age of 25 years. We participate in fewer sports and the responsibilities of career and family crowd out physical activity. The decline is so slow that most persons are not aware of the gradual loss of strength and with it, the accompanying loss of balance. We know, however, that those who consistently engage in moderately intense physical activity throughout life maintain muscle mass well past middle age. Additional benefits of such exercise include a stronger skeleton and the ability to avoid falls.

Specialized muscle cells provide feedback that reveals to the brain the exact position of body parts. As an example, with your eyes closed you can wave a hand around at random and then place the tip of any finger precisely on the top of your ear, the bridge of your nose or the center of your chin. When muscles waste away from lack of use this instantaneous position sense disappears too.

Anyone can regain balance at any age. It begins with resistance exercise using weights or machines. Specific exercises to increase balance help a faster return to normal.

Practice standing on one foot with eyes closed — but hold onto something for safety. You can even do this in the grocery line but be sure to keep your eyes open. Yoga and t'ai chi are helpful but they require long and persistent practice, which explains why some studies show little benefit.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at