Feeling Unsteady? Take These Steps to Improve Your Balance.

Smart ideas to help you avoid falls

By Hallie Levine

February 4, 2024

person doing yoga in living room with couch and plants in background

While you can slip and fall at any point in life, it’s more common with age. More than 1 out of 4 older adults take a tumble each year, and about 20 percent of these falls lead to injuries such as broken bones, according to the Centers for Disease Control and Prevention.

A host of aging-related changes may be at fault. “We lose muscle strength and flexibility, and our senses become less sharp,” says Anne Vanderbilt, CNS, a nurse practitioner at the Cleveland Clinic’s Center for Geriatric Medicine. Vision and hearing can become less sharp, reducing awareness of fall hazards. Chronic conditions such as arthritis can affect balance, as can certain meds, says Audrey Chun, MD, vice chair of geriatrics and palliative medicine outpatient services with the Mount Sinai Health System in New York City.

Age also affects your vestibular system, the area of your inner ear that helps you maintain balance, says Greg Hartley, DPT, an associate professor of physical therapy at the University of Miami Miller School of Medicine in Coral Gables, Fla.

But there’s plenty that you can do. Consider the following.

Assess Your Steadiness

Four quick “tests” at home can help you gauge your balance, says Richard Marottoli, MD, MPH, medical director of the Dorothy Adler Geriatric Assessment Center at the Yale-New Haven Hospital. Have a sturdy chair or person nearby to hold on to if you need some support.

Stand in place with your feet together.
Move one foot forward so that the instep is next to the other foot’s toes.
Return to the original position, then place the toes of one foot behind the heel of the other foot.
When back in the original position, stand in place on one leg, then the other.

Ideally, you should be able to hold each move for 10 seconds. If not, or if you have any concerns, tell your doctor. They may refer you to physical therapy or screen you for conditions such as diabetes, stroke, or Parkinson’s disease. And note that your doctor should inquire about balance at annual wellness visits.

How to Improve Your Stability

Review your meds annually. “The most common offenders are those that affect your level of alertness or your blood pressure when standing up,” Marottoli says. These include some medications for high blood pressure; anxiety, such as diazepam (Valium); an overactive bladder, such as oxybutynin (Ditropan); and antihistamines such as diphenhydramine (Benadryl).

Your best bet is to follow the CDC’s advice and go over everything you take regularly—prescription and over-the-counter products, including supplements—with your doctor or pharmacist each year. In addition, “if you feel foggy/groggy or off-balance after starting a new medicine [or increasing a dose] or dizzy or unsteady on standing up, make sure to let your clinician know,” Marottoli says.

Get your eyes and ears checked. Research suggests that poor vision doubles the risk of falls for older adults. And a 2020 study published in JAMA Otolaryngology-Head & Neck Surgery found that hearing problems, especially among older people, impair balance.

“When you have vision or hearing loss, your brain has to work harder to compensate, which means you have less cognitive reserve to focus on balance,” says Debra Rose, PhD, director emerita of the Center for Successful Aging at California State University in Fullerton. The American Academy of Ophthalmology recommends that all adults over age 65 see an eye doctor every year or two. And the American Speech-Language-Hearing Association says that people should be screened by an audiologist every three years after age 50.

Improve your strength. Our muscles typically shrink about 3 to 8 percent per decade after age 30, and weakening accelerates after age 60. Strength, endurance, and flexibility are key for good balance, Chun says. So older adults should do exercises that target one or more of those every day, Hartley says.

Research shows that simply getting out and walking is helpful. Yoga is also a good option. A 2023 review published in the Annals of Internal Medicine found that older adults who did yoga were stronger and had better balance—as well as more endurance and a faster walking pace— than those who didn’t. Another 2023 review found that the mind-body practice of tai chi improved balance and reduced fall risks in older adults, too.

Get the right footwear. It’s important because it provides a stable base for your feet, legs, and body. To help your toes grip the ground more firmly, Marottoli recommends shoes with a wide toe box. For added stability, he suggests footwear with soft but supportive insoles, a closed back, and laces or a fabric-fastener closure like Velcro. Avoid heels higher than an inch or two, sandals, and flip-flops. If you notice foot pain and have long or thick toenails or a condition that affects sensation or circulation, like type 2 diabetes, he also suggests seeing a podiatrist “They can help diagnose and treat these problems,” he says, “and make sure that you’re wearing appropriate footwear.”

Build your confidence. Up to 60 percent of older adults are concerned about falls even if they’re never had one. But this can limit your activities significantly, according to a study published in BMC Geriatrics in 2021. “Unfortunately, this creates a vicious cycle: People are afraid to move, so they lose even more muscle strength and their balance worsens, which makes them even more fearful,” Hartley says.

If you’re experiencing something similar, take walks only where you’re familiar with the terrain for the time being. And consider doing exercises that carry little risk of falling, like swimming, pool aerobics, and stationary cycling. These can increase lower body strength, which aids balance. If you still feel apprehensive after a month, a physical therapist can screen you for problems that may be affecting your balance (and confidence) and work with you on a plan to get you moving with more ease.

Fall-Proof Your Home

Nearly 80 percent of emergency room visits for falls by older adults are the result of accidents that happen at home, according to a 2021 study published in the American Journal of Lifestyle Medicine.

To ensure that your home is as safe as possible, the Centers for Disease Control and Prevention recommends the following steps.

Keep your floors clutter-free.
Get rid of throw rugs.
Add grab bars in the bathroom.
Install handrails on all staircases.
Make sure that your home is well lit.

This includes adding lights at the top and bottom of all your staircases and night lights in hallways, especially those that lead to bathrooms.

6 Moves That Center You

Hartley says these are his favorite balance exercises.

The Standing March: Hold on to your kitchen counter and march in place for a minute. As your balance improves, try this without holding on.
Sit to Stand: Sit in a sturdy, armless chair and push yourself up to standing. “It improves your lower extremity strength, which is important for good balance,” Hartley says. Do 10 to 15 reps.
Side Steps: Stand with your feet together and knees slightly bent. Lightly hold on to a kitchen counter if necessary. Step your left foot out to the side and move your right foot to meet it, then do the sequence in the opposite direction. Repeat this three times.
Three-Way Kick: Lightly hold on to a kitchen counter if necessary, stand on one leg, and slowly raise the other leg in front of you. With the raised leg as straight as possible, lower it down. Do the same move with your leg out to the side and then with your leg behind you. Repeat on the other side.
Toe Raises: Stand facing a kitchen countertop (hold on to it if necessary) and lift the toes of both feet as high as is comfortable. Then lower them. Repeat 10 to 15 times.
Heel-Toe Walk: Standing, place the heel of your right foot just in front of the toes of your left foot. Then take a step, placing your left heel just in front of your right foot. Repeat 10 to 15 times. Hold on to a sturdy item for stability.

Editor’s Note: This article also appeared in the February 2024 issue of Consumer Reports On Health.

Hallie Levine

Hallie Levine is an award-winning magazine and freelance writer who contributes to Consumer Reports on health and fitness topics. Her work has been published in Health, Prevention, Reader's Digest, and Parents, among others. She's a mom to three kids and a fat but feisty black Labrador retriever named Ivry. In her (nonexistent) spare time, she likes to read, swim, and run marathons.