Balance 101

Have you ever caught yourself wobbling a little and thought, "Uh-oh, my balance isn’t what it used to be" ? You’re not alone! Many of my physical therapy patients make these comments to me when they first come in. They are often surprised to learn that balance isn’t all or nothing - it’s more like a puzzle with several pieces that contribute. And the great news is this: you can improve your balance at any age. 

Let’s talk about the four major pieces of the balance puzzle: vision, sensation, proprioception, and the vestibular system. These all work together to help you stay steady on your feet. There are things you can do to make sure each component is running smoothly, so that you feel more steady and confident. 

1. Vision: Your Eyes Help You Stay Upright

It may sound obvious, but your eyes play a huge role in your balance. They constantly scan your surroundings and send messages to your brain about how your body is positioned, relative to your environment. If you start to tip to one side, for example, your eyes notice it, and they send that information to your brain. This is crucial so that your body can adjust itself, before you fall.

As you age, your vision naturally changes. After age 50 - and even more so after 70 - you need more light to see well. In fact, older adults may need two to four times more light than younger adults! That’s why places like dim restaurants, movie theaters, or walking to the bathroom at night can all increase your risk of falling.

What can you do?
While you can’t fix vision with exercise, you can visit the eye doctor regularly, wear the right glasses or contact lenses, and ensure adequate lighting throughout your home to stay safe. 

2. Sensation: Feeling the Floor Beneath You

The bottoms of your feet give your brain important information. They help you feel where you’re putting pressure—like if you’re leaning forward, backward, or to one side.

If you have nerve damage (from something such as diabetes or from a surgery), you might not be able to feel your feet very well. That makes it harder for your brain to know whether you are standing level or not, and balance becomes more difficult.

What can you do?

You can’t always restore lost sensation with exercise (there are cases when treatment for the low back, such as physical therapy or surgery, can help), but you can always strengthen the other systems that support balance. That way, you’re less likely to stumble, even if the nerves in your feet aren’t sending perfect messages. 

3. Proprioception: Knowing Where Your Body Is

The fancy word “proprioception” simply means your body’s “position sense.” Without looking, you can tell whether your arm is bent or straight, and that’s proprioception at work. It’s especially important in your ankles, knees, and hips when you’re standing or walking to prevent falls.

Proprioception can absolutely be improved with exercise. In physical therapy, we work on this all the time by practicing things like:

• Standing with feet close together

• Balancing on one foot

• Using unsteady surfaces like balance pads 

• Gentle pushes to challenge your balance and teach your body how to react safely

These activities may feel challenging at first—but over time, they help your body become quicker and smarter at correcting itself.

4. Vestibular System: Your Inner Balance Center

Deep inside your ears, there are tiny organs that sense motion and head position. These organs make up your vestibular system. Your vestibular system allows you to bend, turn your head, and roll over in bed, without feeling disoriented or dizzy.

As we age, this system can weaken, which can cause sensations of spinning, vertigo, or a general sense of unsteadiness. But just like muscles, your vestibular system can be trained and strengthened through specific exercises like:

• Gaze stabilization (training your eyes and brain to work together) 

• Habituation (getting your body used to certain movements so they don’t trigger dizziness)

A trained physical therapist can help guide you through these safely and effectively. If you want to try a vestibular exercise, in this video I walk you through how to practice a type of gaze stabilization exercise. You can try it by clicking HERE to watch on Instagram, or clicking HERE to watch on Facebook. 

Other Things That Affect Balance

Of course, there are outside factors beyond just these four systems that play into your balance. Things like medications, blood pressure changes, past strokes, alcohol, strength, or even your mood (yes, anxiety can throw off your balance!) all play a role.

But here’s the key point: Even if one aspect of your balance isn’t functioning perfectly, you can still strengthen the others. That means you can still improve your overall balance - and lower your risk of falls.

The Takeaway: You’re Never “Too Old” to Improve Your Balance

Let’s say you have nerve damage in your feet, and your eyes can’t see as clearly as they used to. This means that your vision and sensation aspects of your balance aren’t fully up to par. BUT, that doesn’t mean you’re doomed to fall! Rather, it makes it even more important that you focus on exercises that strengthen your proprioception and vestibular system, so that you can feel more steady on your feet and prevent falls. 

Balance isn’t just one thing. And that means there’s more than one way to improve it.

If you’ve been worried about falling, or feel a bit unsteady now and then, I want you to know: you’re not stuck. With the right support, a little knowledge, and the right exercises, you can take control of your balance—and feel confident again.

Looking for guidance for specific things you can do? You're in luck- coming in August I have a free virtual masterclass that I will be hosting, AND the doors will be opening for the 2025 Enrollment for The Balance Boost Course! If you don't want to miss out, fill out the form below and you’ll be the first to know when signups are available!