Balance and Falls Prevention

Balance and Falls Prevention

As we get older our balance deteriorates. This can be for a number of reasons but often its because we lose our physical strength, joint flexibility, or we have an injury or surgery that affects our balance. Inner ear problems can also cause our balance to be affected. As we get older our vision and reaction times decrease and our risk of having a fall increases.

Often, due to reduced strength, reduced bone density and poor balance, it can take us a while to recover from falls.

Balance depends on a number of things including our vision, sensation from our ear canals and from the receptors in our joints. We rely on all 3 systems to supply us with information regarding where we are in space. In order to maintain our balance while getting up, walking or going up stairs we need to constantly receive information through these sensors and integrate it to coordinate our movement.


If any of these 3 systems fail, our balance is affected. Here are some examples:


If our vision deteriorates or we’re getting used to new glasses, especially bifocals we can struggle with our balance. Imagine standing with your eyes closed, how does that affect your balance?

Vestibular (Ear):

Your ear has semicircular canals filled with fluid in them. There are messages sent from the canals to your brain about the position of your head relative to the ground. Your vision is also used to coordinate the position of your head. Have you ever experienced light-headedness from an ear infection or knock to the head?


Joints have receptors in them that let us know when that joint is moving. For example, if you close your eyes and move your arm above your head, the sensation in your joints will let you know that your arm has moved overhead. If you’ve sprained a joint or had a knee replacement, you’ll know that those receptors are not as accurate, and you need to retrain them to restore your balance.

There needs to be constant communication between these systems. If our movement is interrupted, for example if we trip walking over a rug, our body moves beyond our base of support and if our response isn’t quick enough or is not accurate we are at risk of falling.

If our joints are stiff or we don’t have good strength in the surrounding muscles, even though we may be aware that we are about to fall, we may not be able to prevent it.


Therefore, it is very important to ensure we regularly check our balance and see our GP and physiotherapist if we have a fall or feel like our balance is reducing.

Most causes of poor balance can be corrected. For example, glasses can be prescribed, causes of dizziness can be treated and correct rehabilitation after injuries can improve proprioception (sensation from our joints).

It is important to see a trained professional, such as a physiotherapist, to correctly diagnose the issue, and to get correct exercises prescribed that are safe, yet challenging to do.

Physiotherapists can measure our balance to see how we are improving and can give advice such as removing unnecessary clutter at home and moving rugs to reduce the risk of tripping over something.

There are also many walking aids that can be prescribed and adjusted for you, and that may be temporary while you work on improving your balance or more permanent if you require it.

Key Points:

  • Balance reduces with age and risk of falls increases
  • Many causes of falls can be prevented
  • Exercises prescribed by your physiotherapist can improve your balance and reduce your falls risk.

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Above are examples of balance exercises. ** Always complete balance tests and exercises near a wall/chair or rail for support** **Not all balance exercises are suitable, ensure you get your own personalized program from your physiotherapist**

Written by Physiotherapist Kornelia Molenda.

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