Ms. Colberg is an exercise physiologist and associate professor of exercise science at Old Dominion University in Norfolk, Virginia. A diabetes researcher with almost four decades of practical experience as a type 1 diabetic exerciser, she is a Fellow of the American College of Sports Medicine, a professional member of the American Diabetes Association, and the author of three books on diabetes.


Editor's Note: Falling and fear of falling are frightening concerns for many older people. What is far more serious, however, is the downward spiral this fear sets in motion, with a fall or the fear of a fall causing the person to cut back on their exercise and even their day−to−day activities and errands. The result is an even greater loss of balance and muscle, leaving the person much more vulnerable to a fall than had they kept at it.

Your sense of balance relies on a dynamic process in which your brain and body take in and respond to physical information through your eyes, muscles and nervous system as you physically navigate the world. Without this feedback, your body's ability to respond to it and balance itself suffers.

Posture is part of balance. As the authors explain below, how you hold your body can make a big difference in your balance. Working on your balance and posture will improve your stability and mobility and prevent many forms of back and neck pain.

Be sure your monitor, keyboard and desk chair are all set at the appropriate heights so they do not interfere with good posture. Give yourself plenty of get−up−and−walk−around time. Take exercise breaks.

The following is an excerpt from a new book by The Doctor's Senior Living specialist, gerontologist, Dr. John Morley: The Science of Staying Young, 10 Simple Steps to Feeling Younger than You Are in 6 Months or Less, written with Sheri R. Colberg, Ph.D. (McGraw−Hill, 2008). Used by permission.


Just to ask, when was the last time you practiced balancing on one leg for a minute or two? Although you may not have realized it, your balance begins to deteriorate starting around the age of 40. Poor balance is associated with an increase in falls and injuries such as wrist and hip fractures, even in middle−aged individuals. In studies on old rodents, researchers found that these animals experience deterioration in neural connections in the part of the brain that helps fine tune movements (the cerebellum) when sedentary. If placed in a new environment and encouraged to walk on narrow beams, however, they regain their balance. Similarly to rats, humans of any age can regain much of their ability to balance by practicing doing it.

Regardless of your age, if you can't stand steadily on one leg for at least 15 seconds — with or without your eyes closed — then you definitely need to start practicing as soon as possible to improve your balance.

How can you tell how good your balance is? Poor balance is readily apparent if you stand on one leg and shut your eyes. (Don't try doing this without holding onto something.) You may be surprised how much worse your balance is with your eyes closed. To balance effectively, you need adequate strength in your ankle and hip muscles, good feedback from the nerves in your feet (to help your brain with its position sense), and a functioning cerebellum. Most of us rely more heavily on our eyes for balance to compensate for negative changes in our ability to balance over time. Regardless of your age, if you can't stand steadily on one leg for at least 15 seconds — with or without your eyes closed — then you definitely need to start practicing as soon as possible to improve your balance.

The easiest balance exercise is actually done by holding onto a table with both hands and standing on one leg. Once you feel stable in this position, you should slowly release one hand. This exercise needs only to be done two to three times a day on alternating feet. Within a couple of weeks or months, your balance will rapidly improve.

This easy exercise can improve your balance further if you modify it slightly. Incorporate these more advanced balance techniques as you progress:

  1. holding on with only one fingertip;
  2. not holding on at all; and
  3. if you are very steady on your feet, closing your eyes (still without holding on).

It's a good idea to have someone stand close by in case you ever feel unsteady, though, particularly when your eyes are closed.

Anytime Balance Exercises
The following exercises also improve your balance, regardless of how young and steady you still are. You can do them almost anytime and as often as you like, as long as you have something sturdy nearby to hold onto if needed.
  • Grab a towel with your toes. Place a towel on the floor and practice grabbing it with the toes of both of your feet, alternately, while both sitting and standing.
  • Stand on a cushion. Try using cushions or pillows of varying firmness, and stand on them with your legs alternately together and apart.
  • Stand with a changed position. Try standing under different conditions — with your eyes open or closed, your head tilted to one side or straight, your mouth talking or silent, and your hands at your sides or out from your body.
  • Walk heel−to−toe. Position your heel just in front of the toes of the opposite foot each time you take a step. Your heel and toes should touch or come close. You may want to start first going along hand rails or with a wall next to you.
  • Walk backwards. Try walking backwards along a wall or a kitchen counter without looking back, using the wall or counter to steady yourself infrequently.

Better Posture Leads to Pain Prevention and Improved Balance
Did your parents ever make you walk around the house balancing a book on your head when you were young? Although it's not routine to do anymore, the reason behind this activity was valid: to establish a habit of good posture. Posture is reflection of how you balance your body, which would fall forward if your muscles did not pull it back. You continually use your muscles reflexively to balance whenever you sit or stand. To help you keep an upright posture, you use your eyes to gauge what is level (which is why balance exercises are harder with your eyes shut), along with sensory information from your inner ears, muscles, and joints. If something affects the way you carry your body, your brain adapts and adopts new muscle and joint positions. To avoid undue pain, you may temporarily adopt a new movement pattern, such as when one of your hips hurts. As a result, you'll think that you are standing straight up even when you aren't Muscles, ligaments and nerves change as they adapt to changes in your movement patterns.

Effects of Good Posture versus Bad
Over time, your body tends to bend forward, moving your center of balance the same direction, making your body unstable as you walk, and increasing your chances of falling down. Similarly, adaptive patterns of movement can increase the stress on your joints. For instance, frequently slouching puts pressure on your vertebrae, ultimately causing discs to become compressed and resulting in neck and back pain. Conversely, good posture makes you feel better. Your muscles are more limber, and you have better mobility and less tension in your neck and shoulders, back, legs, and spine. Thus, having a good posture is very important to preventing pain and maintaining better balance.

Posture is reflection of how you balance your body, which would fall forward if your muscles did not pull it back.

Improve-Your-Posture Exercise
For better posture, a single exercise done properly is best. We suggest that you stand with your back to the wall with your heels two inches from it. Hold your chin down onto your chest, and then with your chin tucked in, attempt to touch the wall with the back of your head. Most people over 50 years old don't succeed in doing so, but it is a good exercise to practice anyway.

Find out more in The Science of Staying Young, 10 Simple Steps to Feeling Younger than You Are in 6 Months or Less. Copyright ©2008 by John E. Morley and Sheri R. Colberg. Reprinted by permission of the authors.