Q&A: Muscular Strength And Balance In Seniors

Question: What can be done to improve balance in seniors? Are there any specific exercises you recommend?

Answer: To maintain your balance while stationary or moving requires a coordinated effort of your nervous and muscular systems. Your nervous system constantly senses whether you are in balance and tells each of your muscles how forcefully to contract to regain or maintain it. If there is a problem with either of these systems your balance will be compromised.

Many older people develop problems with balance despite having normal, properly-functioning nervous systems due to sarcopenia, the age-related loss of muscular strength and size. Fortunately this loss of muscle can be significantly reduced or even reversed with proper strength training at any age.

If the problem with your balance is neurological, depending on the type of problem you might also benefit from practicing the specific activities you are having difficulty with. Don’t make the mistake of wasting time learning to balance on gimmicky balance equipment like Bosu balls, balance boards and discs, however. Balances skills are specific and do not transfer between different activities. The skill of maintaining your balance on a wobble board does not transfer to other activities.

If you’ve got too much body fat you can also improve your balance by leaning down. The less you weigh the easier it is for your muscles to move your body or hold it in a position of equilibrium to maintain your balance. While losing fat is primarily a matter of diet, for the best possible results you should also be strength training.

Senior performing compound row exercise

Exercise and balance skills practice are distinct activities that need to be performed separately. Do not make the common mistake of trying to combine the two by either adding balance challenges to your workouts or strength and conditioning challenges to your balance practice sessions.

Exercise is for stimulating improvements in the general factors of functional ability and is made less effective by adding a balance challenge. Choose exercises and equipment that challenge your strength not your balance.

Balance skills are specific and should be practiced the way they are normally performed or the improvements will not transfer. Practice balancing in the positions and during the activities which are difficult for you, but do not add weight to these or alter them to make them more challenging (avoid wobble boards, Bosu balls, and the like).

Choose exercises that do not require you to stand unless they can be performed while holding something for balance or under the close supervision of someone capable of assisting you if necessary. When possible perform exercises on machines which can be used while seated and which can be easily and safely entered and exited (avoid machines which require you to either climb or get down on the ground to use).

To reduce the difficulty of moving between other exercises perform your hip and leg exercises last in your workout. When you finish a leg exercise be cautious. Don’t trust your legs right away, and make sure you are able to stand before you attempt to walk. Don’t attempt to walk if you feel wobbly after any exercise; wait for your legs to recover or get assistance.

For more on strength training for seniors read:

High Intensity Training for Seniors

You Are Never Too Old For Exercise

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  • Andrew Dec 1, 2017 @ 19:36

    I know bosu and the like are at best a gimmick and at worst dangerous but is there utility at least in strengthening the ankle’s supporting musculature? For example, as an adjunct to properly performed resistance training I practice standing on one leg with my eyes closed most days. Don’t laugh(!), it’s just unstable enough to be safe on the joints and reduce risk of falls while allowing me to get a good level of fatigue in the muscles that support the ankle over the course of a couple of minutes. It’s not about balance so much as trying to get positive adaptations in the structures that other leg work maybe misses(?) Could it or another isolation exercise prevent over supination etc of the foot if performed properly or am I just wasting my time?

    • Drew Baye Dec 1, 2017 @ 21:35

      This kind of balance practice would have little effect on ankle strength compared to proper resistance exercises like heel raises and isometric or manually resisted inversion, eversion, and dorsiflexion.

      My wife broke her fibula last spring and needed to have it surgically repaired. After she was out of her cast I had her perform timed static contraction and later manually resisted plantar flexion, dorsiflexion, inversion, and eversion a few times a week. I did not have her perform any of the Bosu or wobble board exercises often recommended for ankle rehab. Her doctor was amazed at how quickly her ankle strength and range of motion improved.

      • Andrew Dec 3, 2017 @ 14:19

        Thabks for the reality check, Drew. I’ve been overly focused on the area as I have spent a good while recently having to consciously re train my gait after having lost a lot of fat and realising how much damage sitting in a chair for over 10 years has done to me.

  • Steven Turner Dec 2, 2017 @ 2:21

    Drew,
    Another issue,

    You could first ask why does a person have balance problems issues. The reason I say this I was talking to a person who was conducting a large study into vestibular dysfunction who said he was appalled at what all these silly types of balancing exercise that are conducted in many gyms as improving balance.

    He said one of the worst things a person with vestibular dysfunction could do is be put into an unbalanced position or so-called balance challenged exercises. I am unaware of any fitness trainer knowing if a fitness client has vestibular dysfunction. There are probably many more conditions that a person may have issues with balance that would be unknown to a fitness trainer. If a fitness client has balance issues they should be referred to a specialist in that area. Not some so-called gym science balance guru trying to impress in front of the gym crowd doing some type of acrobatic balance trick on a swiss ball.

    • Drew Baye Dec 2, 2017 @ 12:32

      This is one of the reasons good trainers review and discuss the health and medical history of all new clients in detail.