Luke Weston, Junior Physiologist at AXA PPP healthcare

Exercises to improve your balance and coordination

14 September 2020

Balance and coordination are critical skills in later life to help prevent falls. Muscle strength is lost at a rate of 3-5% per year as we age so offsetting this is a key part of fall prevention. AXA PPP healthcare Junior Physiologist and qualified personal trainer, Luke Weston explains which exercises to focus on for balance training. 

Why balance & coordination training?

Balance training is something that may not spring to mind when planning a fitness regime. However, it can add value and is worth doing at any age. Especially as we get older, we’re subject to an array of problems that can affect our balance. Conditions such as arthritis, Alzheimer’s, Parkinson’s and heart disease can all affect our ability to move freely and make us less steady on our feet. On top of this, it is thought that muscle strength can decrease at a rate of 3-5% per year in older age, a condition known as sarcopenia. This can result in falls and injuries, which may in turn affect our self-confidence, ability to socialise, to maintain healthy levels of activity; or look after ourselves or our loved ones. 

In short, such injuries can have a devastating effect on someone’s quality of life. 

Balance training is important for older adults in particular as it can help prevent falls. Balance training improves the ability to resist forces within or outside of the body making it harder to fall and therefore also reducing the risk of bone fractures and other injuries. Balance training can be as simple as practicing standing from sitting with as little support as is safe to do so. 

One of the best things anyone can do to improve their balance is through strength training. Strength training helps to maintain muscle and bone density which helps to reduce the potential effects of sarcopenia. 

In relation to balance, by strengthening the muscles of the body we generate greater stability and are therefore less likely to fall. This is known as dynamic balance and is the most important when it comes to preventing falls. The key muscles to focus on are those of the back, legs and abdomen as these are particularly important in control, stability and coordination. Here are Luke’s top 5 exercises to boost balance and coordination – why not give them a go?

Squat

How to do it:

  • Stand with feet roughly hip width apart, toes pointing slightly out
  • Brace your core before starting
  • Simultaneously bend the hips and knees so that you sit straight down – you could imagine you’re about to sit on a toilet
  • Do not allow your knees to cave in, as this could cause future problems for your knees
  • Keep your chest proud throughout
  • Avoid squatting so low that your chest falls forwards or your hips tuck underneath you
  • You could try 10-20 of these while waiting for your morning coffee to brew.

A squat works all the key muscles, such as the quads, hamstrings, glutes and back, that create stability and support the major joints of the body, including the knees, hips and spine. This makes it a key exercise for improving balance and preventing falls. If the squat is too difficult for you right now, why not practice by standing up and sitting down on a chair to help you as you build your strength up. If squats are easy, or you would like some more variation, a split squat version will create more stability demands. The coaching points for split squats remain the same, you are just moving into a lunge position, where one foot is in front of the other, with enough space that you can bend both knees without them going over the toes. Make sure the pelvis is tucked under and keep an upright trunk position, holding onto a counter if more stability is needed.

Hip thrust

How to do it:

  • Set up a bench/sofa behind you, resting the bottom of your shoulder blades on top of the bench
  • Bring your feet up to 90 degrees, hip width apart
  • Brace your core to stop your back from arching
  • Squeeze your glutes (your bottom muscles) to lift yourself up and then lower yourself back down.

Similar to the squat, a hip thrust works the major muscles of the legs and back but puts more emphasis on the glutes, which are key stabilisers of the hips making it a great exercise for your balance. To add an extra stability challenge, hip thrusts can be done on 1 leg instead of 2. Nothing changes doing the single leg version, other than lifting one leg off the floor.

Single arm dumbbell row

How to do it:

  • Set up a flat bench, or use a suitable alternative
  • Choose a dumbbell weight that you are comfortable with, or something from around the house that provides resistance, e.g. a tin can or water bottle
  • You want to set yourself up on the bench in the tripod position, which is:
    • One arm on the bench straight down below your shoulder
    • One knee on the bench directly below your hips
    • The other leg is on the floor, roughly also below your hip
    • In this position your back should be flat, if it’s not adjust knee and/or foot position
  • Start the exercise holding the dumbbell straight down below the shoulder
  • Using the muscles of your back, row the dumbbell towards your hip, leading with the upper arm – imagine you are trying to put the dumbbell in your pocket
  • Hold the dumbbell in this position for a second, squeezing your shoulder blades together
  • Return to the start position to finish the rep.

The single arm dumbbell row is an excellent exercise for developing the muscles of the back as it involves movement of the shoulder blades and stabilisation of the spine, both key for maintaining balance. If you are unable to do this exercise, most gyms have either a machine row or a suspension system you could use.

Plank

How to do it:

  • Lying on your front come up on to your elbows, with them positioned directly under your shoulders
  • Come up on your feet, similar to the press up position
  • Your back should be flat
  • Brace your core, imagine your bracing your spine all the way around, 360°
  • Hold this position throughout the exercise, your hips should not drop or rise at all.

Although a fairly basic core exercise, it should be one of the primary ones in your balance training as it helps to develop bracing and stability at the hips and spine. The core is vital for transferring forces from the lower body to upper body, so being strong in this area makes it easier to do this. In turn it will make it easier to correct yourself should your balance be challenged. A plank can be made easier by raising your elbows up on to a bench or sofa. It can be made harder by simply increasing the time you hold if for, or by adding additional weight to the centre of your back.

Single leg balance exercise

How to do it:

  • A basic balance exercise is standing on one foot, lifting the other leg off the floor
  • If that’s too easy, try using an unstable surface such as a wobble board or cushion
  • Place 1 foot in the centre of the unstable surface
  • Brace your core and lift your supporting leg off the floor
  • Try and remain as still as possible
  • To challenge yourself, try then closing your eyes, but only if comfortable – and safe to do so.

Unstable surface training can be beneficial to regain proprioception in the feet and legs after an injury has occurred. It may be beneficial as part of an overall program as well. Proprioception is the ability to stabilise oneself against perturbations – i.e. readjusting position and posture when our balance is challenged. Proprioception is largely developed through childhood, but it can be retrained if lost through injury or detraining and is therefore worth implementing throughout life.

Bonus exercise: press ups

How to do it:

  • Start on the floor and put your hands just outside shoulder width
  • Raise up on to your feet, straight out behind you
  • Your back should be flat
  • Brace your core
  • Imagine you are trying to ‘screw’ your hands into the floor
  • Slowly lower yourself until you are just off the floor
  • Using the muscles of the chest and your triceps push yourself back up to the start position
  • If too difficult, start on your knees or against a kitchen counter, gradually building up to a full press up

A press up is not necessarily going to prevent falls but in the case of a fall occurring, having the strength in the chest and triceps may allow you to break your fall and reduce the severity of injury. This will happen because press ups will help develop stability at the shoulder and the strength to resist the arm collapsing when you try to break your fall. It therefore should not be overlooked.

As we get older, we’re subject to an array of problems that can affect our balance which increases the likelihood of falling, as well as reducing our quality of life.

References

ACSM Physical Activity Guidelines For Older Adults (2018)

NHS UK. Falls (2018)

NHS UK. Physical activity guidelines for older adults (2019)

NHS UK. Older people ‘would benefit’ from weight training and more protein (2018)

Phillips et al. (2019) Resistance Exercise Training as a Primary Countermeasure to Age-Related Chronic Disease. Frontiers in Physiology; doi: 10.3389/fphys.2019.00645.

Santilli et al. (2014). Clinical definition of sarcopenia. Clinical Cases in Mineral and Bone Metabolism 2014; 11(3): 177-180.

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