Fall Prevention Exercises for the Elderly

As individuals age, bone and muscle mass diminishes, vestibular systems are weakened and falls become
more common. Fall-related injuries make up about one-quarter of hospitalizations in the elderly, and
senior citizens without balance and strength training are more likely to experience falls. For seniors,
exercises focused on fall prevention are essential in minimizing the risk of future injury.
Here are 5 sets of exercises that anyone can do to improve balance when performed in a safe setting. It is
best for one to perform these in a corner with a chair or walker positioned in front, or at a counter with
capable supervision.

Overall Strengthening is necessary for building up muscle mass, which is needed to walk, ascend and
descend stairs, and navigate curbs and sidewalks safely. Here is a list of five main exercises that focus
on muscles used for walking that can also be done without equipment.

Squats

place your feet about shoulder width apart, holding onto a chair or counter in front of
you. Slowly bend your hips and knees, keeping your heels on the floor with your back straight.
If this is difficult to do, find a sturdy chair and practice standing up and sitting down
repeatedly, as this will exercise the same muscles as squatting.

Heel Rises

keeping the legs straight, slowly raise on to your toes, lifting your heels off of the
ground. Think about a string pulling you straight up, you should not move forward when doing
this exercise.

Side kicks

keeping your knee facing forward (not letting your toes point out to the side), slowly
move your leg directly to the side, without letting your foot turn out or letting your leg move
forward. You should feel this exercise toward the side of your hip.

Kick Backs

bending your knee very slightly, move your leg backward without arching your
back. Make sure to move slowly and in a controlled manner, as arching the back may cause
soreness in the low back.

Marching

alternating legs, pull your knees up as high as you can toward your chest. This
should also be done slowly (notice a trend?) and with control.

Static Balance involves balancing in a still position, without extraneous movements. Several
positions that increase in difficulty are outlined below. Remember that these should be done safely
while standing in a corner or with capable supervision:

  • Normal stance–stand how you normally would, without hanging on
  • Rhomberg stance–placing the heels and toes of the feet together (or as close as possible), try to
    balance without hanging on
  • Modified tandem stance–after standing in the rhomberg position, slide one foot forward
    slightly so they are off-set. Try this without holding on to anything, or touching the wall behind
    you.
  • Tandem stance–stand with one foot in front of the other, switch sides. One side may seem
    harder than the other, this generally happens when a weaker leg is positioned in the back. Try
    to slowly shift your weight so it is distributed equally between your feet.
  • Standing on one foot–this is the most difficult static balance exercise that can be done, but is
    extremely useful, especially for those who do not use an assistive device (such as a walker, cane,
    etc). The ability to stand on one foot is extremely helpful because walking involves standing on
    one foot at a time.
  • Standing with Eyes Closed is a strategy for making the above static balance exercises more difficult.
    Vision is the most commonly used sense to assist in balancing, especially for the elderly who might
    have difficulty with vestibular systems and poor sensation in the feet. Closing the eyes forces the
    participant to rely on their other senses and strengthen those instead. Proprioception, the brain’s
    ability to recognize where the body is in space, is also strengthened when the eyes are closed, as the
    person balancing is forced to pay attention to where they are based more on body cues than vision.
  • Vestibular Strengthening is also an effective strategy for improving balance in older adults. The
    vestibular system is responsible for maintaining equilibrium and reducing dizziness in individuals.
    Those who suffer from vertigo or motion sickness have deficits in their vestibular system.
    Focus on a single target, like your thumb held out in front of you as you are seated in a chair.
    Keeping your eyes focused on that object, slowly move your head side to side for 30 seconds. Stop
    and take a break if this makes you dizzy, and try again when you are feeling better. Then, keeping
    focus on that object, tilt your head up and down slightly.
    To progress this exercise, try it while in each of the above stances, if you can safely complete them as
    described. Again, stop if you start feeling dizzy. The eyes and vestibular system can actually be
    trained to reduce dizziness and improve balance by accommodating to the movements over time.

Dynamic Balance involves maintaining balance while moving.

    Some exercises that improve dynamic balance include:

  • Tandem walking–placing one foot in front of the other, like you are walking on a tight rope
  • Reaching while in a static stance–whether it is rhomberg, tandem, or on one foot, practicing a
    reach from side to side or in front will improve balance necessary for household tasks
  • Center of gravity circles–this is very helpful in determining how far you can reach or bend
    before losing your balance. Move your hips in a circle, making sure you are in a safe spot and
    there is something you can hold on to should you lose your balance, and move your body in a
    circle, bending at the ankles and leaning as far as you can in each direction.

Overall, fall prevention is possible and thoroughly encouraged in senior citizens. The above exercises,
when performed in a safe place and with supervision, can greatly increase strength and balance while
decreasing the risk of falls. This should not replace a consultation with a Physical Therapist or other
medical professional, who may provide a more personalized exercise plan specifically suited for their
client.

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