How to improve your balance

Part three of the ‘Exercising your bones’ series gives you tips on improving your static and dynamic balance.

Throughout the last two articles in the 'Exercising your Bones' series, we explored how exercise benefits your bones and how movement specificity, alignment and body positioning can best strengthen your skeleton, especially prior to adding additional loads like lifting and pulling weights. But bone strength is just one component of the healthy bones formula. Balance training is another.

Why good balance is important

Good balance enables you to reach for objects, walk without shuffling and withstand missteps and even tripping. Balance enables you to react and recover to changes occurring throughout daily movement. In essence balance assists you in preventing injuries and avoiding falls.

You may be aware that balance diminishes with age, but you may not associate that change with the dangerous ramifications it has to impact your quality of life. As pointed out by Osteoporosis Canada and the authors of the 2013 Too Fit to Fracture study, “Falls remain the leading cause of hip fractures among older adults, causing 63 to 83% of hip and non-vertebral fractures and about 45% of vertebral fractures.”

You may even associate falls with an older population, but the all-too-common fracture at the wrist is the site of the highest number of fractures in an early post-menopausal population. Why does the wrist fracture? Because when slipping, tripping or falling off-balance, the natural instinct is to reach the hand out to protect your head and chest. Extending the arms breaks the fall (preventing life-threatening injuries) but it often also breaks the wrists.

The balance check

So what makes for good balance? In addition to muscle strength, a static balance test of standing on one leg is what comes to mind for many people. Try it and count how many seconds you can maintain the position. If this was easy, try closing your eyes and see if it’s still so simple! You’ve just learned your first test of balance challenge, since one component of balance stems from the visual input of your nervous system. This is one way to test and improve your stability.

While this static balance test is a good starting point for a baseline assessment, how often do you actually hold that position in daily life or move in slow motion? Therefore you should also try an assessment of dynamic balance, checking how well you can perform a task and maintain stability with a changing center of gravity and base of support, such as occurs while walking. Try walking with one foot in front of the other as if on a tightrope up to 10 steps. This is an example of one of many tests of dynamic balance, and a helpful skill to practice for its balance-enhancing potential.

Now perform the exercises outlined in the second installment of this series, which addressed alignment, and try standing on one foot again as well as the tightrope test. You’ll hopefully notice an improvement in both your static and dynamic balance. These exercises, which enhance joint positioning for bone building, also enable better balance because your body then works with gravity rather than against it in a standing position. This means less effort to stay upright. Let’s examine more closely how these and other exercises better your balance.

Back strength

An exercise of Back Extension similar to that shown in the last article (although with added weight) has shown reduced spine fracture risk by nearly 300%.  But this simple exercise has also proved reduction in fall risk and improved balance, which can enable you to stand taller and avoid loss of height or stooped posture. 

Core stability

Another important contributor to balance is core stability, the control over the region of the abdomen and pelvis. This area serves as the gateway between the upper and lower body, and the lack of control here can ignite an array of issues from low back pain to hip discomfort, along with impaired balance. The Abdominal Press exercise in the last article demonstrates one way to address this area. A key factor in core stability is not just strength but timing in how muscles activate and work together as a team. Their contraction prior to limb motion determines how well your body functions in movement, so training them in this manner can be one of your best resources for healthy living.

Hip and thigh strength

The outer pelvis - which most people think of as the hip bones - offers another great opportunity for targeted balance training. Try Side Stepping with small steps halfway across the room and back. (Be sure to clear the space to avoid tripping on anything!) Notice the fatigue that sets in at the hips, technically the muscles of the hips and pelvis. These provide stability to your pelvis, which can assist in fall prevention and also protect and strengthen the thigh bones.

Side stepping

Another exercise to improve pelvic and lower limb strength is one of the most basic movements you do daily in getting down into and up from a chair. You may be familiar with The Squat – here’s how to safely perform it and avoid the common complaint of knee strain. Stand with feet slightly wider than hip distance and with toes facing forward. Hold onto a handle in front of you if you need additional support and have a fixed chair behind you for extra security. Sit back letting your knees start to bend while you continue looking forward. Send your weight into your heels so that your knees don’t move forward beyond your toes.You can hold your hands out in front of you or push them against the outer thighs to activate the outer hip muscles. Be sure to avoid rounding your back and also keep your knees tracking over your toes rather than collapsing inward. Rise to stand and repeat working up to 10 times.

Feet and ankles

Working down the chain to the end of the body, don’t forget about the feet. Not only are they your contract point with the ground but they hold among the largest number of nerve receptors in the body, serving as an entire communication network to inform your body of its positioning in space and of any small adjustments needed to stay upright.While seated, try curling and wiggling your toes, even moving them as if playing the piano. Next, roll your ankles in and out several times and then roll the entire ankle around to increase the mobility.

Next, stand up and try the Heel Lifts exercise. Stand in front of a post or wall with your toes facing forward. (You can hold a tennis ball between your ankles in the little “pocket” just behind and below the ankle bones.) Lift your heels slowly without bending your knees. Then slowly lower again, repeating 10-20 times. Notice how the lower abdomen sensation from the Ab Press exercise can assist you. This exercise improves ankle stability to prevent twisting or tweaking your ankles (which can lead to a fall) and also increases lower limb strength.

Despite dividing exercises among body parts, we have to address the entire body as a complete unit since it doesn’t operate functionally in distinct parts. In this integrated, mindful approach, observe how when working one area of your body, you can still experience energy and activation in other areas. So let’s revisit the first static balance exercise standing on one leg. Rather than just standing on the leg, holding your breath and hoping for the best, try pushing the ground away to grow taller, finding a gentle lift in the low belly, relaxing your shoulders and breathing naturally. You may observe some additional work in your thigh and hip, for instance, as those muscles and connective tissues wake up to stabilize your pelvis.

Strong, healthy bones require specific, smart exercise. The exercises offered in this series provide a launch pad for other exercises and activities, included adding weights to build additional bone strength. And once you recognize the importance of body positioning and balance, you’re more likely to appreciate the design and function of your body from your enhanced awareness, and movement and exercise will become more interesting and enjoyable. Remember: this is your body, and you have the ability and responsibility to take charge of your balance, your bones and your health.

*Be sure that your health care provider has approved you to try any of the exercises described here.

This article, authored by Rebekah Rotstein, is the second of a three part series on exercise.

Part 1 Exercising your bones
Part 2 Exercises for healthy posture

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1.  Sinaki, M, et al. 2002. Stronger back muscles reduce the incidence of vertebral fractures: A prospective 10-year follow-up of postmenopausal women. Bone, 30(6):836-841.
2.  Sinaki, M et al. 2005. Significant reduction in risk of falls and back pain in osteoporotic-kyphotic women through a Spinal Proprioceptive Extension Exercise Dynamic (SPEED) program. Mayo Clin Proc., 80(7): 849-855.

Rebekah Rotstein is an international exercise presenter and movement educator and the creator of the award-winning DVD and workout Pilates for Buff Bones®. She runs her own studio in New York City and teaches courses on a variety of topics including bone health, functional anatomy and rehabilitation.  Her ongoing study of the body includes annual cadaver dissections, somatic studies and visceral manipulation. Rebekah is a partner of the U.S. Department of Health & Human Services and she has been frequently interviewed by media outlets including CNN, SELF Magazine and Arthritis Today.