Vision contributes to steady balance by monitoring your location and the motion of your head in space. This keeps you aware of your proximity to obstacles or potential dangers in your environment—but as you age, your visual acuity deteriorates, and this can compromise your balance. Your sense of touch can help to mediate this, but any conditions that affect the ability of your nerves to convey sensation to your brain can further impede your balance. Peripheral neuropathy is one example of the kind of nerve damage that can affect older adults, and causes a loss of sensation in the feet and lower limbs. Diabetes is often the cause—high blood sugar damages the nerves. Kidney disease and/or underactive thyroid also can cause nerve damage.

When it comes to the muscles and joints, we rely on our lower leg strength to push us upright from a sitting position, and for a steady gait. Loss of muscle mass as you age, or diseases such as osteoarthritis, which affects joint strength and flexibility, can result in generalized unsteadiness (called presbystasis) that causes gait imbalance and veering while walking.

Dizziness also can be related to orthostatic hypotension: a dramatic drop in blood pressure that can occur if we sit up or stand too quickly (you also may experience this if you take blood-pressure lowering medications). Blood pressure also can be affected by abnormal heart rhythms (arrhythmia) that decrease blood flow to the head.

Improving Balance As You Age

All of these factors mean that as you age balance might come less naturally to you, and it’s important to be aware of the possibility that you might lose your balance unexpectedly. But that doesn’t mean avoiding the movement and activity that helps preserve physical and emotional wellbeing. Speak to your doctor about any balance issues you are experiencing—it may be that an underlying condition, or a medication you take is to blame. Get a regular eye exam, and update your eyeglass prescription as needed. Also keep in mind that you need to practice balance in order to maintain it. Staying active can help you achieve this, as can balance exercises—tai chi is a good example and it’s likely that your local senior center or YMCA offers sessions.

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Getting older isn’t an excuse to avoid an active lifestyle—in fact, research shows that slowing down physically is associated with greater risk for low vitality, poor health, hospitalization, and loss of independence in older adults. Not convinced? Another recent study (Annals of Internal Medicine, Sept. 26, 2016) found that adults age 70 to 89 who regularly exercised were 13 percent less likely to suffer a disability—and more likely to recover faster if they did.

“It becomes even more important to get regular exercise as you age,” confirms David Thomas, MD, professor of medicine and rehabilitation medicine at Mount Sinai. “Physical activity helps boost your energy, mood, heart health, and bone strength, and more and more evidence also is linking it to a sharper memory in old age.”

The same goes for seniors who’ve led a sedentary lifestyle for decades but finally start prioritizing health and fitness. “There is evidence that people who start exercising late in life after years of inactivity benefit more,” Dr. Thomas confirms.

Ease in Gently

If you aren’t used to exercising, it’s important to start slow. If you have a pre-existing health condition, let your doctor know you intend beginning an exercise regimen. “It’s important to find out what constitutes a possible danger sign,” Dr. Thomas says. “For example, if you have a heart condition, your doctor will likely advise you to stop exercising if you experience chest pain or pressure.”

You can expect to feel some aches and pains after exercising, particularly if you aren’t used to activity, but warming up with gentle stretches and marching on the spot can help prevent muscle strain.

Don’t Let Arthritis Put You Off

You shouldn’t avoid exercise if you have arthritis, since studies show that physical activity can ease the pain that accompanies the condition. The same policy applies if you have the bone-thinning disease osteoporosis.

“Many seniors with osteoporosis avoid exercise because they fear falling and fracturing a bone,” Dr. Thomas observes. “However, weight-bearing exercise, such as walking, helps build bone mass.”

A Health and Fitness Key: Stay Alert for Injuries

One common knee injury is a torn meniscus. “The meniscus is a tiny shock absorber that acts as a cushion between the thighbone and the shinbone,” says Dr. Thomas. “It’s vulnerable to tears during sudden rotating movements—for example, the twists and turns you might engage in during a game of tennis. Damage also can arise over time, due to osteoarthritis in the knee joint.”

If you’ve torn a meniscus, you’ll experience symptoms like pain, swelling, and weakness, or you may hear a popping sound inside the knee when you move. “Tears generally heal on their own, with rest,” Dr. Thomas says. “Once the pain has diminished, physical rehabilitation can stabilize your knee by boosting muscle strength in the joint.”

If the tear doesn’t get better, your doctor may recommend arthroscopic (“keyhole”) surgery to repair the damaged meniscus.

The shoulders are another part of the body that can take a beating. “Repetitive motions like swinging a golf club or lifting weights can weaken or even tear the muscles and tendons of the rotator cuff, which holds the shoulder joint in place,” Dr. Thomas explains. “Rest, activity modification, and strengthening exercises are often enough to relieve a rotator cuff injury, but large tears may require surgical repair.”

Exercise Targets

A good starting point with any new workout routine is to do no more than 20 to 30 minutes every other day. “Balance it between cardiovascular activities that raise your heart rate, and resistance exercises that build muscle and bone strength,” Dr. Thomas advises. “Don’t forget flexibility, which will benefit from gentle yoga, and balance, which can be improved by tai chi.”

Ease into the new exercise routine—don’t try to lift more weights than you can handle, don’t start out at a run on the treadmill, and don’t overstretch while trying to touch your toes. “After about six weeks you can start increasing the frequency and duration of your exercise sessions,” Dr. Thomas says.

Keep in mind too that workouts don’t have to be “formal.” You can march on the spot while you’re waiting for your coffee to drip, rake leaves instead of relying on the leaf-blower, do shoulder lifts and rolls when you’re stopped at a traffic light, and take the stairs instead of the elevator.

For related reading, please visit theses posts:

• Knee Joint Pain Solutions, from Strengthening Exercises to Surgery to Alternative Treatments
• Senior Exercise Basics: Getting Ready to Work Out 
• Balance Exercises for Seniors 
• Core Exercises for Seniors 

This article was originally published in 2017. It is updated regularly. 

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Exercise or physical activity is one of the most important steps you can take toward improving your health. Multiple studies have shown that people who are physically active are more likely to live longer and remain independent compared with those who are inactive. And yet, a 2015 report from the United Health Foundation states that 33.3 percent of seniors are not engaging in physical activity, compared with 28.7 percent in 2014. This is a trend that needs to change, because staying active with such routines as balance exercises for seniors can make a positive impact on the aging process.

Benefits of Balance Exercises for Seniors

Exercising regularly produces a number of important benefits. Among them:

• Longevity: Researchers have shown that exercise increases your likelihood of living longer. While it is important to consult with your doctor if you have never been physically active and want to begin an exercise regimen, evidence suggests that it is never too late to reap the benefits. One study found a significant survival benefit in people between the ages of 70 and 85 who started a physical activity regimen compared with those who remained inactive.
• Independent living: Studies have shown that people who are physically active are more likely to be able to live independently as they age. One study evaluated the physical activity level of people at the age of 78 and found that those who were most active were more likely to be living independently at the age of 85.
• Brain age: Exercise has a positive impact on our brains. Increased physical activity is associated with improved cognitive function, including better executive functioning skills like planning, organizing, and strategizing. While exercising can help you avoid or delay the process of developing mild cognitive impairment, it has also been shown to improve cognitive functioning in those already experiencing some degree of impairment.
• Weight control: Exercise can help you maintain a healthy weight and avoid obesity, which, in turn, will help reduce your risk of many diseases. Excess weight is also a burden on the body’s musculoskeletal system and can impair your mobility.
• Decreased risk of disease: Regular exercise has been shown to both reduce the risk of and improve symptoms of many diseases including high blood pressure (hypertension), heart disease, type 2 diabetes, and some cancers. It can also help prevent bone density loss in people with osteoporosis and can improve lung function in people with chronic obstructive pulmonary disease (COPD). Exercise, when part of a doctor-approved program, can help speed recovery from certain illnesses as well.
• Reduced anxiety and depression: Exercise has been shown to improve both anxiety and depression. Exercise releases chemicals like endorphins that can ease depression. One study of an elderly population showed that people who exercised regularly had a 20 percent reduction in anxiety compared with those who did not exercise.
• Reduced risk of falls and hospitalization: Exercise, particularly exercise that increases muscle mass and strength, is associated with a decreased risk of falls and a decreased risk of being hospitalized.
• Financial savings: By being physically fit and minimizing your risk of disease and other age-related disorders, your need for prescription medication can decrease, translating into what can be a substantial cost savings over the years.

Creating an Exercise Plan

It’s particularly important as you age to consult your healthcare provider so you can avoid injury before beginning a new exercise regimen. The most effective way to embark on a successful exercise program is to find one that’s fun and convenient for you.

There are several steps you can take to improve the odds that you will create a plan you can maintain:

• Make it fun: Exercise does not need to be boring. Find an activity you enjoy, whether it is walking, swimming, taking a dance or yoga class, or hiking. There are many different ways to get exercise.
• Make it convenient: Find a place that is easy to get to for your exercise so that getting there does not become burdensome.
• Keep a schedule: Find a time of day and pick certain days of the week when exercising will best fit into your routine.
• Make it social: Finding a partner to exercise with, or joining a class at a gym or community center can not only keep you motivated, but can make the process more enjoyable.
• Be smart: Consult with your doctor on a plan that is healthy for you. Leave yourself time to warm up your muscles before taxing them with more rigorous exercise. If it causes pain, you need to reevaluate your regimen. Be willing to readjust your routine if you have an illness or injury that prevents you from doing the exercise you are used to doing.

Treadmills provide an easy way to get your walking in.

What Types of Exercise Should I Do?

There are four main categories of exercise. Which type(s) you decide to incorporate into your regimen should depend on your health and medical problems. Your doctor can help guide you in creating a safe regimen.

1. Aerobic: Engaging in an exercise that safely raises your heart rate or makes you breathe a little harder—aerobic fitness—can help build up your stamina and energy level. Swimming, tennis, aerobics, or simply walking briskly are examples of activities that raise your heart rate. Most experts recommend 30 minutes a day of this kind of exercise, at least several days a week. If 30 consecutive minutes is too much for you, you can break it into 10-minute segments throughout the day. A study of people between the ages of 60 and 83 showed that this type of exercise was the most beneficial in terms of reducing abdominal fat and C-reactive protein levels (a marker of inflammation), both of which are linked to heart disease and diabetes. (See also our story “The HIIT Trend: High-Intensity Interval Training.”)

2. Strength Training: This type of exercise (including activities like squats or push-ups) helps maintain muscle mass. Muscles support your joints; stronger muscles can help reduce arthritis symptoms and avoid joint injuries.

3. Balance: Balance exercises for seniors can help reduce the risk of suffering a fall. Examples you can try:

• Heel-to-toe walking: Walking in a straight line, place the heel of one foot in front of the toes of the other foot. Walk across a room in this pattern, attempting to stay on a straight course.
• Single leg stand: Holding on to the back of a chair, lift one leg and balance your weight on the other leg for 20 seconds. As your steadiness improves, you can perform this without holding onto the chair.
• Balance walk: One of the most basic balance exercises for seniors involves raising your arms on both sides to shoulder height and walking in a straight line, one foot in front of the other. As you walk, lift the back leg and hold it up for one second. Keep your arms raised at all times.

4. Flexibility: Stretching exercises for seniors keep your muscles limber and can keep you flexible. Increased flexibility helps keep you mobile while also preventing strains and sprains or other types of muscular injury. Working out in water is an ideal way to become more flexible without putting more stress on your joints. Exercises you can do both in and out of the water include:

• Leg abductions strengthen your outer thighs, the muscles around the hip, and the core. Stand tall, holding on to the side of the pool or a wall for support. Lift your left leg out to the side, keeping your foot pointing forward; then bring your leg back to the start position. Do 10 to 12 repetitions, then switch to the right leg. Do three sets (left and right) on non-consecutive days.
• Side raises strengthen the muscles around the shoulders and tones the arms. Stand tall with your feet hip-width apart, arms at your sides. Close your hands, with thumbs pointing upward. Slowly raise your arms up, keeping them slightly in front of your body, not straight out to the side. Keep shoulders down as you raise your arms no higher than shoulder level. Slowly lower to the start position. Do three sets of 10 to 12 repetitions on non-consecutive days.

Originally published in 2016, this post is regularly updated.

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