Balance Exercises for Older Adults: Cutting Falls Risk in Your 60s, 70s and 80s

Key Takeaways

• Balance is a skill your body can rebuild at any age because the systems behind steadiness respond to regular, graded practice.
• Programs that challenge balance and add leg and hip strength have the strongest evidence for cutting falls, more so than walking or general activity on its own.
• Dose decides the result, so effective balance work challenges you, reaches around 3 hours a week and keeps going long term.
• A short routine of eight standing exercises, done most days, covers the balance and strength work linked to fewer falls.
• Exercise is the main lever, though medication, vision, blood pressure, footwear, home hazards and bone strength all shift your risk too.

You step off a kerb you have used a thousand times, and your foot lands half a beat late. Or you reach for the handrail on the stairs without quite deciding to. Moments like these are easy to brush off, and just as easy to start organising your life around.

Balance is not a fixed trait. It is a skill, and like any skill, it responds to practice. Balance exercises for older adults can measurably lower the risk of a fall, even well into your 80s. At least one in three people over 65 fall each year, and for older Australians, falls are the most common cause of injury hospitalisation and injury death, according to the Australian Institute of Health and Welfare (AIHW).

An exercise physiology program can set the right level of challenge and pinpoint your weak points, though it helps to understand what you are training first.

Balance Is a Skill You Can Rebuild

Steadiness is not one thing. It comes from several body systems working together, most of which respond to training well into later life:

Evidence That Balance Training Cuts Falls

Balance and functional exercise reduces the rate of falls by about 24%, a high-certainty finding from the 2019 Cochrane review of exercise for preventing falls, which examined 108 trials of more than 23,000 older people in total. When balance work is combined with leg strengthening, the reduction rises to around a third. The effect holds for people over 75, and it is larger when a health professional guides the program. Exercise and Sports Science Australia (ESSA) reached the same conclusion in its 2024 position statement on exercise for preventing falls.

Age-Related Changes You Can Work With

Several of the systems that keep you upright fade with age, and each one is trainable. Muscle strength drops, and so does the speed at which muscles produce force, which is what you need to catch yourself after a trip. Sensation in the feet and joints, called proprioception, becomes less sharp, so your body reads its own position less accurately. The inner-ear balance organs and eyesight both change, and the brain grows slower at blending those signals together. Muscles regain strength and speed with resistance work, and position sense re-sharpens when you practise moving at the edge of your stability. The body keeps adapting to what you ask of it, which is exactly what makes training as you age worthwhile.

Balance as a Trainable Capacity

Practice works because the nervous system keeps forming new connections throughout life. When you repeatedly challenge your balance in a controlled way, the brain and muscles build faster, more automatic responses to being off-centre. Those responses are what save you when a real stumble happens and there is no time to think. Steadiness gained this way is specific to what you train, so the closer your practice is to standing, turning, reaching and walking, the more it carries into daily life. It also fades if you stop, which is why balance training is something to keep, not something to finish.

What Kind of Exercise Cuts Falls Risk

Not all activity reduces falls. The programs with the strongest evidence share a clear shape, and type matters as much as amount:

Balance and Functional Exercises First

Standing exercises that challenge your balance, alongside the functional movements of daily life, carry the highest-certainty evidence for preventing falls. Balance work means holding and moving through positions that test your stability, such as standing with your feet together, standing on one leg or walking heel to toe. Functional work means rehearsing the movements you are making when a fall tends to happen, such as rising from a chair, climbing stairs, turning around, and reaching overhead or down to the floor. Done standing, not seated, these exercises train the exact patterns you rely on at home.

Strength Work for Legs and Hips

Strength underpins balance because a muscle cannot steady a joint it is too weak to control. Work for the legs, hips and core gives you the control to hold a position and the strength to catch yourself before a stumble becomes a fall. Some of it is worth doing quickly, not just slow and heavy, because catching a stumble depends on force arriving fast. The sit-to-stand is a good marker. If rising from a chair without using your hands is hard, that is strength worth building. Adding strength to balance work is what pushes the reduction towards a third, and it is why leg strengthening several times a week sits alongside balance practice in Australian falls-prevention advice.

Weekly Dose That Changes Your Risk

Falls-prevention guidelines point to at least 2 to 3 hours a week of genuinely challenging balance work, kept going over the long term. Research led by Professor Cathie Sherrington and colleagues found that programs pairing a high balance challenge with 3 or more hours a week cut falls by over 40%, well above the average for exercise. Little and often across the years does far more than an intense month abandoned by winter.

Genuine Challenge to Your Balance

Challenging your balance means working at the edge of your stability, where you feel a light wobble but stay safe. In practice, that usually means narrowing your base of support: feet apart becomes feet together, which in turn becomes standing on one leg. It also means shifting your weight further, reaching beyond arm’s length, turning your head while you stand, taking a hand off the bench, or closing your eyes so your body leans more on the inner ear and less on vision. Too easy, and it will not drive change; too hard, and it is unsafe for now. Real stumbles rarely happen while you concentrate on standing still, so once a level feels steady, adding a task, such as counting backwards or holding a conversation, brings the practice closer to daily life.

Approaches With Weaker Evidence

Some popular choices help general health more than they prevent falls. Walking on its own, and general activity with no balance element, show weaker and less certain effects on falls in the research, because they do not push your stability hard enough to force it to adapt. Tai Chi, with its slow, controlled shifts of weight, may reduce falls, though the evidence is less settled than for targeted balance and strength work. The aim is not to drop what you enjoy, but to add deliberate balance challenge on top of it.

Starting Balance Training Safely at Home

Balance training only helps if you can do it without ending up on the floor, so setup and progression matter as much as the exercises. The right level depends on your current steadiness, your health and any conditions you manage:

Setting Up a Safe Space to Practise

Practise beside something solid you can grab, such as a kitchen bench, a sturdy rail or a corner where two walls meet. Clear the floor of rugs and cords, wear supportive shoes or go barefoot, not socks, and make sure the light is good. In the early weeks, having someone nearby is a sensible precaution, especially if you have fallen before or feel frail. Many falls at home happen in the bathroom or at night, so those are worth thinking through separately from your practice.

Progressing From Easy to Challenging

A common progression starts with two feet and plenty of support, then removes support as you steady. You might hold a position for 10 seconds and build towards 30, moving from feet apart to feet together to standing on one leg, then to the same steps with your eyes closed once each feels secure. Because so much of walking is spent balanced on one foot, it is worth spending extra time on single-leg exercises as you progress. Standing on a cushion or a folded towel softens the ground underfoot and makes the ankles and position sense work harder. Make a move slightly harder once the current version feels controlled, instead of rushing to the hardest option.

Knowing When to Stop and Check

Sharp pain, dizziness or breathlessness means stop and check with a professional before continuing. These are different from the mild unsteadiness of working at the right level and are not something to push through.

Building a Habit That Lasts

The habit matters more than any single session, and short, frequent practice tends to stick better than long, occasional efforts. Balance work folds neatly into daily life. Stand on one leg while the kettle boils, walk heel to toe down the hallway, rise from your chair without hands a few times before dinner. When that is hard to keep up alone, a guided program at home can hold the routine together and show you when to progress.

8 Balance Exercises for Older Adults (With Sets and Reps)

These falls prevention exercises combine balance challenge and leg strength, the pairing with the strongest evidence for cutting falls. Do them beside a kitchen bench or sturdy rail, and start at the easiest version you can do with control. Aim to do the balance exercises most days. Do the strength exercises (1 to 4 and 8) two to three times a week. A full round takes around 15 to 20 minutes. Spread across the week, it helps build towards the 2 to 3 hours of balance work linked to fewer falls.

1. Sit-to-stand. From a firm chair, stand up fully, then lower slowly back down. Do 2 to 3 sets of 8 to 10. Start with your hands on the armrests if you need to. Progress to arms crossed, then a slower lowering phase.
2. Heel raises. Holding the bench, rise onto the balls of your feet, pause, then lower slowly. Do 2 to 3 sets of 10 to 15. Progress by lightening your grip, then by doing one leg at a time.
3. Toe raises. Holding the bench, lift your toes and the front of your feet off the floor while keeping your heels down. Do 2 sets of 10 to 15. This strengthens the shin muscles that help you clear the ground and avoid tripping.
4. Side leg raises. Stand tall holding the bench and lift one leg out to the side without leaning, then lower with control. Do 2 to 3 sets of 10 on each side. These work the hip muscles that stop you tipping sideways.
5. Narrowing stance holds. Stand with your feet together for 10 seconds. Then place one foot half in front of the other for 10 seconds, then heel to toe in a straight line for 10 seconds. Do 3 holds at each level you can manage, building towards 30 seconds before moving to the next level.
6. Single-leg stand. Hold the bench lightly and lift one foot just off the floor. Do 3 holds of 10 to 30 seconds on each leg. Progress to fingertip support, then no hands. Later, try turning your head slowly or standing on a folded towel.
7. Heel-to-toe walk. Walk forwards along the bench, placing the heel of each foot directly in front of the toes of the other. Do 3 to 4 lengths of about 10 steps. Once that is steady, try walking backwards along the bench as well.
8. Step-ups. Using the bottom stair and holding the rail, step up with one leg and bring the other to meet it, then step back down. Do 2 to 3 sets of 8 to 10 on each leg. Lead with the weaker leg first.

Progress one exercise at a time. Make a move harder only when you can complete every set with control and only a light wobble. These sets and reps are general starting points. An exercise physiologist can adjust them to your strength, joints and health conditions.

Other Falls-Risk Factors Worth Checking

Exercise is the strongest single lever, though a fall usually has more than one cause, and the other causes are often quick to address. Older adults with muscle weakness or a gait problem are three to five times more likely to fall than those without, according to Western Australia’s Stay On Your Feet program, and the risks compound when several factors combine. The ones worth reviewing are:

Medication

Taking five or more medicines is linked to a higher risk of falls, and some drugs cause drowsiness or lower blood pressure. A pharmacist or your general practitioner (GP) can review your medicines and adjust them where it is safe to do so.

Vision

Changes to eyesight make edges, steps and obstacles harder to judge, particularly as depth perception fades with age. A regular eye check, up-to-date glasses and care with multifocals on stairs all reduce the risk, since multifocals can blur the ground right where you step.

Home Hazards

Loose rugs, trailing cords, poor lighting and cluttered walkways cause a large share of falls at home. Removing trip hazards, improving lighting, and fitting rails in the bathroom and on stairs make a measurable difference.

Footwear

Well-fitted, supportive shoes with a firm sole and a low heel give you better contact with the ground than slippers, socks or worn-out footwear with smooth treads. Foot pain and untreated problems such as bunions or numbness also change how you walk, so they are worth having checked.

Blood Pressure

Blood pressure that drops when you stand, known as postural or orthostatic hypotension, can cause the light-headedness behind many falls, particularly when you get up quickly. Rising slowly and pausing before you walk off helps, and persistent dizziness on standing is worth raising with your GP.

Bone Strength

Bone strength does not cause falls, but it decides how much damage a fall does. If you have osteoporosis or low bone density, a fall is more likely to break a bone, which is why bone-focused exercise matters alongside balance. A bone-strengthening program can build both bone and the muscle that supports it.

These factors affect people differently, and not all of them will apply to you. A GP or an accredited exercise physiologist can help work out which ones are worth acting on.

Quick Falls-Risk Self-Check

This check can’t tell you your exact risk. It can show whether your steadiness is worth having assessed. Answer yes or no:

• Have you fallen in the past 12 months, or had a near-miss?
• Do you need to push up with your arms to get out of a chair?
• Do you feel unsteady when you walk, turn or climb stairs?
• Do you hold onto furniture or walls when moving around your home?
• Do you worry about falling, or avoid activities because of it?
• Do you take five or more medicines, or any that make you drowsy or dizzy?
• Do you feel light-headed when you stand up?
• Have you lost some feeling in your feet, or do they often hurt?

A quick stand test. With someone nearby and a bench within reach, stand with one foot directly in front of the other, heel to toe, without holding on. If you can’t hold this position for 10 seconds, that is a recognised sign of higher falls risk.

When to Get Assessed

If you answered yes to any question, or couldn’t hold the stand test, a falls or balance assessment is worth booking. Book one sooner if you have fallen more than once, were injured in a fall, or couldn’t get up afterwards. Tell your GP about any fall so medical causes can be checked. Our falls prevention page explains how an assessment and a tailored program fit together. If you answered no to everything, the exercises above remain one of the best ways to keep it that way.

Getting the Right Support for Your Situation

You can begin gentle balance work on your own, though a professional assessment helps you train at the right level and target your weak points. Where structured help fits depends on your history and your confidence:

Assessment That Pinpoints Your Risk

A falls or balance assessment measures where your steadiness sits, using simple tests such as the Timed Up and Go, a sit-to-stand count, or a staged balance test. The Timed Up and Go, for example, records how long it takes to rise from a chair, walk 3 metres, turn, walk back and sit down, and a slower time can flag a higher risk. Australian and international falls guidelines suggest people aged 65 and over be asked about falls at least once a year, and assessed further if they have fallen, had a near-miss or feel unsteady. Knowing your starting point also lets you track progress instead of guessing at it.

Role of an Exercise Physiologist

An accredited exercise physiologist assesses your strength, balance and movement, then builds a program set at a level you can manage and build on. Early sessions may be supervised so the level is right, before more of the work shifts to home. The program is matched to your body, your conditions and your goals, and adjusted as you improve, so you are neither under-challenged nor put at risk.

Support From Your GP and Care Team

Your GP can review medications, arrange vision and bone-density checks, and coordinate referrals. For eligible patients, a Medicare GP Chronic Condition Management Plan may cover up to five allied health services a year, which can include exercise physiology, though your GP decides whether you qualify. The Department of Veterans’ Affairs (DVA) and the Support at Home program accessed through My Aged Care may also help, depending on your circumstances. Scheme rules and rebates are set by government and change from time to time, so confirm current details with your GP or the relevant program.

Safe Ways to Keep Training at Home

Telehealth appointments, group classes and structured home programs keep you progressing between clinic visits, with a practitioner adjusting the level as your balance improves. For people in rural areas or without easy transport, remote options make ongoing training realistic.

Steadier Days and Fewer Stumbles

The unsteadiness you have noticed is real, and so is your ability to change it. Balance responds to training in your 60s, 70s and 80s, which means the near-misses that have been quietly shrinking your world do not have to set the terms. With the right kind of practice, kept up over time, most people can move through their day with more steadiness and less second-guessing, reaching for the handrail because they choose to, not because they must.

Starting sooner tends to be easier than starting later, since steadiness is quicker to keep than to rebuild. If you are weighing up how to train your balance and lower your falls risk, the team at MTP Health can talk you through the options that suit your circumstances.

Frequently Asked Questions (FAQs)

1. What are the best balance exercises for older adults?

The best balance exercises for older adults and seniors are standing exercises that challenge your stability, combined with leg and hip strengthening. Examples include sit-to-stand, heel raises, side leg raises, tandem (heel-to-toe) stance, single-leg standing, heel-to-toe walking and step-ups. Programs that combine balance and strength cut falls by around a third. They work best when the exercises feel genuinely challenging, are done for 2 to 3 hours a week, and are kept up long term.

2. Can balance training help if I have already had a fall or feel afraid of falling?

Yes, and these are often the people who benefit most. A fall or a fear of falling tends to make people move less, which weakens the very muscles and reflexes that keep them upright, so the fear can quietly raise the risk it comes from.

Training rebuilds both the physical steadiness and the confidence, ideally starting at a gentle, well-supported level and building as trust returns. If you have had a fall, it is worth telling your GP so any medical causes can be checked.

3. How long before balance training makes a difference?

Many people feel steadier within a few weeks, though measurable falls-risk reduction builds over months of consistent practice. Progress depends on your starting point, your health and how regularly you train.

4. Are balance classes or one-on-one sessions better?

Both can work, and the research has not found one format clearly beats the other for reducing falls. Group classes offer routine, company and lower cost, while one-on-one sessions allow a program pitched precisely to your needs and closer supervision early on. A common approach is to start individually to get the level right, then move into a group or home routine to keep it going.

5. Can I do balance exercises if I have knee or hip osteoarthritis?

In most cases yes, with the exercises adapted to your comfort and your joint condition. Osteoarthritis is common in this age group and often affects balance and walking, so suitable strength and balance work can help both the joint and your steadiness.

An accredited exercise physiologist can adjust positions, range and load so you train effectively without flaring symptoms. If joint pain is holding you back, osteoarthritis care can treat the underlying joint problem alongside your balance work.

6. Do I need a referral or a GP visit before starting?

You do not need a referral to see an exercise physiologist privately in Australia, so you can book an assessment directly. A GP visit is still worth considering to check for medical causes of unsteadiness and to see whether a Medicare chronic condition management plan could help with the cost. If you have a heart condition, recent surgery or significant dizziness, speak with your GP before starting new exercise.

7. What about yoga for balance?

Yoga builds strength and body awareness but varies widely by class and teacher, so its falls-prevention effect is harder to pin down. It can be a worthwhile addition alongside more targeted balance and strength work, as long as the balance challenge is genuine and you work safely at your level.

Disclaimer: This article is general information only. It does not take your objectives, situation or needs into account, and it is not a substitute for individual assessment. You may wish to speak with your GP or a qualified health professional before starting or changing an exercise program, particularly if you have existing health conditions, have had a fall, or feel unsteady.

If you’re working on balance and stability, book an appointment with our team. MTP Health’s orthopaedic surgeons and physiotherapists consult across Sydney’s North Shore and Northern Beaches.

About the authors

Written by

Luke Kane

Founder & CEO, Exercise Physiologist

Exercise physiologist and Founder & CEO of MTP Health, which he established in 2012, with a career built around movement, rehabilitation and healthcare.

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Reviewed by

Antonia Kendrick

Allied Health Team Leader & Head Physiotherapist

Head Physiotherapist and Allied Health Team Leader at MTP Health, with a genuine, patient-focused approach to physiotherapy, rehabilitation and patient education.

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