Falls become more common as we get older, but they are not an inevitable part of ageing. Most falls are the result of several small things stacking up rather than one cause: leg strength that has quietly declined, balance that is a little less sharp, slower reactions, eyesight, footwear, some medications, and hazards around the home such as rugs, trailing leads and poor lighting.
The strength and balance part of that list responds well to training at any age, including into the nineties and after a fall has already happened. Muscle can still be built, and the balance reactions that catch you when you trip can still be retrained. Confidence tends to follow strength: people who feel steadier do more, and doing more keeps them steadier.
The strongest evidence is for programmes that genuinely challenge balance - working at the edge of steadiness in a safe setting, with something solid to hold - combined with leg strengthening, done two or three times a week over several months. Programmes like this reduce the rate of falls in older adults living at home by around a quarter, and the benefit fades if the exercise stops.
It is worth saying that falls sometimes have a medical cause worth investigating, such as blackouts, dizziness on standing, heart rhythm problems or the effects of medication, so a fall with no warning is a reason to see your GP as well as to start exercising. This programme begins with supported balance and simple strength, progresses to less support and harder balance tasks, and finishes with real-world skills: turning, stepping over obstacles, and walking while doing something else.
Older adults who have had a fall or a near miss, feel unsteady, or have become less confident on their feet. Always exercise where you can hold on to something solid. If you have had blackouts, chest pain, or falls with no warning, see your GP first to check for medical causes.
Begin here with support always within reach. Practise standing balance holding a worktop, simple weight-shifting and marching, and standing up from a chair. Aim for a little every day.
Progress to less hand support and harder positions - feet together, then one foot in front of the other - and add leg strengthening. Challenge your balance enough that it feels a bit wobbly, but stay safe.
The final stage rehearses everyday situations that cause falls - turning around, stepping over obstacles, uneven ground, and walking while talking or carrying something.
Balance and strength begin to improve within 4 to 8 weeks, but the falls-reduction benefit comes from keeping it going - the evidence is based on at least 3 hours of balance-challenging exercise a week sustained over 6 months or more. It works best as a permanent habit.
Balance training only works if it is hard enough to challenge you, so progress by reducing hand support and narrowing your base of support as you steady. Always have something solid to grab. If you feel light-headed on standing, rise slowly and pause before you walk off.
Yes, and it is one of the best things you can do to reduce the chance of another fall - provided you work within arm's reach of a stable surface. Start with the supported exercises and build up gradually.
The research suggests aiming for around 3 hours a week of balance and strength work, spread across most days, and continuing long term. Short daily sessions add up and are easier to stick with.
Having your medications reviewed, getting your eyes checked, treating dizziness, sorting out home hazards like loose rugs and poor lighting, and keeping up vitamin D if advised. A falls assessment can pull these together.
Set up in a corner of the kitchen with worktops on two sides, or have someone with you at first. Fear of falling is itself a risk factor, and gently and safely rebuilding confidence is part of the treatment.
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