4 Balance Exercises That Can Help Prevent Falls After 65, According to Physical Therapists

Reviewed by Dietitian Katey Davidson, M.Sc.FN, RD, CPT

Credit: Getty Images. EatingWell design.

Key Points

Balance exercises can help older adults build strength, stability and confidence to prevent falls.
Sit-to-stands, side-steps, single-leg deadlifts and step-ups support everyday movement.
Use support and exercise modifications to safely build balance and strength over time.

Falls are the leading cause of injury and injury-related death among adults ages 65 and older in the United States. In fact, more than 1 in 4 older adults, or over 14 million people, report falling each year. While not every fall results in an injury or fracture, the physical, emotional and financial toll of a fall—and the mobility challenges that may follow—can be significant.

The good news? Many falls are preventable. One of the most effective ways to reduce your risk is to protect and improve your balance as you age.

“Life happens one leg at a time,” says Mike Wehrhahn, PT, D.P.T. “Walking, climbing stairs, stepping over a curb, getting in and out of a car and catching yourself when you lose your balance all require you to accept and control your body weight on one side.”

“Maintaining strength as we age is extremely important, but fall prevention is about more than just having strong muscles,” Wehrhahn continues. “You also need to be able to shift your weight, control your body on one leg, react when your center of gravity changes and move comfortably through different positions. The more confidently someone can move, the better equipped they are to handle the unexpected.”

Read on for the four balance exercises physical therapists say are worth adding to your routine, along with helpful tips and modifications to make each move work for you.

1. Sit-to-Stands

Whether you’re getting up from the toilet or out of the car, sit-to-stand movements are an essential part of everyday life. Practicing them regularly can help support balance and functional strength as you age. “To stay upright, we must have good strength in our trunk and leg extensor muscles,” says Dana Tress, PT. “A simple movement that we do regularly, like sit-to-stands, can also be used to strengthen these muscle groups.”

“Sit-to-stands are especially beneficial because they strengthen the muscles, like the quadriceps, gluteus maximus and hamstrings, that are needed for everyday activities.” adds Jillian Rohr, PT, D.P.T. “Improving lower-extremity strength can make functional movements easier and help reduce the risk of falls.”

How to Perform:

Place a chair firmly against a sturdy surface, such as a wall or closed door, to prevent it from moving.
Sit toward the front of the chair with your feet about hip-width apart. Position your feet slightly behind your knees.
Lean your chest slightly forward and push through your heels to stand.
Stand up tall, fully straightening your hips and knees.
Slowly lower yourself back into the chair with control rather than dropping into the seat.
Perform 8 to 12 repetitions.

Modifications: To make the exercise easier, use the armrests to help push yourself up, notes Rohr. This can provide additional support as you build strength and balance. To make the exercise more challenging, use less assistance from your arms, slow down the lowering phase or progress to holding added weight.

2. Side-Steps

Being able to move in different directions is important for balance, especially as you age. “Lateral walking trains your ability to maintain balance while moving sideways,” shares Corey Podbielski, PT, D.P.T. “Many falls occur this way, and many people are untrained in this type of movement.”

Rohr agrees: “Side-stepping primarily targets the hip abductors, including the gluteus medius and gluteus minimus. These muscles are important for stabilizing the pelvis when we walk or when we lift one leg to clear an obstacle, such as stepping up on curbs or over objects.”

Research supports this exercise, too. One study found that adding side-stepping exercises to the routines of community-dwelling adults ages 70 and older improved balance and mobility over eight weeks. While more research is needed, side-stepping can be a low-risk addition to your routine when performed with proper form and support.

How to Perform:

Stand facing a sturdy countertop, railing, wall or other stable support. Maintain an upright posture.
Slightly bend your knees and step sideways with one foot. Bring your other foot toward it without dragging your feet. Keep your hands in front of you or lightly rest them on the support for balance.
Continue taking controlled sideways steps in one direction, then return in the opposite direction. Keep your toes pointing forward rather than allowing them to turn outward.
Continue for the length of your countertop or other stable surface, then repeat 2 to 3 times.

Modifications: To make the exercise easier, use both hands for support, take shorter steps or slow down the movement. For an added challenge, both Rohr and Podbielski recommend decreasing hand support, taking larger steps or using a resistance band around the thighs or ankles.

3. Single-Leg Deadlift with Support

Physical therapists recommend exercises that strengthen each leg independently while also challenging your balance through movement. Research suggests that single-leg exercises may help improve both balance and postural control in healthy adults.

“The single leg deadlift is one of my favorite balance exercises because it trains balance as part of movement instead of simply asking someone to stand still on one leg,” says Wehrhahn. “This exercise works the glutes, hamstrings, foot and ankle muscles, hip stabilizers and core, while challenging balance, hip strength, coordination and body control at the same time.”

Wehrhahn explains that relying on a single leg “is much closer to how balance works in real life, where you are almost always moving, reaching, stepping or reacting to something around you.”

How to Perform:

Stand an arm’s length away from a counter or sturdy surface. Lightly place one hand on the surface for support and your other hand on your hip.
Shift your weight onto one leg and keep a slight bend in that knee.
Brace your core and slowly hinge forward from your hips, extending your free leg behind you as your torso lowers. Keep your back flat and hips facing toward the floor.
Move slowly and with control, then press through the foot of your standing leg to return to the starting position. Use the counter for balance rather than pulling yourself up.
Continue for 8 to 12 repetitions each side, depending on your ability, focusing on maintaining control and stability throughout the movement, notes Podbielski.

Modifications: To make the exercise easier, keep one hand on a counter or chair and use a smaller range of motion. As balance improves, gradually reduce your hand support or increase your range of motion.

4. Step-Ups

Stairs are one of the most challenging activities for older adults and can result in falls, making step-ups a useful exercise for practicing the strength and balance needed to navigate stairs and other changes in elevation.

“Step-ups are another exercise I like because they train balance and strength together in a way that directly translates to everyday life,” says Wehrhahn. “They work the quadriceps, glutes, hamstrings, calves, foot and ankle stabilizers and core. This helps maintain the single leg strength and control needed for real-world situations. It also reinforces the ability to confidently shift your body weight onto one side instead of avoiding it.”

How to Perform:

Stand facing a low, stable step. Place one foot fully on the step and lightly hold a wall, railing or other sturdy surface for support, as needed.
Push through the foot on the step to lift yourself up. Keep your movement controlled and avoid pushing off the opposite foot. The leg on the step should do most of the work.
Slowly lower yourself back to the starting position.
Repeat on the same side for 8 to 10 repetitions, then switch sides.

Modifications: To make the exercise easier, start with a low step and use a railing or countertop for support. As you progress, increase the step height or gradually reduce your hand support.

Our Expert Take

Staying physically active is essential for healthy aging, especially when it comes to reducing your risk of falls. Physical therapists recommend practicing balance exercises at home that support everyday movements, including sit-to-stands, side-stepping, single-leg deadlifts and step-ups. Because these exercises mimic activities you perform throughout the day, they can help you build the strength, stability and confidence needed to move more safely.

“Simple movements such as these exercises can be a great way to start,” says Tress. “You can always consult with a physical therapist to help identify your balance needs and work to design an exercise program specifically for you.”

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