Reflecting on our participation in the YMCA Healthy Seniors event, I was so impressed to see such an active bunch of seniors. However, one constant I heard was that many still had an elevated concern about balance and how to keep this in check.

If you are currently going to the YMCA, then you are already doing one important thing to improve balance, which is staying active. Now, let’s dive a little deeper about why that might not be enough and what else you can do to be proactive.

Why Do I Feel Off Balance?

There are many reasons for someone to feel off balance or dizzy or have a higher risk of falls. Some common reasons include:

  • Muscular weakness or coordination deficits from old injuries including stroke or low back
  • Loss of lower body flexibility
  • Urinary incontinence (including waking in the night to use the restroom)
  • The inner ear
  • Low blood pressure
  • Viruses
  • Medication side effects

It’s not uncommon for people who have trouble with balance to have more than one of these factors.

Muscle imbalance where the big hip muscles or ankle muscles are weak can make walking feel like waddling and the foot feel like you are catching it on the ground. A physical therapist is a good resource to determine if this weakness can be improved with exercise. Loss of ankle, hip, or knee flexibility also tends to go hand in hand with these weakness patterns. Sometimes, specific flexibility combined with strengthening helps a lot as well.

With urinary incontinence, an individual may wake up at night and rush to the restroom, which puts the individual at risk. A recent study by Stanich et al. concluded that physical therapy interventions for incontinence in older women may be an important treatment option for also addressing fear of falling.

When the inner ear or vision system is involved, further evaluation can determine if specific positional treatments or habituation head eye type exercises are appropriate to lessen or completely eliminate the movement triggered dizziness symptoms. Ophthalmologists and optometrists are great resources when the deficit is purely visual.

When low blood pressure, viruses, or medication side effects are potential factors for imbalance, then working with your primary care provider is very important to improve these symptoms.

Laura’s Top Tips for Improving Balance

1. Stay active by getting the recommended exercise each week

    • 150 minutes of moderate intensity (i.e. brisk walk)
    • 2 days of total body strengthening

2. See a physical therapist for a balance assessment

• A physical therapist can determine if there’s a specific area you need to address more than general exercise alone.


Fisher S, Stanich S, Ickpyo H, McGaugh J, Hyun-jeong J, Galoway R, Utsey C. Fall Risk Reduction in the Elderly Through the Physical Therapy Management of Incontinence. 2019. Journal of Women’s Health Physical Therapy. 43;1:3-9.
Iwasaki S and Tatsuya Yamasoba. Dizziness and Imbalance in the Elderly: Age-related decline in the Vestibular System. Aging and Disease. 2015. Feb; 6(1): 38–47.
Sparling P.B., Howard B.J., Dunstan D.W. and Owen N. Recommendations for Physical Activity in Older Adults. BMJ. 2015; 350.