Balance is our ability to stay upright whether that’s sitting or standing. Good balance relies on 3 systems of the body working well.

  • The Proprioceptive system (PS) which collects sensory feedback from our skin, soft tissue and joints about where parts of our body are in the space around us, this feeds back to the brain where information collected from our senses combines to tell our body where we are.  Our brain sorts through this information and then decides what it needs to do to correct a part to keep us upright.
  • Vestibular system (VS) collects information from the position of the head and sudden changes in the direction of movement in the head. Fluid within the ear helps with this.
  • Visual system (ViS) collects information from what we see around us.

(Interestingly on a stable surface input is 70% PS, 20% VS and 10% ViS but on an unstable surface it swaps to 10% PS, 60% VS and 30% ViS)


All this information collecting; processing and motor feedback happens in a split second and it’s this that keeps us from falling as we move around in our daily activities.

There are two types of balance, static and dynamic.  Static is a held position such as a single leg stand or a headstand and dynamic refers to our balance as we move around.

When this information process is hindered; it may be by cognitive decline, weak muscles, loss of range of movement in a joint, soft tissue damage, muscle wasting or illness, we become less able to correct our self and our balance becomes compromised leading to a higher risk of falls.

In clinic I use balance as an assessment tool on many of my patients.  I’m looking at how they achieve a static position, can they maintain it for a healthy length of time, can they adjust their position if they wobble. If poor balance is an issue then part of my role is to find out what the underlying causes may be and help them correct it.  Having a history of ankle injuries can lead to an unstable ankle which can affect the proprioceptive system, having weak muscles may mean a patient cant engage their core muscles to keep them standing tall.  Weak hip muscles may mean a hip drop to one side or the inability to stabilise on one leg.  Having poor balance is the major risk for falls which are a very common and a serious health issue faced by older people in England, often resulting in a fracture.  People aged 65 and older have the highest risk of falling; around a third of people aged 65 and over, and around half of people aged 80 and over, fall at least once a year. Falling is a cause of distress, pain, injury, loss of confidence, loss of independence and mortality and is linked to reduce mortality.

So hopefully you can see how important balance is and why maintaining healthy body systems will maintain good balance.  Assessing balance is a vital part of rehab and often patients are shocked at how poor their balance is.  As we age, we lose muscle mass and cognitive ability slows.  Exercise is key to maintaining both of these.  Strengthening our bodies as we age allows us to maintain muscle and challenge or senses to keep them sharp.  Strength exercises have been found to be really important as we age although many older adults are reluctant to use weights or don’t understand how important this element is.  My job is to help educate patients about the importance of exercise and give them ways they can exercise safely: whether its at home or in a group.  Even just practicing balance exercise can improve your ability to balance.  If you are struggling with your balance and would like to find out how I can help, please get in touch and we can have a chat.  You can also drop into clinic and collect some really great leaflets on preventing falls.

The video below shows you how to check your balance, give it a go and see where you are at.  Remember…..its never too late (or early) to work on your balance.


Useful Links

get_up_and_go_0.pdf (

Falls: applying All Our Health – GOV.UK (

Staying strong as you get older | The Chartered Society of Physiotherapy (

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