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Better balance: Mental and physical fitness are both essential

Daily physical activity, targeted balance exercises, and steps to maintain your brain all help prevent falls.

If you’ve ever seen a friend or family member fall and suffer a major fracture—especially in the hip or spine—you know it’s serious business. General physical fitness and targeted exercises to improve balance can prevent falls. But so can staying mentally active to maintain cognitive fitness. A sharp mind helps you to think—and stay—on your feet.

“We need careful planning of our movements, decision making, reaction time, and attention,” says Brad Manor, PhD, an instructor in medicine at Harvard Medical School and director of the Mobility and Falls Program, Hebrew SeniorLife of Boston. “Staying mentally active is very important to avoiding falls.”

Staying balanced

We depend on a complex system for keeping us upright. The inner ear, which senses head motions, has an important role. So does the body’s somatosensory system, which relays the feeling of the ground beneath your feet. And, of course, vision tips you off to obstacles around you. The brain takes in all this information, plans our movements, and carries them out. “Balance is a complex system,” Manor says. “Especially as we get older, cognition becomes a big part of it.” Keeping the mind fit keeps us mentally sharp and helps us to navigate the ever-shifting obstacle course of the world.

Mind-body balance exercise

Manor and his fellow researchers are conducting studies to evaluate the balance benefits of tai chi, a form of exercise that involves moving gently through a series of poses. Tai chi improves balance because it works both the mind and body.

“Tai chi involves planned movements,” Manor explains. “It emphasizes being aware of the movements and how they feel.”

Classes in tai chi and a related exercise system, qigong, are widely available. The American Tai Chi and Qigong Association provides a search engine for finding tai chi and qigong classes in your area at

You could also perform daily “standing balance” exercises. These include repeated moves that involve standing on one leg while gently lifting the other. A good resource is Better Balance, a Special Health Report from Harvard Medical School, available at A personal trainer can also help you learn a balance-improving routine.

Muscle power for balance

Maintaining mental fitness, remaining physically active, and practicing tai chi, qigong, yoga, or some other mind-body exercise can help you keep your balance and avoid stumbling. But if you do lose your balance, recovering requires muscle power. Power is the ability to exert force quickly—the kind of conditioning an experienced ballroom dancer uses to “push off” during quick steps and turns. Rapid, forceful exercises like hopping and side stepping help to build power. For beginners, classes or trainers are valuable to learn how to exercise for power safely.

One thing is for certain: Balance can’t be taken for granted past a certain age; it must be maintained—both in mind and body.

Use fear of falling to your advantage

Becoming fearful of falling is understandable for those who start to feel a little wobbly on their feet. But you cannot let the fear limit your activities too much. “People come in and tell me they are really afraid of falling, often because they have seen a friend fall and they know what happens,” says Dr. Suzanne E. Salamon, associate chief for clinical geriatrics at Harvard-affiliated Beth Israel Deaconess Medical Center and co-editor of Better Balance, a Special Health Report from Harvard Medical School.

But it’s dangerous to react to fear by staying home and being less physically active. Inactivity will only further raise the risk of a fracture due to a fall. However, men who respond proactively to fear of falling can end up healthier and at lower risk of injury. “Let the fear of falling work in your favor,” Dr. Salamon says. “Think of it as something to inspire you to take preventive steps.”

Staying physically active strengthens bones and improves balance. “Keep doing something active every day, whatever it is you like to do,” Dr. Salamon says. Daily walking is an excellent way to get started.

If you feel unsteady on your feet, talk to your doctor about being evaluated for physical therapy, which is proven to prevent falls. Research also suggests that getting adequate vitamin D—800 to 1,000 international units (IU) per day from food and supplements—reduces the risk of falls and fractures by supporting muscle function as well as bone strength.

Despite all these measures, anyone can trip and fall. That’s why staying physically active and boning up with calcium and vitamin D are so important. “If you can keep your bones strong, at least they will not break that easily,” Dr. Salamon says.

Posted by: Dr.Health

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