As I get older, what steps can I take to improve my balance and avoid falling?

DEAR DOCTOR K:

I’m in my 70s. A friend of mine recently fell and broke her hip. I’d like to avoid a similar fate. What steps can I take to avoid falling?

DEAR READER:

Falls send millions of people in the United States to emergency departments each year with broken hips and head injuries. Imbalance is a common cause of falls. Liz Moritz, a physical therapist at Harvard-affiliated Brigham and Women’s Hospital, recommends several strategies to people looking to improve their balance.

  • PHYSICAL THERAPY. Physical therapy for balance focuses on three things: the ability of the joints and brain to communicate, the balance system in the ear (the vestibular system) and vision. Exercises such as standing on one foot, first with the eyes open and then with the eyes closed, can help coordinate all three. Joint flexibility exercises, walking and lower-extremity exercises can also help.
  • MUSCLE STRENGTHENING. Core strength is very important for balance. If the abdominal muscles in your core are weak, they cannot support your legs when you’re walking. And if the muscles in your buttocks and hips aren’t strong, they won’t be able to propel you forward. Muscle strengthening exercises can help.
  • TAI CHI AND YOGA. Tai chi and yoga make you pay attention to the control and quality of movement, which improves your balance. In tai chi, you practice slow, flowing motions and shift your weight from one limb to another. Yoga incorporates a series of focused postures and breathing. Both exercises increase flexibility, range of motion, leg and core strength and reflexes.
  • VISION CORRECTION. If your vision is impaired, your risk of falling increases dramatically. If you’re having trouble with your vision, the fix may be as simple as a new eyeglasses prescription. Once you hit age 40, you should have regular, comprehensive, dilated eye exams.
  • ASSISTIVE WALKING DEVICES. A cane or a walker can complement your balance and give you more stability and confidence walking. Walkers are available with wheels intended for different terrain, lockable brakes, seats, baskets and other features such as headlights. Canes are available with various handgrips and bases.

Balance is one of those things that we take for granted. In most of us, it becomes worse as we enter the last half of our lives. But we often don’t notice it –until suddenly we do.

I remember the moment when I noticed it. A light bulb in a high ceiling fixture needed replacing. So I did what I’d done before, though not for quite a while. I got out the tall ladder and started to climb. Halfway up, it suddenly struck me: I wasn’t very steady. This was not a good idea. Indeed, it was a bad idea.

I called a young handyman who had done odd jobs for us and told him I had a small job for him. When he asked what it was, I replied: “Change a light bulb.” He replied: “Well, this is a first for me, but if the money is good, I’ll be right over”!