The information below is general wellness information and should not be interpreted as personal medical advice.  

One in four older adults will experience a fall each year (Centers for Disease Control and Prevention, 2026). While some falls can result in no injury at all, others can result in the loss of mobility, fracture, head injury, or, in extreme cases, death (Vaishya & Vaish, 2020). These falls are also costly. With an annual 922,428 inpatient stays and 2.3 million emergency department visits, falls in older adults result in a $19.8 billion strain on the medical system (Reider et al., 2024). The situation is not hopeless, however, as balance training is one of the best ways to reduce fall risk and avoid its health and financial consequences.

In 2025, Kirk-Sanchez et al. published a Clinical Practice Guideline (CPG), establishing formal recommendations based on the best available evidence to prevent falls in community-dwelling older adults. These recommendations serve as a roadmap for managing these concerns and promoting healthy aging. Please note that the information in this article is generalized from multiple studies and does not account for all underlying conditions that can create balance deficits, such as progressive neurologic conditions, vestibular pathologies, or other determinants such as strength or range-of-motion deficits. Balance exercises MUST be individualized to the person’s specific needs, but the summary below serves as a general guideline.

What Balance Exercises Should I Do?

Based on the CPG, here are the recommendations for type, difficulty, and length of exercises to improve and maintain balance function:

1. Types of Exercise:
   1. Multi-component exercise (Strong Recommendation): Multi-component exercise incorporates strength and endurance training to supplement balance performance. Balance is a complex interaction between the brain and the body systems, but at the very basics, you cannot balance well if you are not strong enough or get tired easily. Having a well-rounded, consistent exercise routine is important for good balance performance. The CPG recommends that strength training alone is not enough to improve balance, but can be a great place to start if weakness is a primary problem preventing balance performance.
   2. Volitional Step and Gait Adaptability Training (Strong Recommendation): Did you know taking a walk through your local park or hiking over uneven terrain could improve your balance? As most falls occur while people are walking and moving, practicing stepping in multiple directions, over obstacles, and across various surface heights helps to improve balance performance and keep you upright with your feet on the ground.
   3. Tai Chi (Strong Recommendation): One of the strongest findings in the review, which has spanned decades of research, is the use of TaiChi for balance improvement. Through repetitive, gentle movements that incorporate multidirectional stepping, Tai Chi is one of the highest-ranked community exercise programs that can be used. TaiChi focuses on connecting the brain to the body to promote better body awareness, which can help detect early balance losses and prevent them.
2. Difficulty of Exercise: Balance training is most effective with an appropriate challenge (Strong Recommendation). If the balance exercise is too easy, is will not improve or maintain the performance of the system. This is where some exercises become challenging to do alone, and consulting with a physical therapy professional (see the links below) is important to maintain safety while pushing challenge.
3. Length of Exercise: Balance is best improved when performed three hours a week over the course of 6 to 12 months (Strong Recommendation). It seems like a lot of training, but the brain needs a challenge to adapt and better use the body to navigate its environment.

When Should I Do It?

When it comes to balance exercises, it is never too early or too late to start! Balance training should be a part of everyone’s exercise routine, even before older adulthood. Starting to incorporate these items in young or middle adulthood supports healthy aging. If you’re feeling like it’s too late for you, it’s not! Balance training to restore function is a common and effective practice even in people well into their 90s and above.

If you feel like you need to make a change, but don’t know where to start, find a physical therapy near you using the American Physical Therapy Association’s “Find a PT” database or the American Board of Physical Therapy Specialists “Find a Specialist” tools to locate a clinician near you who can help you figure out where to get started.

What are My First Steps?

If you are someone at high risk of falls, meaning you’ve experienced at least one fall in the last year, had an injury as a result of a fall, have multiple health issues that make balance difficult, or you are unable to get on and off of the floor easily, the CPG recommends that you start your balance journey with a physical therapy professional to ensure an individualized and tapered program that will meet your unique needs and goals.

If you do not meet the above criteria, then starting out first by increasing your overall physical activity with a goal of 150 minutes per week to build your stamina and checking out a community balance program such as TaiChi, a local class at your YMCA, or other community fitness option is a GREAT place to start to support healthy aging and quality of life.

References

Centers for Disease Control and Prevention. (2026). Older adult falls data. U.S. Department of Health and Human Services. https://www.cdc.gov/falls/data-research/index.html

Kirk-Sanchez, N., McDonough, C., Avin, K. G., Blackwood, J., & Hanke, T. A. (2025). Physical therapy management of fall risk in community-dwelling older adults: An evidence-based clinical practice guideline from the American Physical Therapy Association – Geriatrics. Journal of Geriatric Physical Therapy (2001), 48(2), 62–87. https://doi.org/10.1519/JPT.0000000000000454

Reider, L., Falvey, J. R., Okoye, S. M., Wolff, J. L., & Levy, J. F. (2024). Cost of U.S emergency department and inpatient visits for fall injuries in older adults. Injury, 55(2), 111199. https://doi.org/10.1016/j.injury.2023.111199

Vaishya, R., & Vaish, A. (2020). Falls in Older Adults are Serious. Indian Journal of Orthopaedics, 54(1), 69–74. https://doi.org/10.1007/s43465-019-00037-x