Why I Don't Prescribe Static Balance Exercise Anymore and What I Do Instead

Like many others in the Clinical Exercise Industry, I have stopped prescribing static balance exercises as the only form of exercise to improve balance.

You may think you already know why I don't like using purely static balance exercises anymore, but this post will take you through 5 reasons why I switched away from it.

Please read to the end to discover what I switched to. No peeking allowed! In the process, you may find your new favourite balance movement to add to your daily exercise routine.

Background: Balance Exercises and I

Let's enter our handy time travel machine and explore my start in clinical exercise prescription.

It was the year 2009, music was on the radio (no podcasts back then), I was driving a beat up car my employee had provided and it was my first year working as an exercise physiologist.

That was the year I started working with the over 65 population helping them to manage their chronic diseases, chronic movement patterns and falls prevention.

I knew I had to integrate balance exercises into my exercise prescription but the only balance exercises I was really aware of were the standard 4 point balance movements.

1. Stand feet together
2. Stand semi tandem
3. Stand full tandem
4. Single leg stand

Fast forward 12 months and my frustrations with prescribing static balance as my only source of balance exercises lead me to look into this topic further.

Here’s why.

5 Reasons Why I don't solely prescribe static balance exercise anymore

Reason #1. Just because someone has good static balance, does not mean they have good balance.

Sorry to be starting with such a confronting topic, but when you consider the many different types of balance someone needs just to walk with confidence and stay on their feet, static balance is only a very small portion of this movement.

I once had a client (82yr Female) who would swear to be black and blue to me that she had great balance. She proved it to me by demonstrating her 30sec single leg stand. However, when I challenged her to some dynamic balance movements (multi directional steps), she was unable to perform these successfully. This was confronting for my client and we then worked together to improve all forms of balance.

As an exercise physiologist, you have to consider the broader impact prescribing only static balance for a client. If I had stuck to static balance with the above client, she would have never improved her dynamic balance and would have increased her risk of falls.

For me, prescribing just one form of balance exercise, is not serving my clients or helping them reach their full balance potential.

Harvard Medical School has a brilliant post on their site that explains the intricacies of balance and goes beyond speaking of balance exercises. It's eye-opening! Check it out here.

Reason #2. There are not many daily movements that require static balance.

Think about all the activities you do throughout your day. How many of these involve standing on one leg for longer than 3sec?

Putting pants on while standing might be the only one. And even then, this task requires to stand on one leg while moving the other leg (dynamic balance) and bending forward to get your leg through the pants (positional balance).

Although I understand that walking involves a period of single leg standing, it also involves transferring your weight from the back of your foot to the front of your foot (dynamic balance) and is not a movement that lasts more than 2 seconds.

Improving your balance while walking requires dynamic balance, sensory balance, postural balance and the ability to navigate obstacles (just to name a few).

By improving your 4 – point balance as described in the intro, you will not necessarily optimise your walking balance or your rate of falls.

Freebie Time: While I'm giving away reasons as to why static balance exercises would be the only exercise for good balance and falls prevention, I may as well tell you about the freebie we have on offer, the Preparing Your House For Falls Checklist.

Click here to download your FREE Checklist “Preparing Your Home For Falls” now.

Reason #3. I Wanted Better Outcomes For My Clients

This one comes down to personal integrity and honestly, I wanted to service my clients better and give them a variety of balance tools and to help improve their balance in all aspects of their life.

Sometimes the best reason to look for a new tool or strategy is to improve your own skills to enable you to help others.

I felt like I was disserving my clients with only prescribing one balance tool. Not only that, I was not seeing the results I wanted from a balance program. I wanted my clients to feel more confident on their feet and to do that they needed to be confident in all components of their balance.

We started this process by starting to test our clients on all forms of balance and really taking note of where their troubles were. That meant testing static, dynamic, postural, reactive, sensory and anticipatory balance.

Now that we had the knowledge of what form of balance our clients required, we could specify their program by prescribing exercises to work on the kind of balance they were struggling with. And the improvements in confidence really started to show.

Reason #4: My grandmother had a fall and her static balance was great.

This is a hard reason to speak about because seeing my grandmother laying in a hospital bed with a broken arm, in pain and on a lot of pain medication was hard to see.

I was only a teenager at the time, and didn’t understand why a person who walked daily and could stand on one leg, would have such a serious fall.

It took a long time (a university masters degree and a year of working in the field) for me to understand that the type of fall she had was based on her poor postural control.

My grandmother (on her daily walk) leant over to pick up some rubbish she had found (always the environmentalist) and was not able to regain her posture back to centre. She fell forward and broke her arm.

If my grandmother had been assessed correctly and it was understood her postural control was poor, this could have been addressed with a number of different exercises and the fall prevented.

Reason #5: Why Prescribing Specific Balance Exercises To Clients Works Better

Currently with my clients, I am undertaking multi-faceted balance testing and prescribing balance exercises based on these results. This makes my exercise program highly specific and focused on the areas of concern.  If someone describes to me that they had a tripping based fall, I would prescribe reactive balance and hip mobility. If a client demonstrates poor dual tasking, I would be prescribing dual tasking exercises like walking while solving a problem. Or if a client is unable to pick an item up off the floor without falling forward, I would be prescribing balance exercises based on postural control, like being seated and leaning forward.  

Only when (and if) a client ever came to me and said they were having trouble standing like a stalk on one leg for the theatre production they are a part of, will I ever focus on prescribed static balance exercises (and as an FYI, no one has ever come to me with that problem – but if you do have this problem, please start undertaking the 4 point balance exercises).

Prescribing balance based exercises specifically towards the clients needs is the best way to not only improve their balance, but to improve their confidence on there feet which will in turn improve their quality of life.

Call To Action

Here is my call to action for you. If you have experienced a fall in the past, have a think about how you fell and why you fell. Was it a tripping based fall? Were you unable to navigate a step? Did you turn to quickly and found yourself on the ground?

The think about where your confidence lacks with your balance. Is it while walking? Do you lack confidence going up/down stairs? Do you lack confidence picking up items from the floor?

By understanding why you have experienced a fall and where you lack confidence in your balance, you will be able to start to understand what kind of balance exercises you require.

If you would like our FREE “Preparing Your Home For  Fall Checklist” please click here.

If you would like to join our Get Up! Stand Up! program, please click here.

That’s a wrap!

In conclusion, there are far more effective balance exercises than the traditional static balance exercises (like single leg stand) to help improve your balance and the confidence you have on your feet. You can find some of these exercises on our socials here and here. As mentioned above, by understanding the how and why you are falling, you will start to understand what balance exercises are best for you.

P.S I love this video of the week check it out here.