Balance Training: Benefits, Exercises and How to Improve Balance

Balance is the ability to maintain control of the body both while remaining still and during movement. It is important not only for athletes. We use balance every time we stand up from a chair, walk up or down stairs, step over an obstacle, move across an uneven surface or try to recover after an unexpected misstep.

Good balance is not simply the ability to stand on one leg for a long time. It is the combined result of muscle strength, joint mobility, coordination, reaction speed and sensory information. To maintain stability, the nervous system continuously processes information from vision, the inner ear and receptors in the muscles, joints and feet.

Balance training can be used to improve everyday movement, reduce fall risk, support rehabilitation after injury and develop athletic performance. However, exercises should match the person’s current abilities and progress gradually. Simply standing on an unstable surface is not always enough and is not necessarily the best starting point.

What is balance?

Balance can be divided into static and dynamic balance.

Static balance is the ability to maintain a stable body position, for example while standing on one leg or holding a tandem stance with one foot directly in front of the other.

Dynamic balance is the ability to control the body during movement. It is required when walking, changing direction, climbing stairs, landing after a jump or trying to regain stability after slipping.

In everyday life and sport, both types of balance work together. A person may be able to stand comfortably on one leg in a quiet environment but lose control when required to step quickly sideways, turn the head or react to an unexpected disturbance.

For this reason, a complete balance-training programme should include more than stationary positions. It can also incorporate stepping, weight shifting, squats, reaching movements, landing and reacting to changing tasks.

Why is balance training important in everyday life?

Good balance helps us move safely and confidently. When body control deteriorates, a person may begin avoiding stairs, uneven surfaces, walking outdoors in winter or other everyday activities.

Over time, this avoidance can reduce physical activity and leg strength, which may further reduce confidence and safety during movement. The goal of balance training is therefore not simply to improve performance on one test, but to help a person maintain independent mobility and respond effectively to unexpected situations.

Balance training may be particularly useful for people who notice that they:

• trip or stumble more frequently;
• feel unstable on uneven surfaces;
• find it difficult to put on trousers while standing on one leg;
• need to hold onto something while using stairs;
• feel that one leg is less stable after an injury;
• are afraid of falling.

These symptoms do not necessarily mean that balance itself is simply undertrained. Vision, inner-ear function, medications, sensory disturbances, muscle weakness and neurological conditions can also influence balance.

Balance training for older adults

With ageing, muscle strength, reaction speed, joint mobility and the ability to recover quickly after a trip or loss of balance may decline. However, falls are not an inevitable part of ageing. Regular balance, strength and functional exercises can help maintain safer mobility and greater independence in everyday life.

Exercise programmes for older adults should not consist only of walking or standing on one leg. It is useful to include movements such as standing up from a chair, stepping in different directions, stepping onto a low platform, squats, weight shifting and other tasks that resemble everyday activities.

Balance exercises are particularly important for people with an increased risk of falls and fractures. In people with osteoporosis, balance exercises should ideally be combined with individually appropriate strength and weight-bearing exercises. Read more in our article Physical Activity for Osteoporosis.

Why is balance important in sport?

In sport, balance is rarely required in a completely stationary position. An athlete must be able to maintain control after contact with an opponent, while changing direction, braking, landing or performing a movement on one leg.

In football, balance is required when kicking the ball with one leg while the other leg supports the entire body. In basketball and volleyball, landing control is important. During running, every step briefly becomes a single-leg support task.

This does not mean that athletes should spend most of their training time standing on a BOSU or soft balance pad. Sport also requires strength and stability on a firm surface, because running, braking, jumping and changing direction usually take place on stable ground.

Balance exercises are most useful when they form part of a broader training programme that also develops strength, coordination, agility, jumping ability and sport-specific movement.

Can balance training help prevent injuries?

Balance training should not be presented as a universal method for preventing every sports injury. However, stronger evidence is available for its role in reducing the risk of ankle injuries.

A systematic review involving almost 5,000 football players found that injury-prevention programmes containing balance exercises were associated with a lower rate of ankle injuries. Proprioception and balance training may be particularly useful for athletes who have previously experienced an ankle sprain.

After an acute ankle sprain, exercise-based rehabilitation may reduce the risk of reinjury, although the optimal exercise content and total training volume have not been precisely established for every patient. In research, balance exercises are generally combined with strength and functional exercises rather than used alone.

Therefore, rehabilitation after an ankle injury should involve more than simply standing on a soft pad. Ankle mobility, calf strength, jumping, landing control, running and the ability to change direction also need to be restored.

Balance training in rehabilitation

Balance exercises are frequently used during rehabilitation after ankle, knee and other lower-limb injuries. They can help restore confidence in the injured leg and gradually prepare a person for more demanding movements.

At an early stage, the exercise may be as simple as shifting body weight from one leg to the other. Later, single-leg standing, squats, reaching in different directions and step exercises can be introduced.

Towards the end of rehabilitation, an athlete will require more dynamic tasks such as jumping, controlled landing, braking, changing direction and reacting to an external signal. Exercises should gradually become more similar to the movements the person needs to perform in everyday life or sport.

Read more about the importance of balance and movement control after knee injury in our article “How to Reduce the Risk of Recurrent Knee Injury?”

Is standing on one leg enough?

Standing on one leg is a useful starting exercise, but over time it can become too easy. If a person can comfortably maintain the position for 30–45 seconds, the exercise may no longer provide enough challenge.

To progress the exercise, you can:

• reduce support from the hands;
• change the position of the head or arms;
• add reaching movements;
• add throwing or catching a ball;
• stand on a softer surface;
• perform a small squat;
• add a step or jump;
• react to an unpredictable signal.

Closing the eyes should generally not be the first progression, especially for people with significant instability. Removing visual information considerably increases the difficulty of the task and may increase the risk of falling.

Practical balance exercises

1. Weight shift from one leg to the other

Stand with your feet approximately hip-width apart. Slowly shift your weight onto the right leg and then onto the left. Keep both feet in contact with the floor and try not to move the upper body more than necessary.

Perform 10–15 slow weight shifts in each direction. If needed, perform the exercise next to a wall or stable chair.

This is a suitable starting exercise for people who do not yet feel confident standing completely on one leg.

2. Tandem stance

Place one foot directly in front of the other so that the heel of the front foot almost touches the toes of the back foot. Distribute your weight between both legs and look straight ahead.

Hold the position for 20–30 seconds and repeat with the opposite foot in front. Perform 2–3 repetitions on each side.

When the exercise becomes easy, slowly turn your head or try taking several steps along a straight line.

3. Single-leg stand

Stand beside a stable support. Lift one foot a few centimetres from the floor and keep the pelvis level. Keep the knee of the supporting leg slightly bent rather than completely locked.

Hold the position for 20–30 seconds and repeat 2–3 times on each leg.

If this is too difficult, lightly touch the support with one finger. If it becomes too easy, add slow arm movements or pass a ball from one hand to the other.

4. Toe taps in different directions

Stand on one leg and lightly touch the floor with the toes of the other foot in front of you, to the side and behind you. Keep the supporting leg stable and avoid allowing the pelvis to move uncontrollably from side to side.

Perform 5–8 rounds in each direction with both legs.

This exercise is more similar to everyday and sporting situations because the body’s centre of mass moves while one leg continues to provide support.

5. Single-leg mini squat

Stand on one leg and slowly bend the hip and knee into a small squat. The knee should generally move in the direction of the foot rather than collapsing uncontrollably inward.

The squat does not need to be deep initially. Perform 2–3 sets of 6–10 repetitions on each leg.

This exercise simultaneously trains balance, hip and knee control and leg strength.

6. Jump and controlled landing

This is a more advanced exercise for people who can already perform the previous exercises safely and confidently.

Perform a small jump forwards or sideways and land on one leg. After landing, maintain a stable position for 2–3 seconds.

Start with a short distance and perform 2–3 sets of 5 jumps in each direction. You should be able to control the landing without repeated small hops or pronounced inward movement of the knee.

This exercise is not appropriate during the early stages of rehabilitation or for people experiencing acute pain.

How can balance exercises be made more difficult?

Balance training should preferably be progressed gradually. Change only one or two variables at a time so that movement quality can still be maintained.

The difficulty of an exercise can be increased by changing:

Base of support. Progress from standing on two legs to a tandem stance and eventually to standing on one leg.

Surface. Progress from a firm floor to an exercise mat, foam balance pad or air-filled balance surface. An exercise mat and a balance pad are not the same type of equipment. A mat primarily provides a comfortable, non-slip surface for exercise, while a balance pad creates considerably greater instability. Read more about AIREX Exercise Mats and Balance Surfaces in our product guide.

Movement. Add reaching, squatting, stepping, throwing a ball or jumping.

Visual challenge. Turn the head, move your gaze to another target or, at a more advanced stage, briefly reduce visual input.

Cognitive challenge. Name numbers, catch a ball or respond to a partner’s instruction while maintaining balance.

Speed and unpredictability. Athletes can progress by reacting to colours, sounds, a partner’s movement or an unexpected change of direction.

An exercise is sufficiently challenging when the body needs to make regular small corrections while the person can still maintain safety and good movement control.

Do you need an unstable surface for balance training?

No. Balance training can begin without any equipment. Standing on one leg, tandem walking, reaching exercises and controlled squats may already provide an appropriate challenge.

An unstable surface is one way to progress an exercise, but it does not automatically make the exercise better. If the surface is excessively unstable, a person may lose good movement technique and may be unable to produce sufficient force.

A soft balance pad can be useful for ankle-control and standing exercises. An air-filled balance disc allows the amount of instability to be adjusted, while BOSU or Togu Jumper-type surfaces provide more movement options and can be used for more demanding strength and coordination exercises. Various balance pads, discs and dome-shaped trainers are available in the Fiziopreces.lv exercise range.

Equipment should be selected according to the goal of the exercise and the person’s ability level rather than assuming that the most unstable surface will always be the most effective.

How often should you train balance?

Balance exercises generally do not produce as much muscular fatigue as heavy strength training, so they can often be performed more frequently. For many people, a practical starting point is 10–15 minutes approximately three times per week.

During one session, you can choose 3–4 exercises and perform each for 2–3 sets. Regular practice and gradual progression are more important than performing one very long session occasionally.

For older adults, the best results are generally achieved with programmes in which balance exercises are performed regularly over several months and combined with functional and strength exercises. Research programmes have often used approximately three sessions per week, although the appropriate volume depends on the person’s starting level and goals.

Athletes can include short balance and neuromuscular-control exercises within a warm-up, rehabilitation session or injury-prevention programme.

Common mistakes in balance training

One common mistake is moving to a highly unstable surface too quickly. If a person spends the entire exercise simply trying not to fall, movement quality and the practical benefit of the exercise may decrease.

Another mistake is repeating exactly the same single-leg standing exercise for months. The body adapts, and without progression further improvement is likely to become limited.

A third mistake is completely ignoring strength training. For a person with significant muscle weakness, training sensory reactions alone is not enough. Adequate leg and trunk strength is also required to regain stability after stumbling.

A fourth mistake is continuing exercises despite significant joint pain or dizziness. Balance training should be challenging, but it should also remain safe.

When is an assessment by a physiotherapist or doctor needed?

Professional assessment is recommended when balance problems appear suddenly, progressively worsen or are associated with dizziness, visual changes, headaches, numbness or muscle weakness.

You should also seek professional assessment if:

• you have experienced several falls recently;
• you consistently need support while walking;
• a feeling of instability remains after an injury;
• one leg is noticeably weaker than the other;
• exercise regularly causes pain;
• you have a neurological condition or significant sensory disturbance.

In these situations, it is important to identify the reason for the balance problem before selecting an appropriate exercise programme.

Summary

Balance is the ability to control body position both at rest and during movement. It is important for everyday safety, independent mobility, athletic performance and rehabilitation after injury.

A complete balance-training programme involves more than standing on one leg or exercising on an unstable surface. It should include weight shifting, stepping, reaching, squatting and strength exercises, followed later by more dynamic movements, jumping and reactions to unpredictable tasks.

For older adults, balance and functional exercises combined with strength training can help reduce the risk of falls. For athletes, balance and proprioception training is particularly relevant after an ankle sprain and can form part of an ankle-injury prevention programme.

Begin with safe exercises on a stable surface and gradually increase the difficulty. Equipment can help provide variety, but the most important factors are an appropriate level of challenge, regular practice and the ability to transfer improved control to real everyday or sporting movements.

References

World Health Organization. WHO Guidelines on Physical Activity and Sedentary Behaviour. Geneva: WHO; 2020.

Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;1:CD012424.

Lesinski M, Hortobágyi T, Muehlbauer T, Gollhofer A, Granacher U. Effects of balance training on balance performance in healthy older adults: a systematic review and meta-analysis. Sports Med. 2015;45:1721–1738.

Al Attar WSA, Khaledi EH, Bakhsh JM, et al. Injury prevention programs that include balance training exercises reduce ankle injury rates among soccer players: a systematic review. J Physiother. 2022;68(3):165–173.

Wagemans J, Bleakley C, Taeymans J, et al. Exercise-based rehabilitation reduces reinjury following acute lateral ankle sprain: a systematic review and meta-analysis. PLoS One. 2022.

Doherty C, Bleakley C, Delahunt E, Holden S. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews. Br J Sports Med. 2017;51:113–125.

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Do You Need a BOSU or Another Unstable Surface to Train Balance?

Aigars Caune
Physiotherapist

No. At the beginning, exercises on a stable floor are completely sufficient, including standing on one leg, reaching movements and controlled mini squats. An unstable surface should be added when the basic exercises become too easy and the person can perform them safely and with good movement quality.

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