When it comes to assigning patients exercise, the Single Leg Stand is one I go to time and time again–I love making people balance on one leg. I have easy versions, hard versions, versions with eyes closed, versions with movement, etc. During our balance testing, if someone struggles with standing on one leg, they earn themselves this type of homework. Most of the time, it’s one leg that performs much worse than the other–this is especially true when people come to me with injury, pain, or weakness.
“But during my normal day, I’m never on one leg” people complain at my video check-ins. Actually, these people are standing on one leg all the time, they just don’t realize it.
Balance is a Regular Part of Your Day
Sure, you might not stand on one leg for 30 seconds like the exercise I assigned you, but all of us are standing on one leg many times throughout the day. Think of when you put on pants, or socks, or shoes–for many, that means balancing on one leg. Even more frequently, think about any time you walk. Every single step you take is a moment in time you are balanced on one leg. The same is true for any curb or stair you step up on.
And If I can detect a balance shortcoming in my quick testing with you, you can bet that imbalance is going to have an effect on your walking and all the other activities that put you on your feet. If you’re an athlete, lacking balance on one leg will impact your performance, and if you’re an older adult, it can mean a much greater risk for falling and getting seriously injured.
For people who had an injury–new or old–balance is commonly impacted. I see this all the time with people who sprained their ankles. A sprained ankle loses proprioception and coordination after it’s injured and needs to be retrained–the same is true of other leg injuries. If your balance is significantly different side to side, it will have an effect on your mechanics with normal daily movement, and soon that starts causing problems in other body parts, like your back or hips.
What’s Normal Balance?
When it comes to standing on one leg, there are age-specific averages for what would be called “normal.” Keep in mind, balance on one leg means you keep your hands on your hips and you don’t hop on or move the foot you’re standing on. Here are the averages:
| Age 18 – 39 | 43 seconds |
| Age 40 – 49 | 40 seconds |
| Age 50 – 59 | 37 seconds |
| Age 60 – 69 | 27 seconds |
| Age 70 – 79 | 15 seconds |
| Age 80 – 99 | 6 seconds |
Try balancing on each leg now, and see how you compare with the average.
When I test people’s balance, I take notice if they fall below average or if there’s any asymmetry–one leg noticeably worse than the other. If I find either of these things, my patients get rewarded with a few balance exercises. While these exercises are frustrating, they are worth it. In my 11 years as a physical therapist, I’ve seen hundreds and maybe thousands of people improve and recover their balance. My own mom went from balancing only 3 seconds on each leg while waving around like one of those inflatable tube men, to being able to stand 30 seconds on each leg after a few months of my exercise assignments.
Why Am I Struggling with Balance?
There’s not always a “single reason” people have balance challenges on one or both legs. If balance were a big machine, there are lots of important parts that make the machine work. One part of the machine is strength, and that includes your trunk, hips, legs, and ankles to keep your body aligned. Coordination is a big part, and that includes your reaction time, your proprioception (joint awareness), and your muscle tone to react to losing balance. Senses like vision and vestibular (inner ear) systems are major parts of your balance. And there are plenty of other important parts like your posture, your endurance, and even your confidence in standing on one leg.
In my assessment of patients, the parts most in need of a tune-up tend to be obvious, but I don’t just focus on those specific areas. Balance training, done with good technique, helps train the whole system–all the parts. If someone’s balance is limited because of outer hip weakness (I see this a lot), standing on one leg will help strengthen their hip, but it will also improve coordination, while improving muscle endurance, while improving confidence. The result is a whole network that works better together and balance improves.
Improvement Will Happen, Even if It’s Slow and Frustrating
Balance rarely improves spontaneously, but nearly every person I have worked with has improved their balance. For older adults, it has meant a decreased risk of falling and getting injured, and for others it’s meant better sports performance or more stability on one leg with dancing. For my ankle sprain patients, better balance means less risk of re-spraining that ankle (resprain risk is high for those who never retrain their ankle). Balance training takes work and consistency, and everyone’s pace of improvement is different. As frustrating as it is, the gains people get from this kind of consistent work are worth it.
What if I’m Struggling with Balance?
No matter your age, situation, or location, balance doesn’t need to be something “you’re just bad at.” Balance can change, and it can improve, but it never happens accidentally. If you are struggling or know someone struggling with balance or falling, let’s get going on some exercise that’s safe and going to improve your situation. Even better, let’s do it before a fall happens or before that balance starts impacting your other body parts.
I, Dr. Alex, am here to support you every step of the way, no matter where you are. Book your free 15-minute consult to talk with me about your concerns and learn more about how we work! Our online physical therapy and personal training can help you regain what you thought you’d lost and go strongly into your future.
At motivPT, we believe your body deserves to feel great.
