Keeping Your Balance

Balance is very important for people with osteoporosis. Your eyes, ears, muscles and joints all play an important role in maintaining your balance and preventing broken bones. Medical conditions and medicines can also affect balance and your risk of falling. Let’s take a look at these and see how you might be able to reduce your chances of falling.

Eyes

Changes in vision happen as you age. Cataracts or glaucoma can develop. Your eyes may take longer to adjust to changes in the light and glare. Changes in vision can affect your ability to judge the steepness of stairs and curbs or to avoid obstacles in your path. 

Your vision not only helps you avoid obstacles and dangers but also helps keep your orientation in space. Your eyes work something like a level, which is a tool that tells you if a surface is flat and even. Without realizing it, you notice vertical and horizontal objects like buildings and doorways, and use this information to help you stand and stay erect.

Keeping your home well lit at night not only keeps you from tripping or banging into objects, but more importantly gives you information on which way is up and keeps you steadier on your feet. It is also important to have regular eye exams. If you have prescription glasses or contact lenses, wear them.

Ears

Changes in hearing happen as you age. Our middle ears contain semicircular canals lined with hair-like structures, fluid and crystals. This system can give us information on our head and body movements to help us maintain our balance.

Medications and some illnesses can affect middle-ear function. Sometimes these problems are associated with ringing in the ear or a sensation of the room spinning (vertigo). Consult your doctor if you’re having any of these problems or problems with balance. Sometimes your doctor or physical therapist can reposition the crystals in your ear and significantly improve your balance.

Testing Your Balance

If you want to test how your eyes and ears affect balance, start by standing next to a countertop or table. Place your hand on top of the counter or table if you are unsteady. Stand still and challenge your balance by bringing your feet close together or standing on one foot. Now close your eyes and see if it’s harder to maintain your balance. You’ll notice it’s more difficult with your eyes closed.

Now stand in this same position, but this time keep your eyes open and shake your head (this affects your middle ear function). What does this do to your balance? By closing your eyes and moving your head at the same time, you’ll see how important our eyes and ears are in maintaining balance.

The following suggestions can help you improve your balance:

  • Join a class or group that practices Tai Chi to help with coordination and balance.
  • Do balance exercises every day.
  • Do weight-bearing and muscle-strengthening exercises to improve muscle strength and how well you move.
  • Wear glasses or contact lenses if you need them. If you wear bifocal or trifocal glasses, practice exercising with them on.
  • Learn about the side effects of your medicines and follow the instructions for taking them.

Muscles and Joints

Strong muscles and flexible joints play a role in our balance. When we stand “still,” we don’t stand fixed like toy soldiers but sway at our ankles. To do this, our ankles make small adjustments keeping our body weight over our feet. If our ankles are stiff, sore or weak, they won’t be able to make the strong, swift adjustments that help us maintain our balance.

The following exercises will help you keep your ankles strong and flexible and reduce your chances of falling. Do them slowly, once daily, with shoes on or off. In addition to these exercises, try the balance exercise example in "Bone Healthy Exercises Examples".

Conditions and Medicines That Can Cause Falls

Certain medicines and medical conditions can affect circulation or your ability to move and get around. They can also cause numbness and tingling in the feet, dizziness, disorientation and slowed reflexes. All of these can lead to falls. Here are some tips to help you:

  • Stay informed about your medical conditions and whether they can increase your chance of falling. Some examples are low blood pressure, stiffness from osteoarthritis and low vitamin D levels. If you haven’t had a vitamin D test, ask your healthcare provider if you should have one.

  • Review the list of medicines you’re taking with your healthcare provider at least once a year. The benefits and risks of medicines can change over time and as you age. Sometimes people may need to change a medicine, try a different dose or even stop a medicine altogether.

  • Talk to your healthcare provider or pharmacist about the side effects of the medicines that you take and how they may affect your chances of falling. Be aware that the use of multiple medicines can increase your risk of falling.

  • If you take any medicines or have any medical conditions that could lead to falls, your healthcare provider should be able to suggest ways to prevent them. Also, mention any symptoms you are having to your healthcare provider. Never change or skip medicines without talking with him or her first.

Categories of Medicines That May Increase the Risk of Falls

  • Allergy medicines
  • Anti-seizure medicines
  • Blood pressure pills
  • Diabetes medicines
  • Diuretics or water pills
  • Heart medicines
  • Muscle relaxers or tranquilizers
  • Pain medicines
  • Sleeping pills

Note: This list may not include all categories of medicines that may increase the risk of falls.

NOF thanks Richard Baldwin, P.T., for contributing to this article. Mr. Baldwin is owner and director of Downeast Rehabilitation Associates in Rockport, ME. He is the osteoporosis support group leader of the NOF Coastal Support Group and an NOF health professional member.

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