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  • Buffalo Niagara PT

Balance, Fall Prevention, Injury Prevention, Injury Rehabilitation


Balance for fall and injury prevention requires strength, and control of your center of gravity (posture) within your base of support (stance position)

against gravitational forces.


We need postural control of our body position during expected movements like walking and unexpected movement like a slip, trip or in athletic cutting, jumping and landing (dynamic balance).





Start training your balance supported with your hands on a counter, chair, cane or stick for support.


Work up to standing on one leg for 10-20 seconds with support. Repeat with the other leg. Use hand support until you achieve no loss of balance episodes. Then reduce hand support from 2 hands, to 1 hand, to no hands.



Normal active people should be able to stand on each leg for 10-20 seconds.


Once this is achieved start over with your eyes closed and using support. Gradually reduce the support required and build up your hold time to 8-10 seconds.


To improve your control of posture and body position against gravity visit our blog on spine and core neuromuscular training.


The STAR balance training described by Gray is an excellent method for improving balance in healthy active individuals. You can set up a training

grid with tape on the floor consisting of 4 intersecting lines arranged at 45 degrees from each other.



Perform a mini squat reaching with your heel forward without losing control of your posture.

Repeat on the other side with the goal of achieving

equal reach distance on each side.

Hinge the hips back and keep the stance knee moving directly over the second toe.


Proceed around each line on the STAR grid.

Gradually increase the heel reach distance and perform 8-12 reps. If that is easy perform reps with a slow 4 sec/4 sec cadence.





You can use hand support on a chair, with a stick or cane

if needed for safety



The 3:00 and 4:00 reach around and behind are challenging to keep the stance knee moving directly

over the second toe.






Remember balance requires control of your center of gravity (posture) within your base of support (stance position) against gravitational forces.


For additional training try the single leg dead lift. With a slight bend in the stance knee over the middle of your foot, hinge the hips back keeping the spine neutral as you move your chest forward and down. First try this with a PVC pipe maintaining contact at the hips-middle back and head. Slowly move forward and then return. Master this for 8-12 reps progressing to a 4 sec down/4 sec up cadence. You can then progress to a single leg dead lift unweighted, and then with weight.

Taking your shoes off increases the neurological and reflex input in your balance training. Use hand support until you achieve no loss of balance episodes.


The risk of fall and injury decreases exponentially when you can achieve equal performance on each leg.


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