Advanced Balance Exercises

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Advanced Balance Exercise Program

Woman walking on log fence at beach
Daniel Ingold/Cultura/Getty

Maintaining balance is essential when performing basic functional mobility tasks like standing, walking, and running.  After an injury or surgery, you may benefit from the skilled services of a physical therapist to help restore your normal mobility.  Working to improve your balance may be one component of your physical therapy program to help you get back to your normal activities.

Being able to engage in upright activities requires many different systems in your body to interact.  Your muscles, joints, visual system, and vestibular system all must work together to help you stand, walk, or run safely.  Your balance, like many other systems in the body, can be improved with exercise.

Your physical therapist can teach you basic balance exercises like single leg standing and tandem walking to help get you started on improving your balance.  When these exercises become easy to perform, you can continue to work on improving your balance with this advanced balance exercise program.

Remember, to effectively improve your balance, you must create situations that challenge your balance systems.  You must not compromise your safety when doing so.  Therefore, it is essential you check in with your physical therapist or doctor before starting this, or any other, exercise program.

The advanced balance exercises can be performed every day, but a day of rest may be required if you experience DOMS, or delayed onset muscle soreness.

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Single Leg Stance with Squat

Image of the single leg stance with a squat.
Stand on one foot with your other leg out in front, then slowly squat down. Brett Sears, PT, 2015

To start advanced balance exercises, try the single leg stance with a squat.  To do this, stand on one foot with your other foot off the ground and directly in front of you with your knee straight.  Slowly bend the knee of your stance leg and squat down a few inches.

Make sure your knee goes directly over your toes and does not turn in or out as you squat.  After squatting a few inches, return up to the starting position.

Repeat the single leg squat for 10 to 15 repetitions, and then move on to the next exercise: the single leg T-stance. 

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Single Leg T-Stance

Photo of woman practicing yoga on the beach.
The T-Stance is a great exercise to build better balance. Zero Creatives/Getty Images

To perform the single leg T-stance exercise, stand on one foot.  Extend both arms out to the side, and then extend your other leg out behind you - make sure you keep your back straight and your pelvis level.

Hold the T-stance position for 30 seconds, and then return to the standing position.  You can challenge yourself further by rotating your torso left and right while maintaining the T-stance position.

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Bonus: Stand on Foam to Add Difficulty to Single Leg Stance Exercises

Image of balance exercises on therapy foam.
Use a piece of foam or a pillow to add difficulty to your balance exercises. Brett Sears, PT, 2015

Single leg squatting and the T-stance exercises may become easier with practice.  When this happens, challenge yourself further by standing on a piece of foam or on a small pillow.  The unsteady surface will alter your proprioception and your body's feedback to your brain.

Be sure to remain safe while standing on an unsteady surface while performing the single leg squat and T-stance.  Improving your balance requires that you challenge your balance, but creating a situation where you fall down is not recommended.

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Standing BAPS Board

Lower extremity balance can be improved with a BAPS board.
The BAPS board can be used to improve ankle stability and proprioception. Brett Sears, PT, 2012

The BAPS board is a therapy tool found in many physical therapy clinics designed to help improve lower extremity proprioception.  When you are working to improve your balance, using the BAPS board is a great way to work all of the muscles that support your ankle, knee, and hip.

The BAPS board requires that you place your foot on the unsteady board and move your ankle in specific directions.  You should hold onto something stable when on the BAPS board.  Control is key - don't allow the board to quickly slap in multiple directions.  The motions on the BAPS board should be performed for 15 to 20 repetitions.

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Wobble Board Exercises

Photo of a wobble board.
A wobble board can provide an unsteady surface on which to perform balance exercises. Rollover/Getty Images

 A wobble board is a plastic or wooden platform with a curved shape on the bottom of it.  Standing upon the board challenges your balance because the wobble board creates an unsteady surface.

Working with a wobble board to improve your balance can be challenging, and you should be sure you remain safe when standing upon it.

Starting exercises on the wobble board should be done with both feet.  Stand upon the board with your feet on either side of the board.  Try to maintain steady balance for 30 to 60 seconds, and then take a break.  You can challenge your balance further by closing your eyes while standing on the balance board.

To further add challenge to balance board exercises, try standing upon the board with both feet, and then perform a mini squat on the board.  Hold the squat for a couple seconds, and then return to the upright standing position.

When double leg standing on the wobble board becomes easy, you can advance the exercise by standing upon the board with one foot.  Place one foot in the middle of the board and stand for 30 to 60 seconds.  Again, close your eyes to increase the level of difficulty.

Single leg standing on the wobble board can be made even more challenging by performing a one legged mini squat.  Stand on one foot on the board, and then slowly squat down a few inches by bending your knee.  Hold the squatted position for a couple of seconds, and then return to the starting position.

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BOSU Ball Exercises

Photo of a BOSU ball.
You can use a BOSU ball to perform advanced balance exercises. Rich Legg/Getty Images

 A BOSU ball is a therapy and exercise tool that helps to improve proprioception and balance by creating an unsteady surface on which to exercise.  BOSU stands for "both sides up," which means you can use the BOSU with the flat side on the floor or with the curved ball side down.

Start BOSU exercises by standing upon the BOSU with both feet on the curved side.  Hold your balance for 30 to 60 seconds, and then close your eyes to increase the challenge.  Performing squats on the BOSU can be performed to further challenge your balance and improve leg strength.

Once double leg standing on the BOSU becomes easy, switch to standing on the BOSU with one leg.  Again, increase the exercise intensity by closing your eyes or by performing mini squats on the BOSU.

When you flip the BOSU over and place the curved side down, you can repeat the balance exercises by standing on the flat side.  Progress from standing with both feet on the BOSU, closing your eyes, and performing mini squats.  Then perform the exercise progression with one leg on the BOSU.

After an injury, illness, or surgery, your functional mobility may be limited and you may have difficulty moving around.  Impaired balance may be one variable that affects your functional mobility.  By working closely with your physical therapist and by progressing appropriately through these advanced balance exercises, you can safely and quickly return to your optimal level of function.

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