Why Balance Declines as We Age - and How We Can Improve It
Balance relies on your brain continuously combining information from three main sensory systems: vision, the vestibular system in the inner ear, and proprioception — your body's awareness of where it is in space.
As we get older, changes in eyesight, inner-ear function, joint movement, muscle strength, sensation and reaction time can make maintaining balance more challenging.
The encouraging part? Balance isn't simply something we have to accept losing with age.
Regular movement, strength and balance exercises, maintaining good mobility, looking after vision and hearing, and addressing musculoskeletal problems can all help support steadiness and confidence as we get older. Chiropractic care may also form one part of a broader approach to maintaining comfortable movement and sensorimotor function.
Balance is one of those things we rarely think about - until it starts to feel different.
Perhaps you feel slightly less steady stepping off a curb. You hold the handrail going downstairs when you never used to. Standing on one leg to put your shoes on suddenly requires a little more concentration.
For many people, these changes creep in gradually.
But balance isn't controlled by one muscle, one joint or even one part of your brain. It's an incredibly sophisticated conversation happening between your brain and body every second you're standing, walking or moving.
Understanding that conversation helps explain why balance can change with age — and importantly, why there are things we can do to support it.
What controls our balance?
Your ability to stay upright relies heavily on three sensory systems working together:
1. Your visual system — your eyes
Your eyes provide your brain with information about your surroundings.
They help you understand where you are in relation to the floor, walls, stairs, furniture and other people.
Try standing on one leg with your eyes open and then closing them — safely, with something sturdy nearby if needed.
Most people immediately notice how much harder the second version is.
That's because you've removed one of the major sources of information your brain uses to maintain balance.
Changes in eyesight as we age can therefore contribute to feeling less steady, particularly in low light, on stairs or when navigating unfamiliar environments.
2. Your vestibular system — your inner ear
Deep inside each inner ear is your vestibular system.
It contains tiny sensory structures that detect movement and changes in the position of your head. This information helps your brain understand whether you're moving, turning, tilting or accelerating.
Your vestibular system also works closely with your eyes to help keep your vision stable while your head is moving.
It is one reason you can walk down the street while looking around without the world appearing to bounce wildly with every step.
Changes affecting the vestibular system can contribute to dizziness, vertigo or unsteadiness, although dizziness has many possible causes and persistent or sudden symptoms should always be properly assessed.
3. Your proprioceptive system — your body's internal GPS
The third piece of the balance puzzle is proprioception.
Proprioception is your brain's ability to know where different parts of your body are without having to look at them.
Close your eyes and bend your elbow.
You know where your arm is even though you can't see it.
That's proprioception at work.
Specialised sensory receptors throughout your muscles, tendons, joints and skin constantly send information towards your central nervous system about position, movement and load.
Your brain integrates this information with signals from your eyes and inner ears to create a constantly updated picture of where your body is in space.
Why does balance often decline as we get older?
There's rarely one single reason.
Ageing can bring gradual changes across several systems at once.
We may lose some muscle strength. Reaction times can become slower. Vision may change. Sensation in the feet may decrease. Joints may become stiffer or less comfortable to move. Some medications can contribute to dizziness or unsteadiness.
And importantly, we may simply move less.
That matters.
Balance is a skill.
Like strength, coordination or flexibility, it benefits from being challenged.
If you gradually stop walking over uneven ground, climbing stairs, getting down onto the floor, standing on one leg or moving your body through different positions, you're giving your balance system fewer opportunities to practise.
Over time, the movements you stop doing tend to become the movements that feel more difficult.
What does the spine have to do with balance?
This is where proprioception becomes particularly interesting.
Your brain isn't only receiving information from your feet and legs.
Sensory information is coming from throughout your musculoskeletal system, including muscles and joints associated with the spine.
The neck is particularly interesting because your brain needs to distinguish between movement of your head and movement of the rest of your body while simultaneously integrating information from your eyes and vestibular system.
If movement becomes restricted or uncomfortable, or the sensory information coming from joints and muscles changes, it may alter the proprioceptive information available to the central nervous system.
A simple way to think about it is this:
Good balance requires good information.
Your brain needs to know:
Where is my head?
Where are my feet?
Where is the ground?
Am I moving?
Is my environment moving?
How quickly do I need to react?
And it has to answer those questions extraordinarily quickly.
Is this why chiropractic may influence balance?
There is emerging research exploring the relationship between chiropractic care, proprioception and sensorimotor function.
One randomised controlled trial involving 60 adults over the age of 65 compared 12 weeks of chiropractic care with usual care.
Researchers measured several factors associated with falls risk, including ankle joint position sense, stepping reaction time, postural stability and multisensory processing.
After 12 weeks, the chiropractic group demonstrated improvements in some measures of sensorimotor function, including ankle joint position sense and choice stepping reaction time, compared with the control group.
The researchers were appropriately cautious: these findings do not prove that chiropractic care prevents falls.
Instead, they suggest chiropractic care may influence some aspects of sensory and motor function associated with falls risk, and that further research is needed.
That's an important distinction.
At Nomad Chiropractic, we see chiropractic as one piece of a much bigger movement picture — not a replacement for strength, exercise, medical assessment, vision care or vestibular rehabilitation when these are needed.
Why your feet matter too
We can't talk about balance without talking about feet.
Your feet are the interface between you and the ground.
Sensory information from the feet helps your nervous system understand the surface you're standing on and make tiny adjustments to keep you upright.
Think about the difference between walking barefoot across firm ground and walking across soft sand.
Your body automatically changes its strategy.
Good foot and ankle movement, strength and sensation therefore form an important part of maintaining balance.
Simple activities such as walking on different safe surfaces, calf raises, controlled single-leg standing and foot-strengthening exercises can provide useful challenges.
And don't forget the hips and pelvis
Your hips are another important part of the balance equation.
When your body begins moving outside its base of support, your ankles and hips help make rapid corrections.
Strong legs and hips also make everyday movements easier — getting out of a chair, climbing stairs, stepping over obstacles and catching yourself when you stumble.
This is why improving balance shouldn't involve balance exercises alone.
Strength matters too.
Australian physical activity guidance for older adults recommends including activities that support strength, flexibility and balance as part of regular movement.
Can balance actually improve?
Yes.
While some age-related changes are unavoidable, declining balance is not something we should automatically dismiss as "just getting older."
Research supports balance and strength exercise as important strategies for maintaining stability and reducing falls risk in older adults.
Useful activities may include:
walking regularly
strength training
sit-to-stand exercises
calf raises
heel-to-toe walking
stepping in different directions
safe single-leg balance
Tai Chi
mobility exercises
appropriately challenging different surfaces and environments.
The right starting point depends on the individual.
Someone who already feels unsteady or has experienced a fall needs a very different program from an active 60-year-old who simply wants to maintain their balance for the decades ahead.
A simple balance check
Here's something you may notice in everyday life.
Can you comfortably:
Stand on one leg while putting your shoes on?
Walk upstairs without needing to pull yourself up with the railing?
Turn quickly when someone calls your name?
Walk confidently across grass or uneven ground?
Get down onto the floor and back up again?
Walk through your house safely at night?
These aren't diagnostic tests.
They're simply examples of the everyday tasks that require your visual, vestibular, proprioceptive and muscular systems to work together.
If these tasks are becoming noticeably more difficult, it's worth paying attention rather than waiting until you've had a fall.
How we approach balance and mobility at Nomad Chiropractic
Our approach is simple: keep people moving confidently through every stage of life.
For an adult concerned about stiffness, mobility or balance, we may assess areas such as spinal and joint movement, general mobility and how comfortably you're moving through everyday tasks.
Where appropriate, chiropractic care may include gentle adjustments or mobilisation alongside practical movement and mobility advice.
But chiropractic isn't the only answer.
Depending on what we find, improving balance may also involve strength work, specific balance exercises, vision assessment, vestibular rehabilitation, medication review with your GP or assessment by another health professional.
Good healthcare means knowing when another member of the team needs to be involved.
When should balance problems be medically assessed?
A gradual feeling that you're not quite as steady as you once were is very different from suddenly losing your balance.
Seek medical assessment if you experience new or unexplained balance problems, particularly when associated with symptoms such as significant dizziness, fainting, weakness, numbness, difficulty speaking, severe headache, changes in vision or hearing, or following a fall.
If you've already experienced a fall, discussing it with your GP or appropriate healthcare professional is also worthwhile.
Falls are common in older Australians, but they're important.
Prevention matters.
The bigger picture: movement keeps us capable
We often think about exercise in terms of fitness, weight or cardiovascular health.
But movement gives us something else that's incredibly valuable:
options.
The strength to get off the floor.
The balance to walk across the garden.
The mobility to turn and look behind you.
The confidence to climb stairs.
The ability to travel, play with grandchildren, garden, walk along the beach and keep doing the things that make life enjoyable.
That's why maintaining balance isn't simply about avoiding falls.
It's about maintaining confidence, capability and independence.
And you don't have to wait until balance becomes a problem to work on it.
Keep walking.
Keep strengthening.
Keep challenging your balance.
Keep your joints moving comfortably.
Look after your eyes, ears and feet.
And if movement is becoming harder, get it assessed.
Your body is designed to move — and giving it opportunities to keep practising is one of the simplest things you can do to support healthy ageing.
Frequently Asked Questions (Chiropractic for Balance and Fall Prevention)
What are the three systems responsible for balance?
Balance primarily relies on information from the visual system, vestibular system in the inner ear and proprioceptive system. The brain integrates these sensory signals with muscle activity and movement to help keep the body stable.
Why does balance get worse with age?
Ageing can affect eyesight, vestibular function, sensation, muscle strength, joint mobility and reaction time. Medications and some medical conditions can also affect balance.
Can you improve balance as you get older?
Yes. Balance and strength exercises can improve stability in older adults. Activities such as strength training, Tai Chi, heel-to-toe walking and appropriately challenging balance exercises can be useful.
Does proprioception affect balance?
Yes. Proprioception provides information about the position and movement of the body. Research suggests proprioceptive and sensorimotor exercise can improve measures of balance in older adults, although the certainty of the available evidence varies.
Can chiropractic improve balance?
Yes. Some research suggests chiropractic care may influence aspects of sensorimotor function associated with falls risk. A randomised controlled trial in adults over 65 reported improvements in measures including joint position sense and stepping reaction time, but further research is needed and this does not establish that chiropractic care prevents falls.
Balance depends on three major sensory systems: vision, the vestibular system of the inner ear and proprioception - the body's awareness of its position and movement.
Age-related changes in vision, sensation, joint mobility, muscle strength and reaction time can contribute to reduced balance.
Regular strength and balance training, walking, maintaining mobility and addressing vision, vestibular or musculoskeletal problems can help support stability. Chiropractic care may form part of a broader approach to maintaining comfortable movement and sensorimotor function, although current evidence does not establish chiropractic care as a method of preventing falls.
If you're noticing changes in your balance, mobility or confidence with walking and stairs, an individual assessment can help determine what's contributing and what type of care or exercise may be appropriate.
Want to learn more? Book a FREE 15min discovery call with one of Sydney’s best Chiropractors today: Book HERE
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Holt KR, Haavik H, Lee AC, Murphy B, Elley CR. Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated With Falls Risk in Older People: A Randomized Controlled Trial. Journal of Manipulative and Physiological Therapeutics. 2016;39(4):267–278.
PubMed study
Australian Spinal Research Foundation. Chiropractic Care and Falls Prevention in Older People. This is useful as the reader-friendly chiropractic explanation of the Holt/Haavik study.
Australian Spinal Research Foundation article
Healthdirect Australia. Older people and falls – causes, treatments and prevention. Healthdirect notes that changes including poorer eyesight, weaker muscles, reduced sensation and slower reaction times can contribute to falls with ageing.
Healthdirect falls information
Healthdirect Australia. Physical activity guidelines for older people. Useful support for strength, flexibility and balance training recommendations.
Healthdirect physical activity guidelines
Sensorimotor and proprioceptive exercise programs to improve balance in older adults: a systematic review with meta-analysis. Useful independent evidence supporting proprioceptive and sensorimotor training rather than relying solely on chiropractic literature.
PubMed systematic review
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The information provided on this website is for general educational purposes only and is not intended to replace professional healthcare advice, diagnosis, or treatment. Chiropractic care may assist with musculoskeletal function and nervous system health; however, individual outcomes may vary.
This content does not constitute medical advice and should not be used to diagnose or treat any health condition. Always seek advice from a registered healthcare professional if you have concerns about your symptoms, particularly if symptoms are severe, worsening, or persistent.
If you experience red flag symptoms such as unexplained weight loss, fever, loss of bladder or bowel control, progressive weakness, or significant trauma, seek immediate medical attention.
Nomad Chiropractic practitioners are registered with the Australian Health Practitioner Regulation Agency (AHPRA) and provide care in accordance with Australian healthcare standards and scope of practice.
Good balance isn’t just about staying steady - it’s about staying confident, capable and moving well through every stage of life.