After 60: not long runs, not heavy squats – the three balance moves physiotherapists say prevent dangerous falls

The first wobble often happens in an ordinary moment. You turn quickly to answer the door, catch your toe on the rug, feel the floor tilt for a heartbeat. You do not fall, but the jolt lingers long after the kettle has boiled. Someone suggests long runs, someone else swears by heavy squats. Your knee murmurs in protest at the very idea.

At 8:32 a.m., in a small physiotherapy clinic off a ring road, a woman in her late sixties walks heel-to-toe along a strip of tape on the floor, fingers hovering over the back of a chair. Her physio counts softly, watches her ankles work, then asks her to pause, turn her head, and keep walking. The room sounds like rubber soles and careful breathing. No barbells. No treadmills. Just three deceptively simple moves that have quietly become the heart of her programme.

After 60, physios say your most protective exercises are not the ones that look impressive on a smartwatch. They are the ones that stop you hitting the ground when life throws you a wobble – stepping over a dog, reaching for a top shelf, getting out of a low chair on a rainy day. Again and again, when you ask physiotherapists what really prevents dangerous falls, they come back to the same trio of balance drills.

Why balance, not mileage, protects you after 60

Falls are the leading cause of injury-related hospital admissions for older adults in the UK. A broken wrist or hip is not just a nuisance; it can mean surgery, loss of confidence, and a cascade of reduced activity. The surprising part is how early the risk creeps in. Balance starts to decline in our fifties, often before joints or heart complain loudly enough to grab attention.

Balance is not one thing. It is your eyes, inner ear, joints, muscles and brain holding a conversation in fractions of a second. Long runs and heavy squats can be good for fitness in the right bodies, but they do not automatically train the quick, small corrections that stop a trip becoming a fall. You can run 10k and still go down hard if your ankles, hips and reflexes are slow to answer.

“After 60, I am less interested in how far you can jog and more in whether you can stand on one leg while you put your trousers on,” says Emma Lewis, a physiotherapist in Manchester who works mainly with people over 65. “That’s where the injuries happen – in the wardrobe, the shower, the garden path.”

The good news is that balance is trainable. When you challenge it safely, nerve pathways sharpen, feet and ankles wake up, and your brain learns to predict and correct small losses of stability. You do not need special kit. You do need consistency, and moves that look suspiciously like everyday life.

Meet the three moves physios swear by

Ask three different physiotherapists for their “if I could only teach you three exercises” list, and the details shift. The themes do not. Over and over, you see:

• A supported single-leg stand to train the “catch yourself” reflex.
• A heel-to-toe walk to narrow your base and sharpen control.
• A slow sit-to-stand to hard-wire safe transfers in and out of chairs.

They are not glamorous. You can do them in a hallway in your slippers. But together they target ankles, hips, and the coordination between eyes and inner ear – the systems that keep you upright when the world moves unexpectedly.

“For most of my patients, these three are non-negotiable,” says Lewis. “Once they are solid, we can get fancy. But skipping the balance work and going straight to big weights is like decorating a house with no foundations.”

The three-move routine, step by step

Do this near a stable support – a kitchen counter, heavy table or banister – not a wobbly chair. Wear flat shoes, or go barefoot if it feels secure. If you already fall often, feel dizzy, or use a walking aid, speak to your GP or physio before starting.

Aim for 10–15 minutes, three to five days a week. You can break it into shorter chunks.

1. Supported single-leg stand (“the flamingo hold”)

This trains your ankle, hip and core to work together when you’re briefly on one leg – like stepping over a pothole or into the bath.

1. Stand side-on to a counter, light fingertips resting on it.
2. Place your feet hip-width apart, weight evenly spread.
3. Gently shift your weight onto your right leg and lift your left foot a few centimetres off the floor, knee slightly bent.
4. Hold for up to 10 seconds, breathing steadily. Try to feel your toes and ankle making tiny adjustments.
5. Lower the foot with control, rest, then repeat on the other side.

Start with 3 holds each side. As it gets easier, progress:

• Use just one fingertip, then hover your hand above the counter.
• Turn your head slowly side to side while you hold.
• Close one eye (never both at once) for an extra challenge.

Lewis has a rule: “If your knuckles go white on the counter, you’ve gone too far. Balance work should feel wobbly, not frightening.”

2. Heel-to-toe line walk

This mimics walking on a narrow path or kerb, teaching your body to control side-to-side sway.

1. Find a clear strip of floor near a support.
2. Stand tall, look ahead (not at your feet).
3. Place one foot directly in front of the other so your heel touches the toes of the back foot, as if walking on a line.
4. Step forwards, bringing the back foot in front in the same heel-to-toe pattern.
5. Take 5–10 slow, controlled steps, then turn carefully and walk back.

Use the counter or wall lightly if needed. If heel-to-toe is too much at first, start with “narrow walking”: feet a little closer together than normal, but not touching.

To progress:

• Turn your head slightly as you walk, as if checking a shop window.
• Count backwards or recite the days of the week – cognitive load makes this closer to real life.

3. Slow sit-to-stand from a chair

You do this movement dozens of times a day. Practising it with control strengthens thighs and hips, keeps your ability to get up from the floor or toilet, and improves balance as your weight shifts forwards and up.

1. Choose a stable chair with arms, placed against a wall if possible.
2. Sit tall, feet flat and slightly back under your knees.
3. Lean your chest gently forwards (“nose over toes”), press your feet into the floor and stand up without using your hands if you can.
4. Once fully upright, pause for a second to find your balance.
5. Slowly lower yourself back down, aiming to land softly rather than plonking.

Start with 5–8 repetitions. If it feels unsafe without hands, use the armrests lightly and work towards hands-free over time. To progress, cross your arms over your chest or use a slightly lower chair.

Physios often time this as a test – how many controlled sit-to-stands can you do in 30 seconds? Improvements here closely track easier stairs, better walking speed, and fewer stumbles.

Common pitfalls and how to avoid them

Balance training fails less because the exercises are wrong, and more because the set-up is. A few frequent traps:

• Training when tired or rushed. Balance is a brain job. Do your routine when you’re alert, not at the end of a draining day.
• Practising in clutter. Pets, loose mats, cables and side tables are all trip hazards. Clear a “balance lane” and claim it as your practice spot.
• Jumping to advanced moves too fast. One foot off the ground is enough of a challenge for most at first. Save foam pads, wobble boards and eyes-closed work for when the basics feel boring.
• Holding your breath. Breath-holding stiffens you and actually makes balance worse. Try counting out loud; if you can’t, you’re probably bracing.

“People think if they’re not sweating, it’s not doing anything,” says Lewis. “But for falls prevention, we care more about precision than puff. Five perfect minutes beats twenty sloppy ones.”

How often, how much – and when to stop

Balance behaves like language: use it most days or you lose fluency. The sweet spot for most over-60s is:

• Frequency: 3–5 days per week.
• Duration: 2–3 sets of each move, totalling 10–15 minutes.
• Intensity: A little wobble, no panic. You should feel challenged but able to talk.

Stop and seek advice if you:

• Feel spinning dizziness, chest pain, or new shortness of breath.
• Have blurred vision or feel as if the room is moving.
• Notice sudden weakness or numbness.

A brief, mild unsteadiness during or just after a drill is normal. Persistent symptoms are not.

Quick reference: the three moves at a glance

Move	Main benefit	Simple target
Supported single-leg stand	Trains “catch yourself” reactions in ankle, hip and core	3–5 holds of up to 10 seconds per leg
Heel-to-toe line walk	Sharpens side-to-side control and confidence on narrow paths	2–3 passes of 5–10 steps each way
Slow sit-to-stand	Strengthens legs and rehearses safe getting up and down	2–3 sets of 5–10 smooth repetitions

Ten quiet minutes a day often buys you fewer bruises, fewer scares, and more years of moving how you like.

What this tiny routine changes in everyday life

The real shift is not in the clinic. It is in the supermarket queue, where you turn to reach the conveyor without clutching the trolley. It is on the bus, when you stand up before it fully stops and your feet find the floor without drama. It is in the bathroom on a damp Tuesday, stepping out of the shower with less fear.

We have all seen the way one bad fall can shrink a life – fewer walks, fewer visits, more days spent near the safest chair. Three small balance moves will not freeze time, but they stretch your margin for error, which is often what matters most. Care is a series of tiny, boring choices made in ordinary mornings. Your body remembers those choices in steadier steps, surer turns, and the quiet relief of not grabbing the doorframe quite so often.

Key points for your own routine

• Start with a clear, supported space and shoes you trust.
• Focus on quality and calm breathing, not sweat.
• Progress slowly: less hand support, narrower stance, small head turns.
• If in doubt, check in with a physiotherapist or GP, especially if you already fall or feel dizzy.

FAQ:

• Are long runs and heavy squats bad after 60? Not necessarily, but they are not the starting line for most people. For many over-60s, joints, heart or blood pressure make high-impact or very heavy lifting less suitable without medical clearance. Balance and functional strength work usually come first.
• Can I do these exercises if I already have osteoporosis or arthritis? Often yes, with adjustments. The moves are low-impact, and better balance can reduce fracture risk. But if you have pain, recent fractures or a complex condition, ask your GP or physio to tailor them.
• When will I notice a difference? Many people feel a little steadier within 2–4 weeks if they practise most days. Objective changes – fewer stumbles, easier stairs – tend to show up over 6–12 weeks.
• Do I need special equipment like wobble boards? No. A sturdy chair, counter and bit of floor are enough. Physios add unstable surfaces later, but the basics work without gadgets.
• Is it ever too late to start balance training? Research and clinic experience say no. People in their eighties and nineties still improve. The earlier you begin, the more reserve you build, but starting today is always better than waiting for the next scare.