Balance training

Balance training is exercise that makes it hard to stay steady. It goes by other names too, such as sensorimotor training and proprioceptive training.^{1Hoffman, NSCA’s Guide to Program Design, pp. 211–213.} It aims to improve joint stability during movement, balance, and the sense of how the body is moving.^{1Hoffman, NSCA’s Guide to Program Design, pp. 211–213.}

Balance comes in two kinds. Static balance is holding an upright posture while standing still. Dynamic balance is staying stable while moving through space.^{2Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 253.} Better balance lowers the risk of falls, especially in older adults and people with neurological conditions. It also helps prevent sport injuries, especially at the ankle.^{2Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 253.}

Falls are common. Almost one in four US adults aged 65 or older falls each year.^{3Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 441.} Training that mixes balance, agility and proprioceptive work reduces falls when done 2 to 3 days a week.^{3Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 441.} In studies, balance training gave clear benefits over doing none.^{4Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 443.}

It has limits. Balance training does little to build jumping power or strength.^{5Hoffman, NSCA’s Guide to Program Design, p. 214.} For athletes, regular resistance or plyometric training should come first for strength and power.^{5Hoffman, NSCA’s Guide to Program Design, p. 214.}

In practice

• Make it harder step by step by shrinking the base of support: narrower stance, heel-to-toe, then one leg.^{6International Personal Trainer Academy, Certified Personal Trainer Textbook, p. 383.} Then add an unstable surface, and later a push or pull from outside.^{6International Personal Trainer Academy, Certified Personal Trainer Textbook, p. 383.}
• Other options include heel or toe walks, closing the eyes, turning the head while walking, and tai chi.^{7Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 442.} Many of these cause little fatigue, so they can be done daily.^{7Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 442.}
• Keep it hard. For healthy athletes, an exercise that never forces a balance correction doesn’t work.^{8Hoffman, NSCA’s Guide to Program Design, p. 216.} Once a move is mastered, make it harder or swap in a new one.^{8Hoffman, NSCA’s Guide to Program Design, p. 216.}
• Hoffman suggests programs of at least four weeks, with at least three sessions a week to keep the gains.^{5Hoffman, NSCA’s Guide to Program Design, p. 214.} Each rep should last at least 20 seconds.^{9Hoffman, NSCA’s Guide to Program Design, p. 215.}

Where sources differ

How much balance training to do is still open. ACSM says there’s no agreement yet on the right dose for lowering fall risk.^{7Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 442.} Its effect on knee injuries is also debated. One study found that adding balance training cut ACL injuries in amateur soccer players, but a systematic review disputes this.^{10Haff and Triplett (eds.), Essentials of Strength Training and Conditioning, 4th ed., pp. 428–429.}