Balance and falls in adults

Daniel Smit | Physiotherapist

Understanding changes in balance, reducing falls risk and knowing when to seek support

Balance can change at any age

Balance helps us stay steady when we stand, walk, turn, reach and move across different surfaces. It depends on the brain combining information from vision, the inner ear, sensation in the feet and joints, and the body’s strength and movement responses. A change in any of these systems can make everyday movement feel less secure.

A fall is not an inevitable part of ageing. Falls can happen at any age, and they often have more than one contributing factor. A fall, near-fall, new unsteadiness or growing concern about falling is a useful reason to check what may be affecting movement and confidence.

What can affect balance and falls risk?

Balance and falls risk can be influenced by a combination of health, movement and environmental factors, including:

• reduced leg strength, endurance, walking speed or confidence after illness, injury or a period of reduced activity
• dizziness, vertigo or difficulty adapting to head movement and changes in position
• changes in vision, sensation in the feet, joint awareness or hearing
• neurological or other health conditions that affect coordination, movement or reaction time
• pain, fatigue, an acute illness, dehydration or feeling faint when standing
• medicines that may contribute to dizziness, drowsiness or changes in blood pressure; ask your prescriber or pharmacist to review these, and do not stop a medicine without advice
• foot pain, unsuitable footwear, mobility aids that need adjustment, or hazards such as poor lighting, loose rugs and clutter.

When should you seek an assessment?

Consider speaking with your GP or physiotherapist if you have fallen, had near-falls, feel unsteady, have new dizziness, find it harder to get up from a chair or manage stairs, or are avoiding activities because you are worried about falling. A fall can still be worth discussing even if you were not injured.

Seek urgent medical help after a fall if there may be a serious injury, you have hit your head and feel unwell, you cannot get up, you have severe pain, fainting, chest pain, new weakness or numbness, difficulty speaking, or a sudden severe headache. Call 000 for an emergency. If you may be injured, do not try to stand without help.

How physiotherapy can help

A physiotherapist can ask about your falls, near-falls, dizziness, health, medicines, daily activities and goals, then assess relevant aspects of strength, balance, walking, transfers and movement. The assessment helps identify what is most relevant for you and whether input from your GP, pharmacist, occupational therapist, optometrist, podiatrist or another health professional would also be useful.

Support may include an individual exercise plan, practice of everyday tasks such as standing from a chair or turning while walking, balance and lower-limb strength training, advice about safe mobility, and vestibular rehabilitation when indicated and within the clinician’s scope. Exercises can be adapted for different abilities and progressed as capacity changes.

Practical steps that may help

• Keep moving in ways that feel manageable. Build activity gradually and choose activities that fit your health and goals.
• Include exercises that challenge balance and everyday movement, alongside strength work. Walking is beneficial for health, but walking alone may not provide enough balance challenge for falls prevention.
• For older adults, Australian community guidelines recommend 2–3 hours of ongoing exercise each week, primarily targeting balance and mobility and including strength training. The amount and starting level should be appropriate to the person; people with previous falls or significant balance difficulties may need a tailored, supervised plan.
• Wear secure, well-fitting footwear and use a prescribed mobility aid as advised. Ask a clinician to check the fit and show you how to use it safely.
• Improve lighting, keep frequently used pathways clear, secure loose mats and arrange rails or other home changes to match your needs. An occupational therapist can provide a tailored home safety assessment.
• Arrange vision, hearing, foot and medication reviews when relevant. Stand up gradually if you feel light-headed and discuss recurrent symptoms with a health professional.

What to do after a fall

If you are injured, have severe symptoms or cannot get up, call 000 or use your personal alarm/emergency contact. If you are on the floor and do not appear injured, take your time, keep warm and call for help if you are unsure or unable to get up safely. Contact your GP or physiotherapist after a fall to discuss what happened and whether a review would help. Recording when, where and how the fall happened can help guide that conversation.

How Strides can support you

At Strides Health Group, adult physiotherapy is centred on what matters to you. We can assess balance, walking, strength, dizziness and everyday mobility, then work with you on a practical plan that supports participation and independence. If your symptoms are sudden, severe or medically concerning, seek urgent medical care rather than waiting for a physiotherapy appointment.

Book an appointment

Strides Health Group, Narre Warren | Call 0411 876 851 | Visit strideshealth.com.au

Download the balance and falls in adults handout (PDF)

References and further information

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