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Balance 101

Balance 101

Wednesday, February 26, 2020

Balance, or lack of balance, is a common issue that we all have to address as we age. Balance involves multiple body systems, including your muscles, bones, vision, inner ear, nerves, heart, and blood vessels. These must all work properly for you to have normal balance. If any of these systems are disrupted or deficient, you can experience balance problems.

Pro tip: You can learn more about how to improve your balance at our free Better U lectures, and take part in a balance screening test to learn about what exercises can help you at our March clinical screening events.

Let’s take a deeper look into identifying the root cause of balance issues and some common treatments.


Balance Symptoms


Vertigo is the sense of motion or spinning. Here are some common conditions that cause this symptom.

  • Benign Paroxysmal Positional Vertigo (BPPV) - This occurs when calcium crystals in your inner ear (which help control balance) are dislodged from their normal positions and move elsewhere in the ear. BPPV is the most common cause of vertigo in adults. You might experience a spinning sensation when turning your head or tilting your head back to look up.
  • Meniere’s Disease - Meniere’s disease is characterized by sudden and severe vertigo that can cause fluctuating hearing loss, buzzing, ringing, or a feeling of fullness in your ear. The specific cause is not known and usually affects people between the ages of 20 and 40.
  • Migraine - Vestibular migraines can cause dizziness and sensitivity to motion. They aren’t always accompanied by pain, although pain is common. 15 percent of the U.S. population suffers from migraines.
  • Vestibular Neuritis - This is an inflammatory disorder, probably caused by a virus that affects the nerves in the balance portion or your inner ear. Symptoms are usually severe and persistent that include nausea and difficulty walking. Symptoms generally last several days and gradually improve without treatment.

Feeling Faint or light-headed

  • Orthostatic Hypotension (Postural Hypotension) - Standing or sitting up too quickly can result in a significant drop in blood pressure, resulting in presyncope. (Sensation that you’re going to faint)
  • Cardiovascular disease - Abnormal heart rhythms (heart arrhythmia), narrowed or blocked blood vessels, a thickened heart muscle (hypertrophic cardio myopathy), or a decrease in blood volume can reduce blood flow and cause presyncope.

Loss of Balance or Unsteadiness

Losing balance while walking or feeling imbalanced.

  • Vestibular problems - Abnormalities in your inner ear can cause a sensation of a floating or heavy head, and unsteadiness in the dark.
  • Nerve damage to your legs (Peripheral Neuropathy) - This causes difficulties with walking.
  • Joint, muscle or vision problems - Muscle weakness and unstable joints can contribute to your loss of balance. Difficulties with eyesight can lead to unsteadiness.
  • Medications - Many medications have a side effect of loss of balance or unsteadiness.
  • Neurologic conditions - These include cervical spondylosis - age-related wear and tear affecting the spinal disks in your neck, Parkinson’s disease, and others.


A sense of dizziness or lightheadedness can result from the following:

  • Inner ear problems - Abnormalities of the vestibular system can lead to a floating sensation or other false sensations of motion.
  • Psychiatric disorders - Depression, anxiety, and other psychiatric disorders can cause dizziness.
  • Abnormally rapid breathing (Hyperventilation) - Often associated with anxiety disorders.
  • Medications - Lightheadedness can be a side effect of medications.

Test your balance

Balance tests

Balance is a skill that is easier to maintain than to rebuild. Your exercise program should include balance exercises at all age and skill levels. Think of balance as its own movement system in your body. Just like strength and flexibility, balance can be improved with regular progressive exercises.

Test 1

  • Stand with your feet together and your ankle bones touching.
  • Cross your arms and close your eyes.
  • Hold this position for as long as you can.

A healthy standard is to be able to hold this position for 60 seconds. If you can do that, then you’re well on your way to establishing a solid balance foundation.

Test 2

Stand on one foot and bend your other knee to lift the non-supporting foot off the ground without touching the standing leg. Do this near a wall or doorway, so you can support yourself if needed.

  • Close your eyes (the eyes open standards are also included below)
  • Cross your arms over your chest
  • Hold this position as long as possible

Below 60 years old (passing standards)

  • 29 seconds with eyes open
  • 21 seconds with eyes closed

Over Age 60 (passing standards)

  • 22 seconds with eyes open
  • 10 seconds with eyes closed

Exercises for balance

Exercises for balance

One leg stands - Stand Straight. Raise one leg, bending your knee to 45 degrees. Hold for 5-10 seconds. Repeat 10 times and then switch legs. You can do this while waiting in lines or doing stationary work, such as washing dishes.

Heal to toe walking - Walk with the heel of the front foot touching the toe of the back foot as you take 10 steps forward. Repeat 10 times. Try backwards heel to toe walking for an increased challenge.

Side-Stepping - Step to the right. Then bring your left foot to meet your right foot. Advance to cross-stepping, where you side-step to the right and cross your left leg behind, then side-step to the right again and cross your left leg in front. Continue this pattern as you walk across the room.

Unassisted standing from a chair - Sit in a firm chair and stand without using your arms for balance. Try this with one leg to challenge leg strength.

Ankle pumping when you get out of bed - If you are prone to dizziness when rising from your bed, sit on the edge of the bed for a few seconds and pump your ankles before you stand up.

Tai Chi - Try a Tai Chi class, which is excellent for promoting balance.

Strength Training - Lifting weights promotes muscle strength which plays a key role in balance.

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