It usually starts small. A hand on the counter when you get up from the kitchen table. A slower step off the curb on Washington Boulevard. Maybe you’ve quietly stopped walking on the beach because the sand doesn’t feel as solid under you as it used to. Each of those on its own? Easy to shrug off. Until one day it isn’t.
So where does physical therapy come in? First, it finds out what’s actually going wrong, whether that’s weak legs, stiff ankles or something else. Then it works on fixing it, so you’re stronger and steadier and you trust your own two feet again. Exercise works here.
A Cochrane review of 108 trials found that exercise cut the rate of falls in older adults living at home by about 23%, and balance and functional training had the strongest evidence of all.
How common are falls after 65?
More common than most people think. According to the CDC, more than 1 in 4 adults 65 and older fall each year, and fewer than half tell their doctor.
Physical Therapy For Balance & Fall Prevention
The fallout is real. Falls by older adults lead to about 4.5 million emergency room visits a year. They’re also the most common cause of traumatic brain injury in this age group, and in 2019 they were behind 88% of hip fracture ER visits and hospital stays.
Then there’s the part that doesn’t show up in the numbers. The CDC notes that many people who fall, even with no injury, become afraid of falling. So they move less. Moving less means weaker legs, and weaker legs make the next fall more likely. Breaking that loop is a major part of physical therapy.
Are you at risk? Three questions and three tests
The CDC’s STEADI program, a fall-prevention toolkit for health care providers, starts with three plain questions. Have you fallen in the past year? Do you feel unsteady when you stand or walk? Do you worry about falling?
If you answered yes to even one, mention it at your next appointment. That’s when the testing starts, and the tests themselves are pretty simple.
| Test | How it works | When it’s a warning sign |
| Timed Up and Go | Get up from a chair, walk 10 feet, turn around, come back, sit down | It takes you 12 seconds or longer |
| 30-Second Chair Stand | Count how many times you can stand up and sit back down in 30 seconds | The count is low for your age |
| 4-Stage Balance Test | Four standing positions, the last with one foot right in front of the other | You can’t hold that last one for 10 seconds |
One thing, though. Don’t do these by yourself. Even the CDC’s instructions tell the person running the test to stay right beside you, in case you wobble.
What happens at a balance therapy visit?
Your first visit at Garrow Wellness Center is mostly about figuring out what’s going on. We run functional movement screens and check how far your joints move, how strong you are and how flexible. Somewhere in there is the weak link. Could be an ankle that’s gotten stiff. Could be your hips. Could be a knee that’s never been quite right since surgery.
After that, treatment is part hands-on, part exercise. The hands-on part is soft tissue work, joint mobilizations and trigger point release, for whatever’s tight or not moving well. The exercises are about the stuff you do every day without thinking. Getting up out of a chair. Going up the stairs. Lifting a leg over the side of the tub. Your plan is built around your own goals. For one person, that’s gardening again. For another, it’s walking the boardwalk without holding on to someone’s arm.
First time seeing a physical therapist? No problem. What Exactly Does a Physical Therapist Do? Walks you through it.
Which exercises help most?
Ones that make you a little wobbly. That’s the point.
Remember that Cochrane review? The best evidence by far was for balance and functional exercise. Think shifting your weight from foot to foot, stepping forward, sideways and back, and getting up out of a chair over and over. Mixing in some strength work on top probably helps as well. Tai chi? Maybe. The research there just isn’t as solid yet.
What about how much? The CDC says adults 65 and up should get at least 150 minutes a week of moderate activity. A brisk walk counts. On top of that, 2 or more days of strength training, plus some balance practice. And that balance practice can be pretty low-key. Walk heel-to-toe down the hallway. Get up from a chair without pushing off with your hands. That’s the kind of thing they mean.
Why push strength? Because muscle you don’t use fades, and that happens faster as you get older. How Does Physical Therapy Help Muscle Wasting? gets into that. Once your therapist has shown you what to do, Physical Therapy Exercises That You Can Do By Yourself At Home gives you something to work on between appointments.
Is it always your legs?
Nope. Your inner ear, your eyes, your medicines and even your living room all get a vote, and a physical therapist can’t fix every one of them alone.
Take dizziness. If the room spins when you roll over in bed, start with How Physical Therapists Can Help with Dizziness. Arthritis is another one. Sore, stiff joints change how you walk, and Can Physical Therapy Help With Arthritis? explains what PT can do about it. Then there’s the medicine cabinet. Some prescriptions make people drowsy or lightheaded, so have your doctor or pharmacist look over everything you take. Book an eye exam if it’s been a while. And walk through your own house with fresh eyes. Throw rugs that slide, a dark hallway, stuff piled on the stairs.
When should you start?
Honestly? Before you fall. Nobody needs a broken wrist or a close call to earn a spot on the schedule.
Some signs it’s time: you reach for the wall or the back of the couch to get across a room. You walk slower than you used to. You’ve given up something you love, like golf or gardening, because it feels risky. Or you’ve already fallen, whether you got hurt or not. And if you see a chiropractor too, Chiropractic Care For Elderly Patients explains how that fits in.
Frequently asked questions
Can physical therapy really prevent falls?
It can make falls less likely. In a big Cochrane review, older adults who exercised had about 23% fewer falls, and balance and functional training had the best evidence behind it.
What is the Timed Up and Go test?
You stand up from a chair, walk 10 feet, turn around, walk back and sit down. Taking 12 seconds or longer is a sign of fall risk.
How much exercise should adults over 65 get?
At least 150 minutes of moderate activity a week, plus 2 days of strength training and some balance activities, per the CDC.
Do I need to have fallen before starting balance therapy?
No. Starting early is better. Feeling unsteady or worrying about falling is reason enough.
Ready to feel steadier on your feet? Garrow Wellness Center has served patients at the Jersey Shore since 1999. Visit us at 2204 NJ-35 #7 in Sea Girt or call 732-223-1990. Learn more about our Physical Therapy services or contact us to book an evaluation.