Exercise - Thrive

Exercisefor balanceand fall preventionThis information is not intended to diagnose health problems or to take the placeof medical advice or care you receive from your physician or other health careprofessional. If you have persistent health problems, or if you have additionalquestions, please consult with your doctor. 2009, The Permanente Medical Group, Inc. All rights reserved. Regional Health Education010526-037 (Revised 6-12) RL 5.012

Falls can be a serious health risk, especially for older adults. Keepingyour body strong and making your surroundings safe are the bestways to reduce the risk of falling. Here at Kaiser Permanente,your physician, physical therapists, and other health care profes sionals want to help you stay healthy, active, and independent.We developed this exercise booklet to help you improve your bal ance, endurance, strength, and flexibility.Other resourcesVisit kp.org/mydoctor to find resources such as the Checklistfor Preventing Falls at Home. Under the “Tools and Classes” tabfind information about classes and other programs to help youimprove your balance and strength. Once there, you can alsowatch a short video called “Preventing Falls.”Aerobic exerciseThese are activities that increase your heart rate and breathing fora sustained period of time. You can try walking, swimming, waterexercise, riding a bike, dancing, or Tai Chi. If this activity is newto you, start with 5 minutes 5-6 times per week and build up toat least 30 minutes 5 days a week.Exercises to help keep you flexibleFlexibility exercises including stretching can give you more free dom of movement for your daily activities such as getting dressed,reaching objects on a shelf, and driving. Repeat each exercise 2-3times per day. Calf StretchStand facing a wall or counter, gently holdingon for balance and support. Place the leg youwant to stretch behind you. Keep your heel onthe ground, your knee straight and your toespointed straight ahead. Lean forward until youfeel a gentle stretch in your calf. Hold the stretchfor 30-60 seconds. Repeat on both sides.Frequency211

Single Leg Standing Balance Hip Flexor StretchStand on a firm surface backed intoa corner of a room or stand next to acounter top.Try and remain steady for 10-15 seconds.Stand next to a wall or counter, gently holding onfor balance and support. Place your right foot infront of the left (like you are taking a step). Yourleft knee should be almost straight. Squeeze yourbuttock muscles and shift your weight to yourfront leg until you feel a stretch in the front ofyour left hip. Hold the stretch for 30-60 seconds.Repeat on both sides.Repeat with your other leg. Continue alternating sides.Frequency .Touch the walls or counter only if youneed to regain your balance. Stand onone leg.Frequency Forward Reach using Hip StrategyStand on a firm surface close to, but not touching a counter. Keepyour feet flat on the floor, shoulder width apart. Touch the counteronly to regain your balance and to prevent a fall.a) Reach forward with your hands and move your hips backwardsto counterbalance you. Keep your back straight as you move.Come back to the starting position.Frequency Alternate Hip Flexor StretchPlace your foot on the seat of a chair behindyou. Hold on to a wall or counter for balance.Gently tighten your buttocks and feel thestretch down the front of your hip andthigh. Hold the stretch for 30-60 seconds.Repeat on both sides.Frequency Upper Back StretchSitting or standing, reach up withyour right arm and reach back withyour left arm. Squeeze your shoulderblades together. Hold for 5 seconds.Frequencyb) Reach across to the left with your hands and move your hipsbackwards to the right. Return to the starting position. Thenrepeat the exercise reaching right with your hands and movingyour hips backwards to the left.Frequency103

Exercises to improve your strengthBuilding up muscle strength improves your ability to performeveryday activities like carrying groceries, lifting a grandchild, orgetting up out of a chair. Repeat all exercises 2-3 times per day. BridgingLie on your back with your kneesbent and feet flat on the floor.Gently tighten your stomach andbuttock muscles. Lift your hips3-5 inches from the floor withoutarching your back. Hold for 5-10seconds, and then slowly loweryour hips to the floor. Side SteppingStand with a long counter infront of you, only touching thecounter if you need to regainyour balance. Step sidewayswith one leg and bring yourother foot to it. Repeat for5 steps in the same direction.Repeat 5 steps in the oppositedirection.Frequency Tandem WalkingStand at the end of a hallway or long counter. Only touch thewalls or the counter if you need to regain your balance. Focus ona target directly in front of you.Frequency Mini Squat using a ChairGently hold onto the back of thechair or counter with your feetshoulder width apart. Slowly bendyour knees and squat down just afew inches. Keep your knees directlyover your feet. Hold for 5-10seconds; then return to thestarting position.FrequencyStartEndWalk forward by placing one foot directly in front of the other asif you are walking a tightrope.Walk as straight as you can, not veering to either side.Frequency49

3-Way Hip in Standingc) Stand with one foot in front of the other. Tryto count to 30 without losing your balance.You can progress exercises a, b, and c by:UÊ Ã }ÊÞ ÕÀÊiÞiÃÊ Êv Ü }Êinstructions aboveorUÊ/ÕÀ }ÊÞ ÕÀÊ i ÊÃ Ü ÞÊvÀ ÊÃ iÊÌ ÊÃ iÊÌ À Õ} ÕÌÊthe exercise Body Circle SwayStand backed into a corner with your fingertips able to gently touch the walls. Touch thewalls only if you need to regain your balanceand prevent a fall. Keep your feet flat on thefloor, shoulder width apart. Move only fromyour ankles. Start by shifting your weight sideto side 5 times, then shifting it forward andback 5 times. Combine the movements andshift your weight in a circle clockwise andcounter-clockwise.FrequencyStanding, hold on to a counter ora chair. Keep your pelvis level andtry to avoid arching your back.a) Move your right leg forwardand back to the starting position.Repeat on the other side.FrequencyStartEndb) Move your right leg out to side andback to the starting position.Repeat on the other side.FrequencyStartEndStartEndc) Move your left leg backwards and thenreturn to starting position.Repeat on the other side.Frequency85

Marching for Hip StrengthExercises to improve balanceStand and hold on to a counter or high back chair that isat your side.Stand on your left foot and lift yourright knee up, then return it to thestarting position.Stand on your right foot and lift yourleft knee up. Return to the startingposition.Alternate legs as if you are marching.StartEndFrequencyBalance exercises can help prevent falls by improving your abilityto control and maintain your body’s position. To keep safe, pleaseread and follow exercise descriptions carefully. It’s a good idea tostand in the corner of a room when you do these exercises. Usethe walls on either side of you to help you regain your balance ifyou feel like you might be falling. We also recommend that youplace the back of a chair in front of you for support. If you are alittle unsteady while doing these exercises, that’s okay. That meansyou are working those muscles! The following exercises are listedin the order of least to greatest level of difficulty. Repeat the balanceexercises 2-3 times per day. Standing Balance Heel Raises and Toe RaisesHold on to the back of a chair or counter for balance and support.Stand on a firm surface backed into a corner ofa room or stand facing a counter top. Touch thewalls or counter only to regain your balance andto prevent a fall.a) Rise up on your toesand return back down.a) Stand with your feet shoulder width apart.Try to count to 30 without losing your balance.Frequencyb) Shift your weight to yourheels and lift your toes upoff of the floor.b) Stand with your feet close together. Try tocount to 30 without losing your balance.Frequency67

Marching for Hip StrengthExercises to improve balanceStand and hold on to a counter or high back chair that isat your side.Stand on your left foot and lift yourright knee up, then return it to thestarting position.Stand on your right foot and lift yourleft knee up. Return to the startingposition.Alternate legs as if you are marching.StartEndFrequencyBalance exercises can help prevent falls by improving your abilityto control and maintain your body’s position. To keep safe, pleaseread and follow exercise descriptions carefully. It’s a good idea tostand in the corner of a room when you do these exercises. Usethe walls on either side of you to help you regain your balance ifyou feel like you might be falling. We also recommend that youplace the back of a chair in front of you for support. If you are alittle unsteady while doing these exercises, that’s okay. That meansyou are working those muscles! The following exercises are listedin the order of least to greatest level of difficulty. Repeat the balanceexercises 2-3 times per day. Standing Balance Heel Raises and Toe RaisesHold on to the back of a chair or counter for balance and support.Stand on a firm surface backed into a corner ofa room or stand facing a counter top. Touch thewalls or counter only to regain your balance andto prevent a fall.a) Rise up on your toesand return back down.a) Stand with your feet shoulder width apart.Try to count to 30 without losing your balance.Frequencyb) Shift your weight to yourheels and lift your toes upoff of the floor.b) Stand with your feet close together. Try tocount to 30 without losing your balance.Frequency67

3-Way Hip in Standingc) Stand with one foot in front of the other. Tryto count to 30 without losing your balance.You can progress exercises a, b, and c by:UÊ Ã }ÊÞ ÕÀÊiÞiÃÊ Êv Ü }Êinstructions aboveorUÊ/ÕÀ }ÊÞ ÕÀÊ i ÊÃ Ü ÞÊvÀ ÊÃ iÊÌ ÊÃ iÊÌ À Õ} ÕÌÊthe exercise Body Circle SwayStand backed into a corner with your finger tips able to gently touch the walls. Touch thewalls only if you need to regain your balanceand prevent a fall. Keep your feet flat on thefloor, shoulder width apart. Move only fromyour ankles. Start by shifting your weight sideto side 5 times, then shifting it forward andback 5 times. Combine the movements andshift your weight in a circle clockwise andcounter-clockwise.FrequencyStanding, hold on to a counter ora chair. Keep your pelvis level andtry to avoid arching your back.a) Move your right leg forwardand back to the starting position.Repeat on the other side.FrequencyStartEndb) Move your right leg out to side andback to the starting position.Repeat on the other side.FrequencyStartEndStartEndc) Move your left leg backwards and thenreturn to starting position.Repeat on the other side.Frequency85