Balancing on a single leg may seem simple, but it can be surprisingly difficult as we age. Practicing this exercise, however, can improve strength, enhance memory, and support brain health.

While flamingos might do it naturally, most people spend little time poised on one leg. Balance is usually effortless in childhood, with abilities maturing around ages nine to 10, peaking in the late 30s, and gradually declining after that. For those over 50, being able to balance on one leg for more than a few seconds can reveal much about overall health and aging.

There are several reasons to practice standing on one leg. It can reduce fall risk, build leg and hip strength, and improve memory. "If you find that it's not easy, it's time to start training your balance," says Tracy Espiritu McKay, a rehabilitation medicine specialist for the American Academy of Physical Medicine and Rehabilitation.

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Why balance matters

Doctors often use single-leg balance tests as indicators of health because they are linked to age-related muscle loss, or sarcopenia. Muscle mass declines by up to 8% per decade after age 30, and research suggests that by their 80s, up to half of older adults may experience clinical sarcopenia. This affects blood sugar control, immunity, and muscle strength, all of which are reflected in balance ability. Regular one-legged exercises help maintain leg and hip muscles, reducing vulnerability to sarcopenia later in life.

"The ability to stand on one leg diminishes [with age]," says Kenton Kaufman, director of the motion analysis laboratory at Mayo Clinic in Rochester, Minnesota. "People are over 50 or 60 when they start to experience it and then it increases quite a bit with each decade of life after that."

Balance is not only a physical measure but also a sign of brain health. Standing on one leg requires the brain to integrate information from the eyes, the vestibular system in the inner ear, and the somatosensory system, which senses body position and ground contact. "All of these systems degrade with age at different rates," says Kaufman.

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Espiritu McKay adds that balance ability can reveal the state of key brain regions, including those involved in reaction speed, daily task performance, and sensory integration. Brain atrophy occurs naturally with age, but rapid decline can limit independence and increase fall risk. CDC data shows that unintentional falls are the leading cause of injury among Americans over 65. Practicing single-leg exercises can reduce this risk.

"These single leg training exercises really improve the balance control and actually change how the brain is structured," says Espiritu McKay.

According to Kaufman, falls often result from slower reaction times rather than a lack of strength. "Imagine you're walking along, and you trip over a crack in the sidewalk. Most often, whether you fall or not isn't a strength issue, but it's whether you can move your leg fast enough, and get it to where it needs to be, to arrest your fall."

Single-leg balance can even reflect short-term mortality risk. A 2022 study found people unable to maintain a single-leg stance for 10 seconds in mid-later life were 84% more likely to die within seven years. Another study of 2,760 adults in their 50s showed that the single-leg stance test was the most informative predictor of disease risk: participants who could balance for two seconds or less were three times more likely to die over 13 years than those who could maintain 10 seconds or more.

"In Alzheimer's patients, researchers are actually finding that if they're unable to stand on one leg for five seconds, it usually predicts a faster cognitive decline," says Espiritu McKay.

Training your balance

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Fortunately, research shows age-related decline can be slowed by practising single-leg exercises. These workouts strengthen the core, hips, and legs, while also benefiting brain health. "Our brains aren't fixed," says Espiritu McKay. "They're pretty malleable. These single leg training exercises really improve the balance control and actually change how the brain is structured, especially in regions that are involved in sensory motor integration and your spatial awareness."

Balancing on one leg also activates the prefrontal cortex, improving cognitive performance during tasks and boosting working memory in healthy adults.

Espiritu McKay recommends people over 65 practise single-leg exercises at least three times a week to enhance mobility and reduce fall risk, ideally incorporating them into daily routines. Starting earlier may offer greater benefits. Claudio Gil Araújo, an exercise medicine researcher at Clinimex in Rio de Janeiro, suggests those over 50 self-assess by standing on one leg for 10 seconds. "This can be easily incorporated into your daily activities," he says, suggesting exercises barefoot and with shoes.

Daily activities like brushing teeth or standing at the sink can be used to train balance for just 10 minutes a day. Smooth hip strengthening exercises with gentle resistance, known as isokinetic exercise, can also improve one-legged stability.

Source: BBC