Balance is one of those functions that we take for granted. We know that, somehow, our brain and body will work in unison to keep us upright and steady. Until it doesn't.

Research shows that, globally, falls are the second biggest cause of accidental death after traffic accidents. In the last three decades the total amount of deadly falls around the world doubled. You may be forgiven for thinking that this may be due to an ageing population. However it is estimated that incidents of falls are increasing at a rate that outstrips our baby boomer population. One study showed that fatal falls for people aged between 45 and 64 jumped by 44% in the years between 1999 and 2007.

Walking is a refined version of a stagger

Standing and walking on 2 legs are far more difficult activities than you might imagine, so difficult in fact that humans are the only mammals that do it exclusively. A complex interaction between the brain, the nerves in the spine and the muscles and joints of the pelvis and legs is required to keep us upright. Even after millennia of adaptation and evolution walking is essentially not much more complicated than a controlled sequence of falls in a desired direction.

Why are we falling more?

Pregnancy, illness and injuries - particularly to the legs - are among things that can effect the balance systems enough to make a fall more likely. Inflammation which is linked to obesity, injuries, stress and infection has also been shown to negatively effect the balance enough to change the way we walk, potentially increasing falls.

As children become more sedentary they have less opportunity to have the stability, that they build up from trial and error as they learn to walk, challenged. This means that they have less reserve to draw down on in later life. Too much sitting, cuts in sport and break times means that young adults are hitting their 20s with less stability than they should. This deficit is then compounded by sedentary lifestyles leading to a drop in strength and making falls more likely. Age-related declines in brain function starts to have an effect on balance by the age of 50.

Use it or lose it

The good news is that balance can be trained and its never too late. It may take a bit longer to train as we get older but with persistence balance can be restored.

First test it out: take off your shoes, close your eyes and stand on one leg. If you can't hold your balance without falling for 30 seconds its time to start training.

• Rock backwards and forwards between heals and toes.
• Start foot strengthening exercises - pick up a marble or a pencil with your toes.
• Walk heal to toe and also walk sideways crossing one leg in front or behind the other. Progress to using a wobble board.
• Walk with your eyes closed.
• Walk barefoot as much as possible. Barefoot on sand is particularly good.
• Take up Tai chi or a reasonably fast paced yoga class. Disciplines that require focused attention on a series of fluid movements have been shown to improve balance.
• Cycle, run and walk outside on rough terrain. This will require you to adjust to the environment constantly and is a lot more effective for balance than working out in a gym.

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