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Physical Therapy to Improve Your Child’s Balance

How balance works

Balance is the even distribution of weight that helps you remain upright and steady.

To maintain good balance:

  • You get the correct sensory information 
  • Your brain correctly uses those details
  • The right muscles respond

Many different systems in your body work together to create stability.

Sensory information for balance comes from your:

  • Visual system - It gives your brain information about your environment. It tells your brain where your body is in its space. 
  • Somatosensory system - It helps you notice things like touch, pressure, pain, movement and position. These sensors are all over your body, in your muscles, joints and skin. They help your brain with body positioning.
  • Vestibular system - It is in your inner ear. It tells your body how you've positioned your head. It also sends information about whether your body is moving forward, backward, up or down.

Changes in any of these systems can cause balance problems. 

Causes of balance problems

There can be many reasons your child may have a change in their sense of balance. These include medication side effects, pain, or nervous system injury.

Work with your health care team to find the causes of your child’s balance challenges. One solution is to work with a physical therapist to strengthen muscles. The physical therapist may also have tips for how to increase safety for your child at home.

Signs of balance issues

Here are some things you might notice if your child is having issues with balance:

  • Difficulty walking
  • Loss of balance 
  • Falling or stumbling
  • Dizziness when changing positions, turning, standing, walking, or sitting

If you see any of these symptoms, talk with your child’s physical therapist or care team. Physical therapy can help strengthen muscles, increase flexibility, and work on positional changes. These things can improve balance.

Exercises to help balance

Physical therapists can look at your child’s balance and create the best plan of care. That can include visits to their office for treatment. It might include a set of home exercises, too. 

Here are some exercises a physical therapist might ask you to do with your child at home:

Standing balance (feet together)

  • Stand with feet together, on an even surface, for 1 minute with no support.
  • Try to reach in all directions without moving your feet for 30 seconds to 1 minute.

For a more challenging activity: 

  • Close your eyes for 30 seconds to 1 minute to challenge your balance. You may need extra support for this exercise to prevent falling or loss of balance. 
  • Do the standing balance exercise on uneven surfaces such as a pillow or foam mat. 
Standing Balance

Standing balance feet together

Single-leg stance

  • Stand on one foot for 30 seconds or more.

Repeat 3 times on each leg. 

If you are unable to maintain your balance or feel unsafe, stand near a sturdy surface.

Single-Leg Stance

Single-leg stance

Tandem stance

  1. Stand with 1 foot in front of the other, heel to toe.
  2. Hold position for 30 seconds or more. 

Repeat 3 times with each foot forward. 

If you are unable to maintain your balance or feel unsafe, stand near a sturdy surface.

Tandem Stance

Tandem Stance

Tandem walking (with head forward and with the head rotating)

  • Walk heel to toe for 10-15 feet. 
  • Repeat 3-4 times. 

Use a wall or person for support as needed to maintain balance. 

For a more challenging activity: 

  1. Walk heel to toe. 
  2. As you walk, rotate your head from side to side, looking to the right and left.

 You may need more support for this exercise. 

Tandem Walking

Tandem Walking

Seated hamstring stretch

  1. Sit with one leg extended and your back straight.
  2. Bend your other leg so that the sole of your foot rests against your mid-thigh.
  3. Reach toward your ankle.
  4. Keep your knee, neck, and back straight.
  5. Feel the stretch in the back of your thigh.
  6. Hold for 30–60 seconds.

Repeat 2-3 times on each leg.

Seated Hamstring Stretch

Seated Hamstring Stretch

Seated calf stretch

  1. Sit with one or both legs extended.
  2. Use a rolled towel or belt around the bottom of one foot, near the toes.
  3. Pull the foot back toward your body until you feel a stretch in the calf area.
  4. Hold for 30–60 seconds.

Repeat 2–3 times on each leg.

If any of the above exercises cause your child pain, stop. Then, let your physical therapist know.

Talk to your care team before trying any exercises.
Seated Calf Stretch

Seated Calf Stretch

Key points

  • A person’s balance depends on their body recognizing and using signals.
  • There are many causes for the balance issues that your child may have during treatment.
  • A physical therapist can help your child strengthen and stretch muscles that can help improve their balance.

Reviewed: August 2022