Quick answer: Balance training helps people with arthritis stay steady and reduce the risk of falls. Practise standard exercises such as heel-to-toe standing, sideways walking and single-leg stands, holding a sturdy support, on at least 2 days a week alongside strength work. Start easy, progress slowly, and talk to your GP if you are falling or feel unsteady.
Good balance is something most of us take for granted until it starts to slip. Arthritis can affect balance in several ways, and feeling unsteady can make you less confident, less active and more likely to fall. The good news is that balance is a skill you can train at any age. Regular, simple exercises, done safely, can help you feel steadier on your feet. This guide explains why arthritis affects balance, gives you a quick self-check, and walks you through ten standard balance exercises with a 12-week plan.
Why arthritis can affect balance
- Pain. Painful joints change the way you walk and stand, and you may avoid putting weight through one leg.
- Muscle weakness. Less activity and joint pain can weaken the leg and hip muscles that keep you steady.
- Reduced joint position sense. Joints contain sensors that tell your brain where your body is. Arthritis can make this less accurate.
- Stiffness. Stiff ankles, knees, hips or a stiff neck reduce your ability to react quickly to a trip or stumble.
- Foot problems. Painful, swollen or deformed feet reduce the stable base you stand on.
- Other factors. Some medicines, eyesight problems, inner ear problems, low blood pressure, fatigue and fear of falling also affect balance.
Why balance training matters
UK Chief Medical Officers' guidelines recommend that older adults do activities to improve strength, balance and flexibility on at least 2 days a week. NICE guidance on falls (NG249) recommends strength and balance exercise programmes for people at higher risk of falling. Balance training can help you feel more confident, walk more steadily, and manage everyday tasks such as getting in and out of the bath, climbing stairs and turning around.
A quick self-check
These simple checks can help you decide where to start. Only do them next to a sturdy support, such as a kitchen worktop, with someone nearby if you are unsure.
| Check | How to do it | What it suggests |
|---|---|---|
| Feet-together stand | Stand with your feet together for 30 seconds without holding on | If you cannot, start at Level 1 |
| Semi-tandem stand | Place the heel of one foot beside the big toe of the other for 30 seconds | If you can, you may be ready for Level 2 |
| Single-leg stand | Stand on one leg for up to 10 seconds, hands hovering over the support | If you manage 10 seconds each side, try Level 3 |
| Five sit-to-stands | Stand up from a chair five times without using your arms | Difficulty suggests leg strength also needs work |
If you have had a fall in the last year, feel unsteady or are worried about falling, speak to your GP before starting. You may benefit from a falls assessment.
Setting up safely
- Exercise next to a sturdy support, such as a kitchen worktop or the back of a heavy chair that will not tip, or in a corner of a room.
- Clear the floor of rugs, clutter and pets.
- Wear supportive, well-fitting shoes rather than slippers or socks.
- Have a chair behind you so you can sit if needed.
- Exercise when someone is in the house if you are less steady.
- Stop if you feel dizzy, light-headed, or unwell.
Level 1: Supported exercises
Hold the support with both hands. Aim for 2 to 3 sets of each.
- Sit-to-stand. From a firm chair, lean forwards and stand up, then sit down slowly with control. Use your hands if needed. Repeat 5 to 10 times. This builds leg strength, which supports balance.
- Heel raises. Stand tall and rise up onto your toes, then lower slowly. Repeat 10 times.
- Toe raises. Rock back onto your heels, lifting your toes, then lower. Repeat 10 times.
- Side leg raise. Lift one leg out to the side, keeping your body upright, and lower slowly. Repeat 10 times each leg.
Level 2: Lighter support
Hold the support with one hand, then just fingertips as you improve.
- Sideways walking. Walk sideways along the worktop for 10 steps, then back the other way.
- Heel-to-toe standing. Place one foot directly in front of the other so the heel touches the toes. Hold for 10 to 30 seconds, then swap feet.
- Heel-to-toe walking. Walk along the worktop placing one foot directly in front of the other, for 5 to 10 steps.
- Step-ups. Step up onto the bottom stair, holding the banister, then step down. Repeat 5 to 10 times each leg.
Level 3: Minimal support
Hands hovering just above the support, ready to grab if needed.
- Single-leg stand. Stand on one leg for up to 10 to 30 seconds, then swap. Keep a soft bend in the standing knee.
- Clock reach or weight shifts. Stand on one leg and gently reach the other foot forwards, to the side and behind, touching the floor lightly each time. Or shift your weight slowly forwards, backwards and side to side without lifting your feet.
When Level 3 feels easy, you can try turning your head slowly while balancing, standing on a firm cushion, or closing your eyes briefly, but only with support close by and ideally after discussing it with a physiotherapist.
Adapting for painful joints
| If you have | Try |
|---|---|
| Knee arthritis | Keep a soft bend in your knee rather than locking it; limit step-ups to a low step |
| Hip arthritis | Make side leg raises small; stand on the less painful leg first |
| Foot or ankle arthritis | Start with weight shifts and heel-to-toe standing, wear supportive shoes, and avoid long single-leg holds at first |
| Hand arthritis | Rest your forearms on the worktop rather than gripping |
| Very limited standing | Seated exercises such as leg lifts and seated marching, see our chair exercise guide |
Your 12-week plan
| Weeks | Balance | Strength | Other activity |
|---|---|---|---|
| 1–2 | Level 1, 3 days a week, 10 minutes | Included in Level 1 | Short daily walks |
| 3–4 | Level 1, add sideways walking, 3 days a week | Add more sit-to-stands | Build walking time |
| 5–6 | Level 2 with one hand, 3 days, 15 minutes | Add a strength session (see below) | Walking most days |
| 7–8 | Level 2 with fingertips | 2 strength sessions a week | Try a tai chi or strength and balance class |
| 9–10 | Add single-leg stands with hands hovering | 2 strength sessions | Continue |
| 11–12 | Level 3, 3 days a week, 15 to 20 minutes | 2 strength sessions | Repeat the self-check and compare |
Strength and balance work together. Include strength exercises such as sit-to-stands, step-ups, heel raises and bridges on at least 2 days a week.
Common mistakes
- Holding on too tightly for too long. Support is important, but gradually reducing it is what trains your balance. Move from two hands to one, then fingertips, then hovering.
- Making it too hard too soon. Eyes-closed or cushion exercises are not a starting point. Progress only when the current level feels steady.
- Only doing balance, not strength. Weak legs make balance harder. Do both.
- Stopping when you feel better. Balance gains fade if you stop practising, so keep a maintenance routine.
- Rushing. Slow, controlled movement is safer and trains balance more effectively.
Track your progress
Every 4 weeks, repeat the self-check and note how long you can hold each position and how many sit-to-stands you can do. Also notice everyday changes: feeling steadier getting out of the car, turning in the kitchen, or walking outdoors. Write them down; it is motivating to see how far you have come.
Classes and programmes
Group classes can be safer and more motivating than exercising alone. Look for:
- Strength and balance or falls prevention classes, such as those based on the FaME or Otago programmes, often run by the NHS, councils or charities.
- Tai chi, which involves slow, controlled weight shifting. See our guide to tai chi for balance.
- Gentle yoga or Pilates classes for beginners or older adults.
Ask your GP, a physiotherapist, or your local council about classes near you. Some areas have NHS falls services that offer assessment and exercise programmes.
If you are afraid of falling
Fear of falling is common, especially after a fall or a near miss. It can lead to doing less, which weakens muscles and makes balance worse. Starting with well-supported exercises, practising in a safe space and building up gradually can help rebuild confidence. Talking to your GP or a physiotherapist about your worries also helps. Our guide to regaining confidence after a fall has practical steps.
Know how to get up from the floor
Knowing what to do if you fall can reduce worry. If you are not hurt and feel able to get up, the NHS advises getting up slowly:
- Lie still for a moment, catch your breath and check whether you are hurt.
- Roll onto your side, then onto your hands and knees.
- Crawl to a sturdy piece of furniture, such as a chair or bed.
- Hold onto it with both hands, bring your stronger leg forward with your foot flat on the floor, and push up slowly.
- Turn and sit down, and rest before doing anything else.
If you are hurt or cannot get up, call for help, try to keep warm by covering yourself with anything nearby, and change position gently every half hour or so if you can. A personal alarm or a phone you carry with you can make sure you can always call for help. A physiotherapist can practise getting up from the floor with you.
Everyday balance habits
- Stand on one leg (holding the worktop) while the kettle boils or you brush your teeth.
- Get up slowly after lying or sitting, and pause before walking.
- Walk regularly, including on slightly varied surfaces such as grass or paths when you feel ready.
- Use handrails on stairs.
- Wear well-fitting shoes with a good grip.
- Keep your home well lit, especially at night.
- Have your eyes tested regularly and ask a pharmacist or GP to review medicines that make you drowsy or dizzy.
Our guide to preventing falls covers home safety and health checks in more detail.
When to get medical help
- Call 999 if you have sudden loss of balance with face drooping, arm weakness, slurred speech, severe headache or confusion, as these can be signs of a stroke.
- Call 999 or NHS 111 after a fall if you are hurt, cannot get up, hit your head, or take blood thinners and hit your head.
- See your GP if you have had a fall, feel unsteady, have dizziness or vertigo, or are worried about falling. You may be referred to a falls service or physiotherapist.
- Ask for a medicines review if you think tablets are making you dizzy or drowsy.
- See a physiotherapist if your balance is not improving after 8 to 12 weeks of regular practice.
How often should I do balance exercises?
Aim for at least 2 days a week, alongside strength exercise; 3 days or more is better if you can. Short sessions of 10 to 20 minutes are enough, and small daily habits add up.
Can balance improve with arthritis?
Yes. Balance is a skill that can improve with regular practice at any age. Combining balance and strength exercises is particularly helpful.
Is it safe to do balance exercises at home?
For most people, yes, if you hold a sturdy support, clear the area and wear good shoes. If you have fallen recently or feel very unsteady, ask your GP or a physiotherapist before starting.
How long does it take to improve balance?
Many people notice they feel steadier within a few weeks of regular practice, with more change over 3 months. Keep going, as the benefit is lost if you stop.
Does knee arthritis affect balance?
It can. Pain, weaker thigh muscles and reduced joint position sense can all affect balance. Strengthening and balance exercises can help.
What is the best exercise for balance?
There is no single best exercise. A mix of heel-to-toe standing and walking, sideways walking, single-leg stands, and strength exercises such as sit-to-stands works well. Tai chi is also a good option.
Should I use a walking stick while doing balance exercises?
During balance exercises, a sturdy worktop or heavy chair is usually a better support than a stick. For everyday walking, use a stick or frame if you have been advised to; a physiotherapist can check that it is the right height and that you are using it on the correct side.
Can I do balance exercises after a hip or knee replacement?
Usually yes, and balance work is often part of rehabilitation. Follow your surgical team's or physiotherapist's advice about movement precautions and when to start standing balance exercises.
Sources and further reading
- NHS: Balance exercises
- NHS: Falls – prevention
- NHS: Physical activity guidelines for older adults
- NICE NG249: Falls – assessment and prevention in older people and in people 50 and over at higher risk
- NICE NG226: Osteoarthritis in over 16s
- UK Chief Medical Officers' Physical Activity Guidelines (2019)
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Tai chi for balance — gentle classes
- Preventing falls — home and health checks
- Confidence after a fall — rebuilding trust
- Fall prevention for older adults — guide
- Exercise hub — exercises by joint