01-05-2025
- Health
- National Geographic
Can you stand on one leg for 10 seconds? The answer matters for aging.
Regular movement and balance training—like the kind seen here—play a crucial role in staying steady and independent with age. Experts say stability-focused exercises can help protect both physical and cognitive health over time. Photograph by Noriko Hayashi, Nat Geo Image Collection
If you can't comfortably stand on one leg for 10 seconds, your body may be trying to tell you something. 'Being able to stand on one leg is one of the most predictive measurements for aging,' says Clayton Skaggs, founder of the Central Institute for Human Performance (CIHP), the Karel Lewit Clinic, and Curious Gap Labs.
A 2024 Mayo Clinic study found that the ability to maintain balance standing on one leg indicates how well a person is aging more than strength or gait. Not only does it let us in on someone's neuromuscular health, but it can also be a signal of other ailments.
'We utilize [balance] diagnostically to rule in or rule out other diseases,' says Paraminder Padgett, a neurological clinical specialist and physical therapy clinical supervisor at Dartmouth Hitchcock Medical Center. 'We know inactivity can lead to poor balance, but problems in the brain can also lead to poor balance. One of our jobs is to help tease that out.'
That's because a wide range of chronic conditions—diabetes, arthritis, multiple sclerosis, Parkinson's, Alzheimer's—can quietly erode your balance over time. Some affect nerves and proprioception, while others disrupt cognitive function and decision-making, all of which affect stability.
So while standing on one leg with your eyes closed might seem like a silly test, it's actually a surprisingly comprehensive check-in. Balance is a complex, full-body symphony involving your eyes, ears, joints, muscles, and brain. Yet after age 40, these systems slowly decline due to the sedentary lifestyle many Americans ease into.
The result? A gradual loss of stability that can have serious consequences down the line: falls, fractures, and a shrinking world as people avoid movement they no longer trust. In 2021 alone, accidental falls caused 38,000 deaths among Americans over age 65. But here's the hopeful part: it doesn't have to be that way. What balance depends on—and what starts to fade
Good balance depends on the integration of our vision, somatosensory system (responsible for the sensory information of touch from our muscles, joints, skin, and fascia), and vestibular system within our ears. When any of these systems start to slip, your sense of equilibrium can go with it.
'Just like we have wrinkles on the outside of your body, you have wrinkles on the inside,' Padgett says. 'If you use it right, the systems in the brain will continue to adapt to that degradation.'
In other words, use it or lose it. However, Skaggs says we don't necessarily need to expect these systems to dwindle as we reach the magic age of 40. 'These concepts of variation are misinterpreted relative to folks just not taking care of their health,' he says. While some physical decline is natural—like changes in muscle mass, joint mobility, or sensory precision—what we think of as 'normal aging' is often a reflection of long-term neglect.
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'When someone is trying to get out of a chair and starts to notice that they can't do that without using their hands, then that internal model will cause them to keep using their hands,' Skaggs says. 'It will become their new way of getting out of the chair, leading to more weakness and less ability to use their legs to get out of their chair.' These accommodations and precautions within these movements expedite their loss. How to protect—and even restore—your balance
The good news is that balance isn't a fixed trait. It can be trained, rebuilt, and maintained at any age—if you keep your body moving and your brain engaged.
'We are designed for our trunk balancing efforts. Your core should be dominating as a point of stability, for standing on one leg, for getting up and off the toilet or reaching down to get something in your kitchen,' Skaggs says. 'When it's not, your upper back, your hamstrings, your pectoral muscles start jumping in to help you do these simple things.' That starts becoming the pattern, and your proximal stability systems wane.
For many, your 50s is when movement starts to decline. 'I hear a lot of 'Well, I worked all my life. I retired. It's okay to sit in my recliner and watch TV all that.' Or, 'I do crossword puzzles. I'm keeping my mind active,'' Padgett says. It's not enough. Movement is essential.
(Do crossword puzzles really keep your brain sharp?)
She works on what they call 'dual tasking'—patients doing a physical activity and cognitive challenge simultaneously – to nurture their balance. For example, she says walking and naming fruits, starting with the letter A, and getting through the alphabet.
Variety in movements is also necessary as we age, especially for the vestibular system. 'The ear canals are oriented in a way to help your brain know where your head is in space, to know what upright is and if you are upright,' Padgett explains. She points to yoga and offers downward dog and other poses where your head is down. 'Your brain has to deal with and assimilate that information to know which way is upright.'
Activities that involve unpredictability or play—like juggling, hiking, or tossing a frisbee—are particularly useful. 'You're introducing complexity, and the more complex you get, the more you need to react,' Padgett says. 'You're working on your reactive balance.'
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Even going barefoot can help. 'The sensory information that comes through when you're barefoot is a lot more pronounced and beneficial. Your foot mobility is going to be more engaged when you're barefoot.' Small changes can wake up underused systems, whether you're standing on a foam pad, walking on an unpaved path, or simply closing your eyes during a balance drill.
Most importantly, find movement you enjoy. 'I certainly do not enjoy all the exercise that I do, but I always feel good when I'm done. I know that it's good for me and allows me to do the things that I want to do, mostly pain free,' she says.
Research supports what these experts see daily: systemic balance training improves physical function and may also boost memory and spatial awareness. 'The most important thing to do is to move and to move as much as possible,' Padgett says. 'So, you have to find something that's enjoyable for you.'
