The exercises on this page were specifically chosen for individuals who experience chronic pain (Lorig et al., 2020).

Balance

There are many exercises that can address balance; however, there are 7 exercises that are supported the most by research.  These 7 exercises are presented below. According to Clemson et al. (2004), the Stepping On program consistently leads to fewer falls, fewer injuries, fewer emergency room visits, fewer hospitalizations, and fewer deaths in adults. In order for increased adherence, it is important to tie these exercises into daily life and meaningful activities.

Seven Foundation Exercises for Stepping On: At Home (SHARE SMR INC, 2020):

1. Knee Extensions
2. Side Leg Lifts
3. Calf Raises
4. Tandem Standing
5. Sit to Stand
6. Tandem Walking
7. Side Stepping

Knee Extensions

Pictured: Knee extensions while typing on the computer for work and writing.

Description: While seated, start with your feet resting comfortably on the floor and your knees bent at a 90 degree angle. Extend one knee in front of you. Bring it back down to the floor in a slow and controlled manner. Repeat. Complete on the other side.

Make it Easier: Decrease how much you extend your knee in front of you. Try extending your knee half way.

Make it Harder: Increase how much you extend your knee in front of you. Hold it in extension for a few seconds.

Side Leg Lifts

Pictured: Side leg lifts while leisurely drawing on a white board.

Description: Start in a neutral, standing position. Lift one leg out to the side as if making a snow angel with that leg. Bring it back down to the starting position in a slow and controlled manner. Repeat. Complete on other side.

Make it Easier: Decrease the distance you bring your leg out to the side. Start with half way to see how it feels.

Make it Harder: Increase the distance you bring your leg out to the side. Hold it out to the side for a few seconds.

Calf Raises

Pictured: Calf raises while brushing his teeth.

Description: Start in a neutral, standing position. Lift up onto your tiptoes. Return to your flat footed position slowly. Repeat.

Make it Easier: Hold on to a table, chair, or other stable surface for increased support and stability during the exercise.

Make it Harder: Increase the repetitions completed. Hold for a few seconds at the top before coming back down.

Tandem Standing

Pictured: Tandem standing while washing the dishes.

Description: Start in a neutral, standing position. Put one foot in front of the other, lining up the heal of the front foot and the toe of the back foot. Ensure they are directly beneath you to promote good balance and distribution of weight. After holding this position, switch so the other foot is in front.

Make it Easier: Lean against the countertop, couch, or other stable surface with your hips. Hold on to the countertop.

Make it Harder: Ensure no body part is touching the counter, couch, chair, or other surface. Hold the position for longer.

Sit to Stands

Pictured: Sit to stands while getting out of bed for the day and on commercial breaks.

Description: From a seated position, stand up off the bed, couch, or chair. Have your feet securely flat on the floor before attempting to stand up. Ensure the movement is slow and controlled. From a standing position, get close to the surface you are going to sit on so the back of your knees are touching it. Use your arms to reach back and make sure the surface is there. Sit down slowly.

Make it Easier: Use your arms to help you stand up. Complete fewer repetitions. Use adaptive equipment if needed. 

Make it Harder: Sit and stand safely without using your arms to promote the use of your core and legs. Increase repetitions.

Tandem Walking

Pictured: Tandem walking while carrying the clean laundry to the linen closet.

Description: Start in a neutral standing position. Put one foot out in front of you. Put the other foot right up behind that foot so your heal and toes are touching. Bring that back foot up in front of the front foot so that heal is now touching those toes. Repeat while walking short distances.

Make it Easier: Leave a few inches between your heal and toes. Decrease the distance you walk like this.

Make it Harder: Increase the distance you walk like this. Carry heavier items.

Side Stepping

Pictured: Side stepping while getting various resources and supplies off the top shelf at work.

Description: Start in a neutral, standing position. Step straight to the side with one leg. Bring your other leg over in the same direction to return to your neutral, standing position off to the side. Return to the center. Repeat as needed. Complete in other direction.

Make it Easier: Complete fewer repetitions. Hold on to a table, railing, or chair for stability.

Make it Harder: Complete for longer distances. Increase the distance you step with your first leg in each direction.

Leg

Hamstring Stretch

Pictured: Stretching his hamstring muscles while listening to music and preparing for his workout. Stretching her hamstring muscles while picking up her kids' toys.

Description: Start in a neutral, standing position. Plant one of your heals down on the floor and keep it there when reaching down. Reach down towards your toes or the floor and hold this position for a few seconds. Return to your neutral standing position. Repeat. Complete on other side.

Make it Easier: Decrease how far down you are reaching. Start by reaching to your shin or knee if your ankle and toes are too far.

Make it Harder: Increase how far down you are reaching. Attempt to touch your toes and the floor each time.

Calf Stretch

Pictured: Stretching her calves while making her daily to-do list.

Description: Start in a neutral standing position. Bring one leg behind you and plant that foot flat on the ground. Lean forward with your hips and shoulders until you feel a stretch in your calf. Hold for a few seconds and relax. Repeat. Complete on other side.

Make it Easier: Decrease the distance you place your back foot behind you. Hold onto a table or chair for support.

Make it Harder: Increase the distance you place your back foot behind you. Reach in front of you and out to the sides.

Foot

Towel Scrunches

Pictured: Towel scrunches while playing a favorite board game.

Description: Start in a seated position with your feet flat on the floor on top of a towel with your knees bent at a 90 degree angle. Use your toes to scrunch the towel bringing it in slightly closer to you. Keep scrunching your toes until the towel has been moved as far as it can towards you. Repeat.

Make it Easier: Complete while barefoot. Use a thicker towel that is easier to scrunch.

Make it Harder: Complete with socks on. Use a thinner towel that is more difficult to scrunch.

Using a Foam Roller

Pictured: Using a foam roller on his feet while completing the daily crossword puzzle.

Description: Start in a neutral, standing position or a comfortable, seated position. Place one foot on top of a foam roller. Move your foot forward and backward on top of foam roller with moderate pressure. Ensure that you go from your heal to your toes and back to get the full foot incorporated. Roll your foot forward and backward for a few minutes and repeat on the other foot.

Make it Easier: Hold onto a table or chair for stability if standing. Decrease the distance the foam roller is in front of you.

Make it Harder: Try different sized foam rollers. Increase the distance the foam roller is in front of you.

References