November is Fall Prevention Month in Canada (Health Canada, 2026), and it lands right as sidewalks start to ice over. The timing is useful. On October 21, 2026, the World Health Organization updated its falls fact sheet: about 842,000 people died from falls worldwide in 2023, making falls the second leading cause of unintentional injury death after road injuries (WHO, 2026). Here at home, falls cause 89% of injury related hospitalizations among older Canadians, and about a third of those hospital stays involve a broken hip (Public Health Agency of Canada, 2025).
The good news is that falls can be prevented (Public Health Agency of Canada, 2025), and exercise has some of the strongest research behind it. This post covers what the research says about balance exercises and falls, which types of exercise work best, how much seems to be enough, and how to start safely.
Please read first. This post is general information, not medical advice. If you've fallen recently, feel dizzy or lightheaded, or have a condition that affects your balance, talk to your doctor or physiotherapist before starting a new exercise program. If someone has fallen and is badly hurt, call 9-1-1.
What the research says about exercise and falls
The strongest evidence comes from a 2019 Cochrane review that pooled 108 randomized controlled trials with 23,407 older people living in the community in 25 countries (Sherrington et al., 2019).
- Exercise of all types reduced the rate of falls by 23% compared with control groups (59 trials; high certainty evidence).
- It reduced the number of people who fell at least once by 15% (63 trials; high certainty evidence).
- To put that in real numbers: in a group of 1,000 people who would have had about 850 falls over a year, exercise would mean about 195 fewer falls.
- Side effects were mostly minor muscle or joint complaints. Two serious events were reported, in one trial.
The review also found that exercise may reduce fall related fractures and falls that need medical attention, but that evidence was low certainty, so those results are less settled. Results were similar whether or not trials picked people who were already at higher risk of falling.
Which types of exercise prevent falls
Not every kind of exercise worked equally well. The same Cochrane review split the trials by type of exercise (Sherrington et al., 2019).
How much each type of exercise reduced falls
Drop compared with control groups that did an activity not thought to prevent falls. Longer bar = bigger drop. Switch views to see falls overall or the number of people who fell.
Source: Sherrington C, et al. Cochrane Database Syst Rev 2019;1:CD012424, 108 randomized trials, 23,407 older people living in the community. Certainty: H = high, M = moderate, L = low. Strength training on its own, dance and walking programs are shown as uncertain because the review couldn't tell whether they reduce falls. Read the review.
What stood out:
- Balance and functional exercises (think sit to stand, stepping and standing on a narrower base) reduced the rate of falls by 24%, with high certainty evidence from 39 trials.
- Multiple types combined, most often balance and functional work plus strength training, probably reduced the rate of falls by 34% (moderate certainty evidence, 11 trials).
- Tai chi may reduce the rate of falls by 19% (low certainty) and reduced the number of people who fell by 20% (high certainty).
- Strength training on its own, dance and walking programs had uncertain effects on falls. That doesn't mean they're useless. It means the trials so far can't show whether they prevent falls when done without balance work.
The 2022 World Guidelines for Falls Prevention, written by a worldwide group of experts, reached the same conclusion. They give their top grade (1A) to programs with balance challenging and functional exercises, and they recommend adding tai chi or progressive strength training where possible (Montero-Odasso et al., 2022).
Does walking count?
Walking is great for your heart, mood and overall health, and you should keep doing it. But the world guidelines are clear that general physical activity alone, like walking, is unlikely to prevent falls (Montero-Odasso et al., 2022). To lower your risk of falling, your balance needs to be challenged on purpose.
That matches Canada's own movement guidelines, which list physical activities that challenge balance as their own item, alongside at least 150 minutes a week of moderate to vigorous activity and strength work at least twice a week (Ross et al., 2020). If you're wondering how to fit cardio and strength into the same week, see our post on balancing strength training with cardio.
How much balance training is enough?
More than most people think, but it adds up quickly.
A 2017 review of 88 trials with 19,478 people found that programs worked better when they challenged balance and added up to more than 3 hours of exercise a week. Together, those two features were linked to a 39% reduction in falls (Sherrington et al., 2017).
The world guidelines turn that into a practical target: sessions three or more times a week, adjusted to the person, made harder over time, for at least 12 weeks, and continued longer for a bigger effect (Montero-Odasso et al., 2022). They also note that the benefits are lost when you stop, so it needs to become a habit, not a one time program.
How close is your week to the research target?
Count sessions where your balance is challenged on purpose: balance drills, sit to stands and squats, yoga, mobility or tai chi. Regular walking doesn't count here.
Targets: more than 3 hours a week of balance challenging exercise was linked to larger effects, and combined with balance challenge to a 39% drop in falls (Sherrington et al., 2017). Three or more sessions a week, progressed for at least 12 weeks and continued longer (World Guidelines, 2022). This tool is for general information, not medical advice.
What about yoga?
Yoga is a natural fit for balance work, since so many poses ask you to hold a position on a small base of support. A meta analysis of 6 trials with 307 people found that yoga had a small effect on balance and a medium effect on physical mobility in older people (Youkhana et al., 2016). The authors noted that more research is needed to know whether those balance gains translate into fewer falls, so think of yoga as a good addition to balance and strength work rather than a replacement for it.
Balance exercises the research uses
The world guidelines describe the kinds of exercises used in the programs that worked (Montero-Odasso et al., 2022):
- Sit to stand. Stand up from a chair and sit back down with control, without using your hands if you can.
- Squats. A bodyweight squat to a depth that feels comfortable and controlled.
- Reaching while standing. Reach forward or to the side as far as you can while keeping your feet planted.
- Narrowing your stance. Stand with your feet together, then one foot in front of the other, then on one leg.
- Stepping and walking in different directions. Step forward, sideways and backward, and walk at different speeds.
- Dual tasking. Walk or balance while doing something else, like counting backward or carrying something.
The guidelines say exercises should be challenging but safe and achievable, and that they should be reviewed and progressed regularly. When you practise at home, stand next to a kitchen counter or a sturdy chair you can grab. Weights can be added to some exercises once they get easy.
If you're curious how early strength gains start in the nervous system, read how your nervous system makes you stronger.
How to start safely
- Talk to your doctor first if you've had a fall, feel unsteady or take medications that make you dizzy. Ask whether there's anything you should avoid.
- Start with what you can do safely today. If standing on one leg feels shaky, start with feet together next to a counter.
- Aim for three sessions a week. Spread balance work through the week rather than saving it for one long day, and build toward the 3 or more hours a week linked to bigger effects.
- Add strength work. Programs that combined balance work with strength training had the largest estimated effect in the Cochrane review (moderate certainty).
- Make it a little harder as it gets easier. Fewer hand supports, a narrower stance, slower movements or adding a simple thinking task all raise the challenge.
- Look after the basics. The Public Health Agency of Canada lists good sleep, eating well and staying hydrated alongside balance and strength exercises as ways to prevent falls. Our posts on sleep and recovery and nutrition coaching can help there.
- Keep going. The benefits fade when you stop, so pick a routine you'll still be doing in spring.
Where should you start?
Two quick questions to point you to a starting place.
This is a training suggestion, not a fall risk assessment. If you've fallen recently or often feel dizzy, talk to your doctor first. In the Cochrane review, balance and functional exercises had high certainty evidence for fewer falls, and programs that added strength training had the largest estimated effect.
How we can help
The world guidelines point out that most of the programs that worked in trials were led by trained instructors, and they recommend closer supervision or smaller groups for people at higher risk of falling (Montero-Odasso et al., 2022). That's how we run things.
At Inner G, a fitness studio in Concord, our coaches run small group classes in strength, conditioning, mobility, yoga and breathwork, capped at 16 people, so a coach can watch your form and scale each exercise to where your balance is today. If you'd rather start one on one, a coach can set up a plan designed around your strength, your balance and your schedule, and progress it as you improve.
We're coaches, not physiotherapists or doctors. We're happy to work alongside your health care team.
- Try 7 days of unlimited classes for $30, credited toward your membership if you join: book your class.
- See personal training for seniors in Vaughan.
- Prefer one on one at any stage? See personal training in Vaughan.
Questions? Call (289) 536-8066 or email g-squad@innerg.ca.
References
Health Canada. (2026). Calendar of health promotion days: November, Fall Prevention Month. Government of Canada. Canada.ca
Montero-Odasso M, van der Velde N, Martin FC, et al. (2022). World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing, 51(9):afac205. doi:10.1093/ageing/afac205. PubMed · PMC
Public Health Agency of Canada. (2025, November 28). Falls among older adults in Canada: Data blog. Health Infobase. Canada.ca
Ross R, Chaput JP, Giangregorio LM, et al. (2020). Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Applied Physiology, Nutrition, and Metabolism, 45(10 Suppl. 2):S57-S102. doi:10.1139/apnm-2020-0467. PubMed · Guideline summary: CSEP
Sherrington C, Fairhall NJ, Wallbank GK, et al. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 1(1):CD012424. doi:10.1002/14651858.CD012424.pub2. PubMed · PMC
Sherrington C, Michaleff ZA, Fairhall N, et al. (2017). Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. British Journal of Sports Medicine, 51(24):1750-1758. doi:10.1136/bjsports-2016-096547. PubMed
World Health Organization. (2026, October 21). Falls [Fact sheet]. WHO. who.int
Youkhana S, Dean CM, Wolff M, Sherrington C, Tiedemann A. (2016). Yoga-based exercise improves balance and mobility in people aged 60 and over: a systematic review and meta-analysis. Age and Ageing, 45(1):21-29. doi:10.1093/ageing/afv175. PubMed
Want a coach to do this with you? See personal training in Vaughan or small group fitness classes.