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Take a “Stance” on Balance

Stance is the position of the feet and legs in standing. Stance has a primary impact on balance, along with movement and surface. Stances that require a small base of support, e.g., tandem, split, single-leg, etc., are more challenging to balance. Conversely, stances that have wide bases (feet apart) are easier on balance. Below is list of standard stances, in order of increasing levels of difficulty:

Normal: feet about shoulder width apart.

Feet Together: feet are positioned near each other in narrow stance, heels may touch.

Split Stance: feet arranged with one foot forward and one foot back.

  • To make balancing easier, widen the frontal plane distance between feet. Narrow the distance to make it harder.
  • Narrowing the sagittal plane distance will also help make balancing easier. Conversely, widening the distance between the feet will make it harder.

    Tandem Stance: one foot directly in front of the other, like standing on a narrow balance beam.

    • Modify tandem stance to make balancing easier; place feet so inside border of heel touches inside border of toe on opposite foot.

      Single-Leg Stance: standing on one foot.

      • For patients unable to stand on one foot, modify single-leg stance by resting the opposite foot on the ground, stool, or wall.

      Functional carryover of narrow stances includes improved ability to stand in confined areas, such as, spaces between furniture, stored items, walls, etc. Split stance postures are also common when reaching deep into a pantry or fridge. Additionally, steadiness in single-leg stance is helpful when stepping over a tub, up/down a curb, up/down stairs, etc.

      The next time you want to increase the level of difficulty for balance training, try a new stance. Modifying stances is a great way to fine tune intensity, helping to ensure proper training at the 20:20 ratio for steadiness and unsteadiness. Don’t be afraid to take a stance, try a new stance, or change stances on balance – your patients will thank you. Happy balancing!   

      Post is based on information and exercises in the The Haas Balance Book: 100+ Exercises for PT's and OT's - release date is March 15th.