Stroke and balance problems: Causes and exercises to regain balance after stroke

balance exercises post strokeBalance problems are a common experience for people following a stroke. Insufficient co-ordination and stability can make people feel unsteady and lead to falls and lack of confidence. Thankfully, there are exercises that can help stroke sufferers regain balance.

The impact of stroke on balance can be complex, but we know that the brain sends signals to the muscles through the nerves to make them move and that a stroke can damage the brain, thus affecting these signals. Balance problems can involve various parts of the body, such as the eyes, ears, muscles, and joints. It is common for a whole side of the body to be weak following a stroke, yet in some cases, a person may only experience weakness in one arm or one leg. The muscle weakness can be mild or severe. Severe cases may even involve paralysis.


Something called drop foot – which causes your toes to catch on the ground when you take steps, problems with stamina, and stiffness or tightness in the muscles – can also impact movement for those who have had a stroke.

Causes of balance problems after stroke

Balance problems can have a negative impact on quality of life if they last for a long time. Regaining balance after stroke is therefore important, but it is helpful to understand the cause of the balance issues. You are more likely to have balance problems when a stroke has affected the left side of your body. Let’s take a look at some causes of balance problems.

Weakness. Most stroke patients feel some kind of weakness, at least on one side. They may have difficulty sitting up, straightening legs, and standing, or they may be okay with walking, but experience drop foot. There is also a chance that they could feel disoriented in crowds or on uneven surfaces.

Loss of sensation. This can happen on the affected side, especially in the leg. It is like you can’t feel where your leg and foot are. This increases the risk of falling since it is very hard to feel the ground when you try to stand and walk.

Injury to brain. Sometimes, stroke occurs in the areas of the brain that control balance (brain stem). This could give you the sensation that you are moving when, in fact, you are not.

Lack of concentration. Moving around and trying to keep balance after a stroke requires a lot of concentration and, therefore, can be tiresome. This is why many stroke patients will not talk when they are moving – it is just too hard for them to concentrate on two tasks at once.

Other common problems that affect your balance after stroke

Drivers with cataracts, blurred vision pose risk to pedestrians at night despite passing the standard vision test: StudyThere are other problems that can affect balance after a person suffers a stroke. For example, some people experience perceptual problems. Often associated with the right side of the brain, perception issues make it hard for a person to interpret their surroundings. When the world around you doesn’t make sense, it makes it very difficult to move, as you can imagine. Below is a list of other common problems.

Vision problems. Focusing can be quite difficult after stroke. Or, patients can have double vision, eye movement problems, or blind patches. This can easily throw balance off.

Dizziness. A feeling like the world is spinning is common after a stroke. Some stroke victims even experience vertigo.

Ataxia. This is a condition that causes clumsy, uncoordinated movements. It normally occurs with strokes affecting the back of the brain.

Medication side effects. Certain medications for treating stroke can cause side effects, including dizziness or weakness.

Exercises to help regain balance after stroke

Stroke balance exercises can be very helpful as a person is going through the recovery process. Physical therapists do caution that balance exercises for stroke patients should begin at a basic level and work towards a more advanced routine. Basic level exercises might seem simple at first. However, to work properly, they do require strong brain connections.

Here are some basic level exercises stroke patients can consider:

  • Heel raises – These require holding onto a sturdy chair or countertop, and rising yourself up on your tiptoes, while keeping knees and upper body straight.
  • Side stepping – Hold onto a counter or ledge, place tape on the floor, and step sideway to cross the line, placing one leg across the front of the other. Reverse the motion, returning to the starting point, but this time crossing the leg behind.

Once a person feels comfortable and steady with the basic balance exercises, they can safely move on to intermediate, such as the exercises outlined below.

  • Heel raises – Similar to the basic level, only you don’t hold onto anything (no counter or chair for support).
  • Side stepping – Perform the side step, crossing your legs across each other as you move across the straight line, but don’t hold onto a counter or ledge.
  • Heel to toe walking – Set up a straight tape line for side stepping and walk forward placing the heel of your foot directly in front of the toe of the other foot as you walk. Go to the end of the tape, turn around, and repeat the process.
  • Gym ball squats – Put an exercise ball between your back and a wall, as you stand tall, slowly lower into a squatting position, then roll back up to the standing position. Repeat this several times.


When stroke sufferers are really dedicated to balance exercises, they are often surprised at how quickly they can progress to the next level. It is different for everyone, so if you have suffered a stroke and are participating in exercises, there is no need to rush it. If and when you are ready, you can move on to high-level balance exercises for stroke, such as those suggested here.

  • Single leg standing – This involves placing both feet flat on the floor and slowly lifting one leg so that you are balancing on the other leg. You hold it for at least 10 seconds and then alternate legs.
  • Backwards walking – Find a room that is free from obstacles and walk backwards slowly. It is best to try this with someone close by the first time just as a precaution.
  • Weighted ball pass – Take a weighted exercise ball and slowly pass the ball from hand to hand as you circle it around your body, while you are standing. Do it clockwise and then counterclockwise.

Aside from these specific balance routines, physical therapy exercises for stroke patients are also commonly used to help people regain strength and stability. In some situations, standing up right after a stroke is very difficult, so sitting balance exercises for stroke patients can be the first step towards recovery. These exercises can include sitting on a sturdy bench and shifting your weight from side to side, so that your hip lifts off the surface, shifting back and forth as you arch and round your lower back, as well as leaning down on your elbows side to side or reaching out as if you want to touch something with your weak side.

Without good balance, it is not only difficult to stand and walk, it can make it hard to get dressed, take a bath, or use the toilet. Investing time and whatever energy you can to complete balancing exercises following a stroke is well worth it. Studies show that rehabilitation that includes balancing exercises provides stroke sufferers with the best possible outcome in the end.


Related Reading:

Warning signs to spot a stroke FAST

Stroke rehabilitation: Arm and hand exercises for post-stroke recovery