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The Berman Method
The Berman Method
Episode #216: Balance Is Everything - Why Standing on One Leg Changes Aging
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In this episode of The Berman Method Podcast, Dr. Jake Berman and PA Jenni Berman break down one of the most overlooked—but most powerful—keys to longevity: balance. From standing on one leg to preventing falls, they explain why balance naturally declines as we age, why most people don’t realize it’s happening, and how it quietly limits movement long before a serious injury occurs.
They dive into the three systems that control balance—vision, the inner ear, and proprioception—and reveal why balance is one of the fastest physical abilities to improve at any age. You’ll learn why “bad balance” isn’t permanent, how poor balance increases fall risk, and a simple daily habit you can start today to retrain your body and protect your independence.
If your goal is to age stronger, move with confidence, and arrive at 80 feeling 60, this episode delivers an easy, practical takeaway you can build into your everyday routine—starting with brushing your teeth.
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Why Questioning Providers Matters
SPEAKER_01And we are rolling, baby, with the Berman Method Podcast. Dr. Jake Berman here, my beautiful co-host.
SPEAKER_00Oh, so kind. Jenny Berman, physician assistant.
SPEAKER_01This is the Berman Method Podcast. We're David going against Goliath. Goliath being the corporate medical system, big pharmaceutical companies, the health insurance companies choosing profits over patient outcomes every single time. They are businesses, and they do not have your best interests in mind. And we are just trying to shed some light on how do you take your own health, take control of your own health, and educate yourself and know more. The more you know, the better informed decisions you can make.
SPEAKER_00Right. Just simply being a self-advocate for yourself and asking the right questions and challenging your providers or not maybe not challenging them, but asking questions to get more information about why they're choosing the decisions that they're choosing, which is going to help you understand if it's the best decision for you or not.
SPEAKER_01Yeah, I don't I don't even hate that term challenging your provider because you should be able to respond to a question. And I love it when people question me. And it forces me to articulate my response in an eloquent way or informed way, education, educated way. And if I can't do that, then I don't know what I'm talking about.
SPEAKER_00Right. If you can't answer the question, or if you're if your answer is I don't know, that's okay as long as you have the ability to research it and and answer the questions. And I'm saying this in a sense that if the patient asks you a question, not regarding the treatment that you're giving them, but just asking other options and you don't know the answer, then you go research it and find out the answer and what's right for them. And that that is a good provider, someone that will actually tell you, I don't know, let me research that and look it up and see if that's the right fit for you. But in terms of when they're treating you and telling you what to do or what to take or why you should be doing something, ask them why. Ask them to explain their thought process behind it or the physiology behind it, or just more information about why they want you to do that.
Defining Balance And Real-Life Stakes
SPEAKER_01Love it. Absolutely love it. So continuing along with our Berman Health Club motto of trying to help seniors transform into ultimate boomers so you can arrive at 80 feeling 60. One of the number one things on the physical side that has to be acknowledged, has to, you got to give attention to this, is balance. We talked a little bit about this on the previous episode, where you have to be able to stand on one leg for at least 10 seconds. Ideally, you should be able to do it for 60 seconds. And if you can stand on one leg, both sides, each side, individually for 60 seconds, you don't have a balance deficit.
SPEAKER_00Right. And being able to balance on one leg and not the other is not good enough.
SPEAKER_01Correct.
SPEAKER_00Which happens so commonly with people where they have a good leg and then they have a not so good leg.
SPEAKER_01Yes. Now here's the cop out. This is the most common cop out is I don't have good balance. It's the most common thing that I hear is I don't have good balance.
SPEAKER_00That's a reason for not being able to do a lot of things, is what you're saying.
SPEAKER_01Yeah, or just question or challenging somebody on their balance. Let me see you stand on one leg and they can't do it for even two seconds, and they immediately say, I don't have good balance. And I said, Okay, well, why don't we make it good?
SPEAKER_00Right.
SPEAKER_01And it's one of the biggest misconceptions in America, at least, I don't know anywhere else, but at least in America, it's one of the biggest misconceptions that if you had bad balance, you're stuck with it.
SPEAKER_00Right, that it can't be fixed.
SPEAKER_01Yeah, and that's not true at all. Balance is out of everything that I've ever worked on in my physical therapy clinic, out of everything back pain, knee pain, neck pain, shoulder pain, rotator cuff, uh, plantar fasciitis, everything that I've worked in in my entire career, balance is the one that responds the fastest.
SPEAKER_00Right. Can improve quickly with a little practice.
SPEAKER_01Yeah. But before we get into how you can how you can do it and how you can go from having horrible balance, can't stand on one leg for even two seconds, to now you can stand on one leg for 60 seconds both sides. Let's talk about the reason why it's important. Obviously, the or I guess the most obvious reason why good balance is important or improving your balance is important is so you don't fall.
The Balance Spectrum And Hidden Decline
SPEAKER_00Right. Because when we're walking, we have to balance, right? You're on the definition of walking is that you're well, I guess running. Running is that you always only have one foot on the ground. But even with walking, you have to be able to balance to move one foot in front of the other.
SPEAKER_01Yes, technically you're correct. We can we might go down a rabbit hole if we go too far down that one, but you're absolutely correct. In order to walk efficiently, you have to have good balance. Right. Because you're standing on one leg while you're swinging the other leg through, and then you're standing on that leg while you swing the opposite leg through. And if you don't have good balance, I define your walking as controlled falling.
SPEAKER_00Right, right.
SPEAKER_01You're leaning forward and you start to fall, and then before you fall, you move your next foot forward, and then you move your next foot forward, and it's controlled falling, is all it is.
SPEAKER_00Is a series of controlled falling, as opposed to stepping and balancing. So one of the most common issues with poor balance is falls.
SPEAKER_01It is. So that's the extreme, right? So if you don't have good balance, most people associate not having good balance with falling, especially in your 70s, 80s, and even 90s. If you don't have good balance, you're at high risk for falls. If you fall, you break a hip. If you break a hip, there's a chance that you don't come home from the hospital.
SPEAKER_00Right. Longevity decreases exponentially.
SPEAKER_01But there's this whole other spectrum that happens before you get to that extreme. If you have zero out of ten balance, then you are at high risk for falling and fracturing a hip and going to the hospital and never coming home.
SPEAKER_00So sad.
SPEAKER_01Why? Because it's real.
SPEAKER_00It's real. Yeah, it is real. Okay, so that's a zero out of ten of balance, meaning like you have zero balance.
SPEAKER_01Yep. But if you got a 10 out of 10 balance, you're Simone Biles, and you can do whatever you want because you're a three-time Olympic or back to back to back Olympic champion, and you've got the best balance in the world. So that's 10 out of 10. Okay. But there's this whole spectrum of balance that starts to degrade. You start to lose balance. It goes from 10 to 9 to 8 to 7 to 6 to 5 to 4 to 3 to 2 to 1 to 0. The vast majority of people live between 3 and 6.
SPEAKER_00Right. Yeah, I was gonna say 4 and 5. So I like three to six.
SPEAKER_01Between three and six, there's a lot of people, especially 50 to 60 to 70-year-olds, that live between three and six.
SPEAKER_00Right. And they don't even know that their balance is not good.
SPEAKER_01You have no idea. Take a 75-year-old Sally. If you didn't test her, she would probably define her balance around a six.
SPEAKER_00Right.
SPEAKER_01But then I say, go ahead and stand on one leg, and she can't do it for five seconds. So it's like, oh, actually it's a three. It's not a zero, but it's not an eight or a nine, where it should be or could be.
SPEAKER_00Okay.
SPEAKER_01But then you take somebody that's 40 years old, right? When's the last time you intentionally stood on one? I shouldn't ask you. Because we do it regularly.
SPEAKER_00We do it regularly in our workouts with our kids. Yes, that's us though.
SPEAKER_01But look at the average 40-year-old. When is the last time the average 40-year-old stood on one leg and started looking around?
Linear Movement And The Boiling Frog
SPEAKER_00Brushing their teeth. That's the most common that we we will recommend. Brush your teeth.
SPEAKER_01That's a that's a solution. We're not getting a solution yet. Okay, okay. Simmer down, simmer down.
SPEAKER_00As far as a 40-year-old, standing on one leg, probably not often.
SPEAKER_01Yeah, you just don't do it. You don't do these things because it's not a normal part of living anymore. Like when you're a kid, it's a normal part of living. You're playing.
SPEAKER_00That's true. The girls are spinning constantly on one leg, aren't they?
SPEAKER_01The girls are constantly twirling their dresses. Especially Vera, two years old. Daddy, daddy, watch this. Twirls her dress on one leg, and I'm going, oh yeah, that was awesome. Good job, Vera. Yay!
SPEAKER_00Yep. As she almost like ping-pongs into the wall. But yes, here nor there. They're always on one leg, but they're kids.
SPEAKER_01Yeah. Now, the issue that arises is as you start to lose balance. So let's say as a kid, you have a 10 out of 10 balance. As a teenager, you go to an 8 out of 10 balance. When you're in your 20s, it's down to a 7 out of 10 balance. And by the time you're in your 30s and 40s, you're down to probably a 6 out of 10 balance. There's no way you're going to walk down a balance beam anymore. I mean, think about that. Stella makes me do that on a regular basis when I'm walking her to school. Is we get right to the school and there's a sidewalk there. Right. And the curb is painted yellow. And she goes, Daddy, daddy, walk down the the uh the balance beam.
SPEAKER_00Yeah.
SPEAKER_01Yeah, the balance beam. And I'm like, I'm doing it every single day that I walk her. I'm going, yeah, I can still do this. I feel good about this.
SPEAKER_00Right.
SPEAKER_01I'll I would consider myself an eight out of ten.
SPEAKER_00Okay.
SPEAKER_01Yeah.
SPEAKER_00Wow. We'll get you up on a high beam then.
SPEAKER_01I would do it. Not doing flips off of it. I mean, that might take me a week or two to practice.
SPEAKER_00Yeah. It's just your center of gravity, that's all.
SPEAKER_01Yeah. But to get back to the point here, as your balance starts to degrade, and when you're in your 40s and 50s, it's officially down to a six or a seven at best. Your brain knows this. Your brain knows that your balance is not as good as it used to be. And it's your brain subconsciously is so much faster than you are consciously. Meaning that it will not allow you to do certain things subconsciously, and you don't even think about it consciously.
SPEAKER_00Right.
SPEAKER_01So what happens is your movement, your overall movement becomes more linear.
SPEAKER_00Yes. Understood. Front to back.
SPEAKER_01Front to back, meaning that I'm gonna go from bouncing off the walls as a kid, as Stella, to now I'm gonna just move forward.
SPEAKER_00Forward.
Why Balance Fades: Use It Or Lose It
SPEAKER_01Minimal side to side, definitely not spinning around, pretty much just going forward. And this is a perfect analogy of you put if you boil a pot of water and you throw a live frog in that boiling pot of water, he'll jump out.
SPEAKER_00Yes.
SPEAKER_01Just jump out. But if you put a s that same frog in a pot of lukewarm water, not even lukewarm water, if you put the same frog in room temperature water and you gradually increase the temperature of the water, it'll just stay there. It will stay there until it's ultimately boiled to death because it didn't realize that it was happening because it was drug out over such a long period of time. That's the same thing that happens to us on a physical level.
SPEAKER_00Got it. We don't recognize the changes occurring as they're occurring slowly.
SPEAKER_01Yep. Then the next thing you know, you're 63 years old, and you trip over a curb, you fall, and you fracture your humoral head, and you're like, oh my gosh, I have bad balance. No, your balance has been going downward for 30 years now.
SPEAKER_00Right. And we haven't been doing the right things.
SPEAKER_01You haven't been doing the right things. So that's all the doom and gloom, right?
SPEAKER_00Can I ask you a question?
SPEAKER_01Yes, you're allowed to ask me a question.
SPEAKER_00Another question, since I just asked you a question. Uh with the balance, what causes our balance to start to decline?
SPEAKER_01You don't use it, you lose it.
SPEAKER_00Okay. But is it a strength? Because you said it's easy to fix. So is it a weakness that's causing the balance to decrease?
The Three Systems Of Balance
SPEAKER_01These are good questions. That's exactly where we're going to next. So we talked about how bad balance presents and how it occurs over a 20, 30, 40 year period. Now let's talk about the reasons why it's so simple to improve. The reasons why it's so simple to improve is because balance is made up, your ability to balance is made up of three major systems.
SPEAKER_00The ear.
SPEAKER_01The ear is one of them. So your inner ear, that's the crystals that you hear people talk about, and when the crystals get out of whack, people get vertigo. So yes, your inner ear is one of the three major components to your balance.
SPEAKER_00Your butt.
SPEAKER_01No.
SPEAKER_00Your belly button. In gymnastics, we are always told our belly button controls our balance.
SPEAKER_01Okay, yes.
SPEAKER_00It's our center of gravity.
SPEAKER_01Okay, sure. Yes. For the purposes of this podcast, your inner ear is number one. Number two is vision.
SPEAKER_00Okay. Makes sense, yes.
SPEAKER_01Being able to see where you're going gives you balance. And then number three, the biggest one that nobody ever thinks about, proprioception.
SPEAKER_00Okay.
SPEAKER_01Proprioception is essentially you have little tiny receptors in every single joint in your whole entire body. And these receptors are constantly sending a signal back to your brain, telling your brain where that joint is in space. So if your eyes are closed and your elbow is bent, your brain knows that your elbow is bent. If you straighten your elbow, your brain knows your elbow is straight. There's those receptors in every single joint, your whole entire body sending real-time instantaneous feedback to your brain, telling your brain where that joint is in space, so that your brain can then instantaneously send a signal back to the muscles that control that joint to move it if it needs to move it.
SPEAKER_00Right. Got it. So like where your ankle is in space?
SPEAKER_01So if you close your eyes, the first thing that starts to move around are the joints in your ankles. The joints in your feet, the joints in your ankles.
SPEAKER_00When you're standing, yes. Okay.
SPEAKER_01And there's over a hundred muscles, tendons, and ligaments in your foot and ankle.
SPEAKER_00Mm-hmm.
SPEAKER_01And the first thing that happens is your brain starts to send a signal down to that complex saying, contract this muscle, contract this muscle, now contract this muscle. And that gives you balance. I'm doing air quotes right now, balance starting at your foot and ankle.
SPEAKER_00Got it.
Night Falls And Vision Dependence
SPEAKER_01This is your proprioception. Now, I mentioned earlier that we tend to go linear. We tend to move linear as we get older. Instead of bouncing on the walls like Stella and Vera are right now, and Walker's about to be doing, we start to get linear. We just go from point A to point B. I'm going to walk forward. We're not going side to side and we're definitely not spinning anymore. So that means that we don't necessarily need our inner ear or our proprioception to give us balance anymore because we're not using it anymore. So we lose it.
SPEAKER_00Got it.
SPEAKER_01We really only need our vision to give us balance if all I'm doing is walking from point A to point B.
SPEAKER_00Moving forward. Okay, got it.
SPEAKER_01So when I'm walking in a linear motion, when I'm moving in a linear motion, a very controlled speed, I don't need proprioception and I don't need my inner ear. I just need my eyes to balance.
SPEAKER_00Which is why a lot of falls happen at night getting up to go to the bathroom because we don't have the vision.
SPEAKER_01Exactly. That's the number one reason why people fall when the lights are off, is because you can no longer rely on vision, and because you've not been training your inner ear or your proprioception, you don't have anything to help you with balance.
SPEAKER_00Understood. That makes sense.
SPEAKER_01Yeah.
SPEAKER_00Got it. So it has nothing to do with your butt muscles.
SPEAKER_01Well, it kind of does in a roundabout way. Okay. Yeah, because butt muscles are the most powerful muscles. But really, balance starts at the foot and ankle, and then it moves up to the knee, and then the hips, and then torso movements. So balance starts from the bottom up. So you could be losing your balance, and by the time you get to your butt muscles, it's too late.
SPEAKER_00Got it. Yes. Okay. So we need to. Oh wait. I'm jumping ahead again.
SPEAKER_01You can jump if you want.
Bottom-Up Control From Feet And Ankles
SPEAKER_00No, is that the end of the why we lose? So now we're ready to know how to fix the loss of balance. Yes.
SPEAKER_01Yes. So now we know why we lose balance because or the now we know why our balance degrades because we're not using it. You don't use it, you lose it. Balance is composed of three major systems in the human body. And we go from bouncing off the walls as a kid, using all three of them regularly on a daily basis, to as a 20, 30, 40-year-old, all we're doing is walking straight forward. So we're not using two out of the three.
SPEAKER_00Right.
SPEAKER_01So we we lose them.
SPEAKER_00Just lose them, yeah. And then our vision goes. Because we're old or it's dark, or not I shouldn't say because we're old. We just we always say that things don't happen because you're aging. But vision starts to decline or it's dark, and then doomsday.
SPEAKER_01Okay. So I thought I was the grim one. Jeez Louise. So the best part about all of this is proprioception is the quickest thing to respond out of anything in the whole entire body. That's what I said 10 minutes ago. Trainable. It's so trainable because it happens instantaneously. All you have to do is the right thing.
SPEAKER_00Right. Well, yeah. What is the right thing?
SPEAKER_01The simplest thing that you can do, you already mentioned it earlier, is most people listening to this podcast brush their teeth.
SPEAKER_00I hope so. Twice a day.
SPEAKER_01Quit quit stealing my thunder.
SPEAKER_00Oh.
SPEAKER_01Most people listening to this podcast brush their teeth.
SPEAKER_00Yes.
SPEAKER_01Most people who brush their teeth brush their teeth at least twice a day.
SPEAKER_00Yes.
The Toothbrushing Balance Protocol
SPEAKER_01And usually most people who brush their teeth twice a day are brushing their teeth twice a day for two minutes each time.
SPEAKER_00Yes.
SPEAKER_01Thank you for not stealing my thunder that time.
SPEAKER_00You're welcome.
SPEAKER_01The simplest thing that you can do, if you can stand on one leg for zero seconds right now, the quickest way to be able to stand on one leg for at least 10 seconds, 30 days from now, is every single time you're brushing your teeth, stand on one leg for 60 seconds using the alternate hand that you're not brushing your teeth with, just using the fingertips in that alternate hand to touch the countertop.
SPEAKER_00To help you balance.
SPEAKER_01To help you balance. This is the key. You don't improve your balance by trying to stand on one leg with zero assistance, flaring flailing around, losing your balance, and having to put the other leg back down. That's not how you improve your balance.
SPEAKER_00Got it. Yes. So stand on one leg, put one leg in the air, like at your ankle.
SPEAKER_01Yeah, just pick it up off the floor.
SPEAKER_00Brush your teeth with your dominant hand, your right hand. Then use your left hand fingertips on the countertop just to help you balance.
SPEAKER_01Yes. The reason why you want your fingertips there is because you don't want to be flailing around.
SPEAKER_00Right.
SPEAKER_01Then you gradually decrease the pressure through your fingertips. Not picking your fingertips up off the counter yet. Just decrease the pressure through your fingertips so that you feel your foot and your ankle working around. You should be doing this barefoot, by the way.
SPEAKER_00Yeah, no hokas.
SPEAKER_01Oh my gosh. Don't even get me started on Hokas. I'm gonna record a whole nother podcast on Hokas. What a Joker Hokas are. Hokah the Joker.
SPEAKER_00We have a friend that will always do the shoe test in front of Jake. He'll take his shoes off and do the shoe test and mimic Jake's old, old YouTube video talking about shoes and shoe shopping. It's hilarious. Oh my gosh. Okay, anyways, barefoot.
Training Goals From 10 To 60 Seconds
SPEAKER_01Hoka is an on-class. Are the worst. The worst. Let me repeat it again. The worst. So, yes, you're doing this barefoot. Stand on one leg, left hand, fingertips touching the counter for 60 seconds, and then switch legs for another 60 seconds. And you're doing that twice a day, every single day for a month, and you're gradually decreasing the pressure through your fingertips. A month later, you're gonna be able to stand on one. You should be able to stand on one leg for a minimum of 10 seconds. I've had people go from zero seconds being able to stand on one leg for zero seconds to being able to stand on one leg for 30 seconds in a month. It's the quickest thing that you can improve upon. Right. One year from now, there's no reason at all why everybody listening, assuming there's no physical ailments or whatever, if you just got normal anatomy going on here and you just got bad balance now, there's no reason at all why you should not be able to stand on one leg for 60 seconds a year from now. Right. Zero reason.
SPEAKER_00Just practice every day, twice a day. Two minutes, one minute on each leg.
SPEAKER_01I don't even like practice. Let's change that word. Just train it.
SPEAKER_00Train, not practice.
SPEAKER_01Yeah, because this is a train. You got to train your proprioceptive system to wake up. Because we're not building muscle strength and endurance or anything, we're just waking up the muscles that you currently have and getting them to use like utilize themselves.
SPEAKER_00Yes. Awesome. So we need balance for longevity. If you can't balance on one leg for at least 10 seconds on each leg, both legs individually, not just one of them. If you can't balance on each of your legs individually for 10 seconds without holding on, you are not the ultimate boomer. So you better start working.
SPEAKER_01You're not the ultimate boomer, but more importantly, I mean, look at what they did in the blue zones projects, right? So if you're not familiar with the blue blue zones projects, what they did was they looked at various places around the world where people were regularly living over 100 years old. And they were looking at what are the things they have in common. And one of the things that they found in common in these quote unquote blue zones was they had a sense of purpose. The the uh seniors had a sense of purpose. For example, in one zone, a lady, her job every single day was to go out to the garden and pick vegetables out of the garden for the family to eat. So that was her job. She had to go out to the garden at 103 years old, bend down, get down on her knees, get back up again with fruit with vegetables, bring them in for the family to eat.
SPEAKER_00Did she have shoes on? Probably not. I'm serious.
Longevity, Blue Zones, And Purpose
SPEAKER_01There's no way she had shoes on. No, because a lot of them are third world-esque, not necessarily third world countries, but very minimalistic areas. And no, not wearing shoes.
SPEAKER_00Right.
SPEAKER_01So this 103-year-old woman, I would almost put money on the fact that if I were to test her, she'd be able to stand on each leg, one leg each side, for a minimum of 30 seconds, because there's no way that you could be able to perform that task if you didn't have a good balance.
SPEAKER_00Right. Right. To be able to get back down and get back up and yeah.
SPEAKER_01Right.
SPEAKER_00Stand up on one leg. I mean, when you get off the ground, you have to be essentially standing up on one leg.
SPEAKER_01Exactly.
SPEAKER_00To be able to get off the ground.
SPEAKER_01And a little teaser. That episode is going to be coming up here very soon, talking about getting down on the ground and back up again. So there's a little teaser. But for now, let's just stick with balance. And here's the quickest thing, here's everybody's take-home message right now is stand on one leg, barefoot, and see if you can make it for 60 seconds. If you can't, now we have a goal. There's zero reason why you should not be able to stand on one leg each side for 60 seconds.
SPEAKER_00And it's just part of your daily routine because you're already brushing your teeth, so just work it in your daily routine to stand on one leg.
SPEAKER_01Yes, we're not adding anything because you're not multitasking, you shouldn't be scrolling through Instagram, brushing your teeth. Just brush your damn teeth and improve your balance.
SPEAKER_00And make sure you switch likes.
SPEAKER_01And switch likes. One minute on each side.
SPEAKER_00Got it.
SPEAKER_01Good?
SPEAKER_00Awesome.
SPEAKER_01Like it.
SPEAKER_00Subscribe.
SPEAKER_01Like subscribe. Yeah, we haven't said that in a long time. Share this episode with somebody that you know does not have good balance.
SPEAKER_00Like everyone.
SPEAKER_01Yeah, everybody. Share this episode with everybody.
SPEAKER_00Okay. Ciao for now.