The ten-second stand: what a one-leg balance test says about ageing

The longevity habits that get talked about are the ones a watch can count: steps, heart rate, hours slept. Balance is the quiet one. Nothing tracks it, nothing aches as it fades, and modern life has been engineered so that it is almost never tested — flat pavements, handrails, supportive shoes. You can lose a great deal of it before a wet bathroom floor lets you know.

It belongs to the same family of practices this journal keeps returning to — like walking, it is free, unglamorous and easy to dismiss. And lately the research has attached a number to it that is harder to dismiss: ten seconds.

The ten-second test

In a 2022 study in the British Journal of Sports Medicine, Araujo and colleagues asked a simple thing of around 1,700 adults aged 51 to 75: stand on one leg for ten seconds, eyes open, up to three attempts. About one in five could not. Over the seven years that followed, the people who had failed the test died at a markedly higher rate — close to double the risk, after the researchers adjusted for age, sex, weight and existing medical conditions.

The ability falls away faster than most of us would guess. Among participants in their early fifties, roughly one in twenty could not hold the stance. Between 71 and 75, more than half could not. The slide from one figure to the other happens quietly, across the exact decades when nobody is checking.

The honest reading is the one we give every observational finding in this series: association, not proof. Failing the test does not cause anything — it reveals things. Standing on one leg draws on muscles, joints, nerves, vision and the inner ear all at once, which is precisely why a ten-second test carries so much information, and why the researchers proposed it as a quick, kit-free check for mid-life and beyond. It is a marker, and a useful one — not a sentence.

Why it matters: the fall, not the number

The reason to care sits behind the statistic. According to the World Health Organization, falls are the second leading cause of unintentional injury death worldwide, and adults over 60 suffer the greatest number of fatal ones. Long before anything fatal, a fall is often the hinge on which independence turns — a broken wrist or hip, months of caution, a quietly shrinking radius of confidence.

Balance rests on three systems working together: the eyes, the inner ear, and proprioception — the body’s sense of where it is in space, fed in large part by the pressure and stretch sensed through the feet. All three dull gradually with age, and none announces the loss. Strength gets a warning: the stairs feel longer, the shopping feels heavier. Balance just goes, until the day it is asked for.

The part that trains

Here is the better half of the story: of all the things that decline with age, balance is among the quickest to respond to practice. In a 2019 Cochrane review, Sherrington and colleagues pooled the trials on exercise and falls in people over 60 living at home, and found that exercise programmes — most of them built around balance and functional movements — reduced the rate of falls by around a quarter, with what the review rates as high-certainty evidence. That is a strong result by the standards of this literature, and it did not come from athletes; it came from ordinary people practising ordinary standing.

The practice asks very little. Stand on one leg while the kettle boils and swap legs when it clicks. Brush your teeth on one foot. Stand up from a chair without using your hands. Walk heel-to-toe down the hallway. Do all of it near a counter or a wall at first — the point is to challenge balance, not to test gravity. And if you are unsteady already, or managing a condition that affects balance, take it to a physiotherapist before you take it to the top of the stairs.

It starts at the ground

Barefoot shoes strengthen the feet. In a 2019 trial in Medicine & Science in Sports & Exercise, Ridge and colleagues found that eight weeks of ordinary walking in minimalist shoes strengthened the small muscles of the foot about as much as a dedicated strengthening programme. That strength protects balance directly: in a 2009 study in Clinical Biomechanics, Mickle and colleagues found that the older adults who went on to fall had markedly weaker toe-flexor strength than those who did not. Stronger feet fall less.

A thin sole does a second job: it lets the feet feel the ground. Pressure and texture pass through to the nerves in the sole, and that information feeds the balance system alongside the eyes and the inner ear. A thick cushioned sole blocks most of it. This matters more with every decade, because the feet weaken and their sensation dulls with age — quietly, like balance itself. One practical instruction applies, the one we set out in our longer essay on heat and barefoot living: change footwear over weeks and months, not days. In a 2013 study, also from Ridge and colleagues, runners who moved to minimalist shoes over ten weeks showed stress reactions in the bones of the foot.

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The sauna rests on the same belief. It is one of the few moments modern life still spends barefoot, and part of why the ritual belongs in a week built for the long term.

Ten seconds, twice

So try it — today, near the kitchen counter, once on each leg. If ten seconds is easy, the test has told you something good. If it is not, it has told you something better: that there is a specific, trainable thing you can start improving this week, for free, in the gaps of an ordinary day.

The sauna teaches the same lesson in a hotter room. Small, repeated, slightly effortful inputs, sustained for years, are what the body actually responds to. The practices that serve you at eighty are the ones that feel too small to be impressive at fifty — and standing on one leg while the kettle boils may be the plainest of the lot.