Yoga for Balance: How to Test For and Cultivate Balancing Skills

Article At A Glance

Good balance is a crucial, tell-tale marker for healthy aging. In this discussion, Erik Dalton, Ph.D., explores the Romberg Test, balance assessments, and how improved balance (including yoga practice) can improve overall health and well-being.

As stated in my recent blog titled “Digital Dementia,” poor posture is not a cause; it is simply a symptom indicating over or under-functioning various bodily systems, including musculoskeletal, endocrine, and nervous. Hours sitting staring at screens, lack of exercise, and poor functional biomechanics all contribute to poor posture, which may lead to other symptoms such as lack of focus, headaches, chronic stress, visual disturbances, and poor balance.

No matter what a client sees me for, their exam has a postural component. I’m not only observing for common compensatory patterns such as upper crossed syndrome, motor dominance, and gait disturbances but also checking specific parts of brain system functioning. For example, one-legged standing tells me a bit about their vestibular system and possible problems arising from the Pons (see Image 2 below) as it transfers information via the eighth cranial nerve to the inner ear. In the one-legged exam (Image 1 right), I’m observing for the “first” direction the client sways, indicating weakness on that side. Another elementary and complementary vestibular exam is the Romberg Test.

digital dimentia photo midbrain
Image 2 Pontomedullary Junction

Posture Assessment: The Romberg Test

The Romberg test for assessing sensory ataxia and gait disturbances caused by funky proprioception arising primarily from joints has been around for 150 years. Equilibrium is maintained through sensory information from the vestibular, somatosensory, and visual systems, making these tests tricky. Remember that clients presenting with proprioception problems (somatosensory) can maintain balance by compensating with vestibular function and vision. Three sensory systems (vision, proprioception, and vestibular) provide input to the cerebellum and midbrain to maintain truncal stability when the eyes are open, and only two of the three systems are needed to maintain balance. The original Romberg test goes like this:

  1. The client removes his shoes and stands with his two feet together with arms crossed in front or pointed straight ahead (Image 3 right).
  2. The client is first asked to stand quietly with eyes open and subsequently with eyes closed while attempting to maintain balance. Note: When the client shuts his eyes, he should not orient himself by light, sense, or sound, as this could influence the test result, resulting in a false positive.
  3. The Romberg test is scored by counting the seconds the client can stand with eyes closed.
  4. To increase the difficulty, the therapist can gently (and safely) attempt to disturb the client’s balance with a perturbation. It is essential for the therapist not to exaggerate the perturbation.

The Romberg test is positive when the client cannot maintain balance with closed eyes. Losing balance can be defined as increased body sway or placing one foot in the direction of the fall. Clients with acute peripheral vestibular problems are usually inclined to sway toward the side of the problem, so I offer my clients special exercises to stimulate the vestibular system. Manual vibration of the limbs and joint mobilization are also great ways to beef up the Pons and vestibular balance apparatus.

The Romberg test is instrumental as a follow-up assessment for clients with balance and proprioception impairments, especially when combined with brain-based exams such as the one-legged standing, gaze stabilization, and spinal push tests. Suppose the therapist observes that the client can stand for extended periods of time with the eyes closed. In that case, it is evident that the client’s balance and proprioceptive deficits have decreased.

Just remember that your brain sets the tone for all your muscles. Like an overprotective mother, it decides how many activations to allow and always errs on the side of caution. The brain can activate or inhibit muscle tone and balance depending on what is the safest course for you. We are wired for survival. Your (Mom) brain is there to protect you and, when functioning correctly, knows when too much or too little of a good thing is right for you.

Cultivating Balance with Yoga

A person in a tree pose, a yoga pose for strong bones to prevent osteoporosis and improves balance.

Practicing yoga asana can help you develop balance and proprioception. Combining physical postures and mindful attention helps build body awareness, one of the core skills needed to maintain balance. The canon of yoga postures includes many positions that require balancing skills. Therefore, these postures cultivate the talent of balancing.

One-legged standing balancing poses are staples for developing balance skills, but it’s also helpful to practice balancing when your body is in other orientations—sitting and kneeling—as well. These three poses, along with many other standing balance poses, can be effective in solidifying balancing skills:

  • Vrksasana (Tree Pose) (shown above)           Bird Dog Pose
    Yoga’s basic one-legged standing pose.
  • Parsva Balasana (Bird Dog Pose): (pictured right)
    Parsva Balasana teaches balance on your hands and knees.
  • Ubhaya Padangusthasana (Upward Big Toe Pose):
    This yoga pose requires you to balance on your pelvis.



Reprinted with permission from Erik

Erik Dalton, PhD., is executive director of the Freedom From Pain Institute, creator of Myoskeletal Alignment Techniques, and author of three best-selling manual therapy textbooks and online home-study programs. Educated in massage, osteopathy, and Rolfing, he resides in Oklahoma City, Oklahoma, and San Jose, Costa Rica. View his articles and videos at or Facebook’s Erik Dalton Techniques Group. 

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