What a 10-Second Balance Test Says About Your Health

By: Brian Hoeflinger, MD

August 4, 2026 | #88

Forwarded this email? Sign up here

Disclaimer: Opinions are my own. Not medical advice.

Medical Trivia of the Week

What is the medical term for your body's sense of where your limbs are without looking at them? (the correct answer is at the end of this email)

A) Proprioception
B) Nociception
C) Interoception
D) Chemoreception

Try This Before You Keep Reading

Stand up. Take your shoes off. Put your arms at your sides, fix your eyes on a spot straight ahead, and lift one foot so the top of it rests against the back of your other calf.

Now hold that for ten seconds. Do it next to a counter or a wall you can grab if you need to.

That is the entire test. No equipment, no cost, ten seconds. And for something that simple, it carries a remarkable amount of information about your health.

In my decades as a doctor, I saw what a single fall can do to an older person. Broken hips. Shattered wrists from trying to catch themselves. Knee injuries that never fully heal. Head injuries where a slow bleed forms around the brain over the following days or weeks. Most of them started the same way, with a loss of balance in the bathroom or on a step. Balance is not a small thing. It is often the line between staying independent and having everything change at once.

What the Research Actually Found

In 2022, researchers published a study in the British Journal of Sports Medicine that followed 1,702 adults between the ages of 51 and 75. At their first checkup, each person was asked to complete this exact ten second one-legged stance. About one in five could not do it.

Over a median of seven years, the difference between those two groups was hard to ignore. Among the people who passed, 4.6 percent died. Among the people who failed, 17.5 percent died. Even after the researchers accounted for age, sex, body weight, heart disease, high blood pressure, diabetes, and cholesterol, failing the test was still linked to roughly an 84 percent higher risk of death from any cause.

I want to be careful here, because this is exactly where findings like this get oversold. Standing on one leg does not keep you alive. Balance is not doing the saving. What balance does is reveal. It is one of the few things you can measure at home that reflects how several systems in your body are functioning all at once, which is why it tracks so closely with overall health.

Why Ten Seconds on One Leg Reveals So Much

Balance feels automatic, but it is one of the most demanding things your nervous system does.

To hold you upright on one foot, your brain is taking in three separate streams of information and reconciling them continuously. Your eyes tell your brain where you are in space. Your inner ear senses the position and motion of your head. And position sensors in your feet, ankles, joints, and muscles, a sense called proprioception, report where your limbs are without you ever having to look at them.

Your brain merges those three signals and fires corrections to your leg muscles dozens of times per second. You also need enough strength in your ankle, calf, and hip to act on those corrections fast enough to matter.

So that is five systems (eyes, inner ear, nerves, muscles, and brain) working together in real time. When you can hold ten seconds, all five are doing their jobs. When you cannot, at least one of them is struggling, and usually more than one.

This is also why balance is such an early warning. A 2024 Mayo Clinic study measured grip strength, knee strength, walking speed, and single leg balance in healthy adults over 50. Balance declined faster with age than any of the others. It fades before your strength does, and long before your walking changes enough for anyone around you to notice.

How You Compare

In that 2022 study, the share of people who could not hold ten seconds roughly doubled every five years:

Ages 51 to 55: about 5 percent failed
Ages 56 to 60: about 8 percent failed
Ages 61 to 65: about 18 percent failed
Ages 66 to 70: about 37 percent failed
Ages 71 to 75: about 54 percent failed

By the early seventies, more than half of people could not do it. That is a steep curve, and most people are somewhere on it without ever having checked.

If you want a target rather than a minimum, the Mayo researchers offered a good one. If you can hold a single leg stance for thirty seconds, you are doing well.

Why This Matters More Than It Sounds

According to the CDC, more than one in four adults over 65 falls each year, and fewer than half of them tell their doctor. Falls are the leading cause of injury deaths in that age group and the most common cause of traumatic brain injury. Falling once roughly doubles your chances of falling again.

Nearly every one of those events begins with a single moment of lost balance. That is the moment this test is measuring.

How to Test Yourself Properly

If you are going to do this, do it the way the researchers did so the result actually means something.

Stand barefoot on a firm, flat surface, within arm's reach of a counter or wall
Place the top of one foot against the back of your opposite lower leg
Keep your arms at your sides and your eyes fixed on a spot straight ahead
Hold for ten seconds without grabbing anything, hopping, or shifting your standing foot
You get up to three attempts on each side, and passing on either foot counts

Test both legs. A big difference between your two sides is worth paying attention to on its own.

And if ten seconds is easy for you, try it again with your eyes closed. Most people are stunned by how quickly they wobble. That is not a trick. It is the point.

If you cannot hold ten seconds, that is not a verdict on you. It is information. And of all the numbers your body gives you, this is one of the most fixable.

The Fix Takes About Two Minutes a Day

Balance responds to training at essentially any age. The nervous system is remarkably willing to relearn this, but only if you ask it to. The trick is not carving out a workout. It is attaching the practice to something you already do every day.

Brushing your teeth. Waiting for the coffee to finish. Standing at the kitchen sink. Any of those is thirty to sixty seconds you are already standing there.

Stand on one leg for as long as you comfortably can, then switch. Two rounds per side. Keep a counter within reach
Make it harder rather than longer. Once thirty seconds is easy, try it with your eyes closed, then on a folded towel or cushion
Build the muscle behind it. Standing up from a chair ten times without using your hands, plus calf raises, gives your balance something to work with
Handle the unglamorous things. An outdated glasses prescription, an inner ear problem, or a medication that leaves you lightheaded will undermine all of the above. All three are worth a conversation with your doctor

A minute a day beats an hour once a month. This is one of those rare cases where the smallest possible habit produces a real, measurable change within weeks.

Ten seconds is a small thing to ask of yourself for a number that tells you how your eyes, inner ear, nerves, muscles, and brain are all doing at once. Try it today. Then try it again in a month and see what has changed.

Impactful Quote of the Week

"Life is like riding a bicycle. To keep your balance, you must keep moving."

- Albert Einstein

Please let me know what you thought of this newsletter by replying to this email. I strive to read and reply to as many as I can.

All my best,

Brian Hoeflinger

P.S. - if you enjoyed this newsletter, you may enjoy my book that details my life as a neurosurgeon and the loss of my oldest son, Brian (see below a synopsis) and/or my podcast where I explain topics in further detail.

Learn More About My Book

Life and Death . . . Two words with such opposite meaning and which inflict such contradictory emotions and yet are so closely intertwined in our lives. As parents, we bring meaning and life into this world through our children. Our lives become defined as a result. We learn the joy, hardship, and responsibility of shaping an innocent life. But a day will come when that life will be taken. For some, death will come too soon. This is the story of my son, Brian Nicholas Hoeflinger, who died unexpectedly at age 18.

https://doctorhoeflinger.com/products/the-night-he-died-the-harsh-reality-of-teenage-drinking

Check Out My Free Podcast

The Dr. Hoeflinger Podcast is about more than medicine, it’s about living a fuller, healthier, and more meaningful life. My son, Kevin, and I discuss medicine, health, fitness, lessons learned from personal tragedy, family, and purpose. Along the way, we invite inspiring guests to bring fresh insights and perspectives. Watch or listen to the podcast below.

YouTube: Click here

Apple Podcasts: Click here

Spotify: Click here

Please reply with any questions you may have or future topics that you want me to write about.

Interested in Sponsoring this Newsletter?

Medical Trivia Answer:
The correct answer is A) Proprioception

*Disclaimer: This newsletter and blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter and blog or materials linked from this newsletter and blog is at the user’s own risk. The content of this newsletter and blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay seeking medical advice for any medical condition they may have and should consult their healthcare professionals for any such conditions.