Even the frail elderly should do exercises from a standing position as much as possible; after all, they sit plenty when not exercising.

Here are the best standing exercises for seniors.

Seniors, especially frail, are at risk of falling. One out of three people over age 65 will suffer a fall (cdc.gov).

So it makes a lot of sense to have your elderly loved-one perform most of their exercises while standing—to increase their body’s ability to stabilize while on the feet and while walking.

I’m a former personal trainer who designed rehab exercises for my mother after she, at age 89, fell and fractured a hip.

These rehab exercises, most from a standing position, have resulted in dramatic improvement—she’s better NOW than she was before the hip fracture!

Her hip surgeon told me, the night prior to the surgery, that there was a “slim” chance she’d never get off of a cane post-surgery (prior to the hip fracture she wasn’t using a cane but was unstable).

If he could see her now, he’d be flabbergasted.

Best Standing Exercises for Seniors Including Frail

BALL CATCH. I started my mother out with a child’s plastic ball. Stand half-way across a room and toss the ball to the senior.

They should catch it with palms facing each other, palms on either side of the ball, as much as possible, rather than with hands low and palms facing outward.

They toss the ball back to you. Do 10 tosses; if the senior isn’t too tired, go to 20. This exercise forces the body to brace for an external stimulus that knocks it off balance.

As the ball approaches, the senior’s eyes process this; the brain reviews it and gives commands to the body to adjust for the impending contact of ball to hands. This occurs in milliseconds.

Next, the body is forced to recalculate once the ball makes contact with the hands.

I have my mother now catching a two-pound medicine ball. This exercise also strengthens the upper body.

TUG of WAR. Have senior hold, palms up, in each hand the handles of an exercise band (tension band).

You hold the other end of it and apply resistance as the senior pulls away from you. When they do this, right foot is ahead of the other, about shoulder width apart.

This exercise forces the body to recalculate from being thrown off balance, which will happen if 1) the senior trips over something, 2) someone accidentally bumps into the senior or 3) the senior accidentally bumps into something.

My mother one day accidentally stepped on one of my father’s shoes, sending her body pitching forward, but her body reflexively recalculated and prevented a fall.

Prior to the hip fracture she would have never been able to do this. The tug of war teaches the feet, all the way up to the top of the spine, to instantly readjust to a force that throws it off balance.

Maintain the tugging (senior uses slightly bent arms) for a few seconds. Rest. Repeat two more times. Then repeat with left foot ahead of the other.

PILLOW PUSH. Have senior face, say, the living room window. You stand to their right side, pillow against their right side/shoulder. Now push gently and have them push back, sideways, to oppose you.

This forces their body to develop recalculation skills in the frontal plane (side to side movement) which is often neglected in exercise programs, even for younger people.

Have them oppose for several seconds. Rest. Do a total of three times each side. This will develop increased ability to—again—recalculate if accidentally bumped into or losing balance while walking on unstable ground or lumpy grass.

SIDEWAYS STAIR CLIMB. Sounds too tough, but a frail elderly person who doesn’t need a cane can do this.

At the bottom step the left side of their body is facing the staircase (body is perpendicular to the steps).

Left foot goes on the first step, foot parallel to the step rather than facing it. Right foot follows, parallel to the other foot. Their entire body remains sideways as they ascend like this.

At all times, you are right under them, hands lightly on them. Do not remove your hands, but don’t over-support, either.

Multiple times my mother has lost her balance doing this, but I was right there and re-steadied her.

This exercise is stellar for improving neuromuscular coordination, balance and recalculation skills, working that frontal plane and forcing the body to adapt to a stimulus that’s continually throwing it off.

This includes the confined space that the feet are standing in, which forces the body to balance more while strengthening the muscles that control the feet. It also has an aerobic component.

The elderly person goes to the top of the staircase, at their pace. Then they walk back down very, very slowly, holding the rail, and do it again facing the other side.

I need to point out that if you’re not very strong or in poor physical condition yourself, you may want to skip this, as you may not be able to efficiently support the senior if they outright fall into you.

Other standing exercises for seniors include overhead dumbbell press, sideways dumbbell lift, frontal dumbbell or medicine ball lift, countertop or wall pushup, going up and down on the toes, knee-high marches in place, swaying left to right with high knees in place, stationary lunges to the front; back; side, and interval walking—in which they speed up for 5-10 seconds, then walk very, very slowly, alternating this way for five minutes.

Depending on the senior’s fitness level, you must stand close enough to them at all times to “catch” them in case they teeter off balance.

I need to be right beside my mother when she goes up and down on her toes, but not when she does the interval walking.

She’s stable with the ball catch, but I must be right behind her when she does lunges, my hands hovering on either side of her, ready to gently grasp if she loses balance.

Another fine standing exercise is stepping over a stool with one leg (body perpendicular to the stool), following with the other leg, walk around and repeat several times.

For seniors who are improving, have them stand with the stool between their legs. They place right foot on the stool, then back on the floor.

Repeat for a total of five times. Then switch legs. This will be very, very challenging to many seniors. You must stand right behind them, ready to give hands-on support if they lose balance.

These standing exercises force the senior frail body to adapt, to develop better recalculation skills, to re-balance when thrown off balance.

Forget the seated exercises that fail to teach the body how to efficiently function when on the feet.

The only seated exercises that I endorse for seniors are the use of seated strength training machines at the gym (chest press, leg press, lat pull-down, etc.), and at home, seated dumbbell presses overhead are good, and also rows with a tension band.

Standing exercises, with proper standby support by the trainer, beat seated exercises hands-down for the elderly.

Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.