The Link Between Leg Strength and Falls Risk: Why Stronger Legs Matter as We Age
Falls are a common concern as we get older. A fall can affect confidence, independence and quality of life, and in some cases, result in serious injury. For older adults and their families, understanding how to maintain safe movement is an important part of healthy ageing.
There are many factors that contribute to falls, including balance, vision, medications, footwear, the home environment and walking ability. However, leg strength is an important factor that can be improved through appropriate exercise.
Strong legs help us perform everyday movements such as standing up from a chair, climbing stairs, walking over uneven surfaces and responding when we lose our balance. Maintaining lower-limb strength can therefore play an important role in supporting mobility, independence and falls prevention.
Why Is Leg Strength Important for Reducing Falls?
Our legs play a major role in helping us stay stable and move safely. Walking, turning, stepping over obstacles and recovering from a trip all require our muscles to generate force effectively.
As we age, muscle mass and strength can gradually decline. This process may be accelerated by inactivity, illness, hospitalisation or periods of reduced mobility.
Reduced leg strength can make everyday activities more challenging. For example, someone with reduced thigh or hip strength may find it harder to stand up from a low chair, climb stairs or step over an obstacle. They may also have greater difficulty recovering their balance after an unexpected movement.
Research supports a relationship between lower-limb strength and falls. A 2025 systematic review and meta-analysis involving more than 8,000 community-dwelling older adults found that several measures of lower-limb strength and rapid force production were associated with falls or a history of falling.
Importantly, strength is something that can be trained and improved at many stages of life. Regular resistance and functional exercise can help maintain or develop the muscle strength needed to support everyday movement.
How Can Reduced Leg Strength Affect Everyday Activities?
Leg strength is closely linked to functional ability. When the muscles around the hips, thighs and lower legs can meet the demands of everyday activities, movements such as walking, standing and transferring between surfaces can become more manageable.
Reduced strength may contribute to difficulty with:
Standing up from a chair
Getting in and out of bed
Climbing or descending stairs
Walking longer distances
Stepping over obstacles
Getting up from the floor
Changing direction while walking
Recovering after a trip or loss of balance
These challenges may also cause someone to become less active. For example, a person who finds walking or getting out of a chair increasingly difficult may begin avoiding activities they previously enjoyed.
Over time, reduced activity can contribute to further losses in strength and fitness. This can create a cycle in which declining physical capacity makes everyday movement more difficult, leading to even less activity.
Maintaining strength can help interrupt this cycle by supporting continued participation in daily activities and exercise.
Can Strengthening Exercises Help Reduce Falls?
Research suggests that exercise can reduce falls in older adults, particularly when programs incorporate strength, balance and functional exercises.
An evidence report and systematic review prepared for the US Preventive Services Task Force included 37 exercise trials involving more than 16,000 participants. The exercise interventions were associated with reductions in the overall rate of falls, the proportion of people experiencing one or more falls, and the rate of injurious falls.
Many of these programs combined strengthening with balance and functional training. This is important because having sufficient leg strength is valuable, but being able to use that strength during real-life movement is equally important.
More recent research continues to support structured exercise. A 2026 systematic review of 27 trials involving community-dwelling adults aged 60 and over found that exercise programs were associated with reductions in falls across the included studies.
Together, these findings support regular exercise as an important part of falls prevention, with strengthening forming a key component of many exercise programs.
While exercise can help reduce falls risk, no single exercise or program can eliminate the risk entirely. An individual's needs, abilities and other risk factors should also be considered.
What Types of Exercises Can Improve Leg Strength?
There are many ways to strengthen the lower limbs, and exercises can be adapted to suit a person's current ability, balance and physical capacity.
Common examples include:
1. Sit-to-Stand Exercises
Repeatedly standing up from a chair is a functional exercise that targets the thighs, hips and other muscles involved in standing. It also directly relates to an everyday activity that many older adults perform several times each day.
2. Squats
Supported or unsupported squats can help strengthen the hips and thighs. The depth of the squat and the level of assistance can be adjusted according to the person's strength and balance.
3. Step-Ups
Stepping onto a low step challenges the muscles involved in climbing stairs and managing changes in height. The exercise can be modified to suit the person's current ability.
4. Calf Raises
Calf raises strengthen the muscles around the lower leg and ankle, which contribute to walking and movement.
5. Resistance Exercises
Resistance bands, weights and gym equipment can provide progressively greater challenges to the muscles, helping improve strength over time.
The most appropriate exercises and resistance will depend on a person's current strength, balance, health and goals. Someone who is unsteady or has significant weakness may require additional support when starting an exercise program.
A physiotherapist can help determine a suitable starting point, adjust exercises to individual needs and progress the program as physical capacity improves.
Strength Is Important, but So Is Balance and Coordination
Having strong muscles is valuable, but falls prevention also involves using that strength effectively during movement.
For this reason, physiotherapy programs may combine strengthening exercises with balance and functional activities, such as:
Weight-shifting exercises
Stepping in different directions
Turning practice
Walking over different surfaces
Obstacle negotiation
Standing balance exercises
Stair practice
Practising getting up from a chair
These activities help people practise applying their strength to movements they perform in everyday life.
For example, being able to perform a strong squat is useful, but safely stepping onto a kerb, recovering from a trip or standing up from a low chair also requires balance, coordination and movement control.
Combining these elements can help build the physical skills needed to move more confidently around the home and in the community.
How Can Physiotherapy Help Improve Leg Strength and Reduce Falls Risk?
Physiotherapy can play an important role in identifying reduced strength and other factors that may contribute to falls.
A physiotherapist can assess:
Lower-limb strength
Balance and postural control
Walking ability and gait speed
Functional mobility
Ability to stand up from a chair
Stair-climbing ability
Use of walking aids
Confidence with movement
Individual goals and daily activities
Following an assessment, a physiotherapist can develop an individualised exercise program designed around the person's specific needs.
For someone with significant weakness, exercises may initially be performed while seated or with support. As strength and confidence improve, exercises can be progressed by adjusting resistance, repetitions, movement complexity or balance demands.
This gradual progression helps provide the muscles with an appropriate level of challenge while taking the person's abilities and safety into account.
Physiotherapy may also include education about other falls risk factors and strategies for maintaining safe mobility at home and in the community.
What Else Can Help Reduce Falls Risk?
Although leg strength is an important part of falls prevention, it should be considered alongside other factors that affect safe movement.
Other strategies may include:
Maintaining balance and mobility: Practising appropriate balance and functional exercises can support safer movement.
Choosing appropriate footwear: Well-fitting footwear can help support stability during walking.
Addressing vision concerns: Vision difficulties may affect the ability to identify obstacles and navigate the environment safely.
Reviewing medications: A healthcare professional can review medications where appropriate, particularly if side effects may affect balance or alertness.
Improving home safety: Addressing hazards such as loose rugs, clutter, poor lighting and difficult transitions can help make the home safer.
Using appropriate mobility aids: A walking stick or walker should be suitable for the person's needs and correctly fitted.
A comprehensive approach means that strengthening does not need to occur in isolation. Instead, it can form a central part of a broader plan to maintain mobility, confidence and independence.
How Can You Maintain Your Leg Strength as You Age?
The good news is that it is never too late to work on strength.
Regular resistance exercise can help maintain or improve muscle strength. This might involve body-weight exercises, resistance bands, weights, gym equipment or functional movements such as sit-to-stands and step-ups.
The key is consistency and appropriate progression.
If you have noticed that you are walking more slowly, finding stairs increasingly difficult, using your arms more to get out of a chair, or avoiding activities because you feel weak or unsteady, these may be signs that your physical capacity could benefit from assessment.
A physiotherapist can help identify areas of weakness, assess your balance and mobility, and develop an exercise program appropriate to your current abilities and goals.
For older adults who prefer to exercise in familiar surroundings, home-based physiotherapy can also provide an opportunity to practise everyday movements in the environment where they are most often performed.
Take the Next Step Towards Stronger Legs and Safer Movement
Strong legs are an important part of maintaining independence and managing falls risk as we age.
Good lower-limb strength can make everyday activities such as walking, climbing stairs, standing up from a chair and responding to a loss of balance easier to perform. Research suggests that exercise programs incorporating strengthening, balance and functional activities can help reduce falls in older adults.
However, falls are influenced by several factors. Strength should be considered alongside balance, walking ability, vision, medications, footwear and the home environment.
At Your Health Your Way, our mobile physiotherapy team provides in-home physiotherapy across Sydney's Northern Beaches and North Shore. We can assess your strength, balance and mobility and develop an individualised program designed around your abilities, goals and everyday activities.
Concerned about your strength, balance or falls risk?
Contact our friendly team today to discuss an in-home physiotherapy assessment and take a positive step towards maintaining your mobility, confidence and independence.
References
Zhu RTL, et al. (2025). Association of lower-limb strength with different fall histories or prospective falls in community-dwelling older people: A systematic review and meta-analysis. BMC Geriatrics.
Montero-Odasso M, et al. (2024). Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults: A Review. JAMA.
Feltner C, et al. (2024). Interventions to Prevent Falls in Older Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA.
(2026). Effects of exercise interventions on fall-related injuries in community-dwelling older adults: An updated systematic review and meta-analysis.
(2026). Effectiveness of Balance- and Strength-Based Exercise Interventions for Fall Prevention in Community-Dwelling Older Adults: A Systematic Review of Randomized Controlled Trials.