One thing that can really create terror while we age is falling. No matter the gender or the background, anyone who is getting older would never tell you that they want to get weaker or that they would not improve their skill in fall prevention. Indeed, as we age, maintaining balance becomes one of the most important aspects of long-term health. Therefore, let’s look at what muscle is extremely important for balance: the gluteus medius.
As a Clinical Myotherapist here at Melbourne Massage and Treatment in Fitzroy North, I always encourage my patients to undertake exercises, and in specific heavy lifting exercises, to promote their strength, stability, and make them independent from aids and support in their everyday life. And a good start is always to make them realise where their equilibrium is at, and make them aware of how the gluteus medius, particularly for women approaching or after menopause, can help prevent falls.

The Hidden Role of the Gluteus Medius in Balance

The gluteus medius, as the name suggests, is a glute muscle, and it is responsible for stabilising the pelvis when we stand on one leg, like when we walk, run, or even when we go up and down the stairs. Every step we take requires this muscle to activate.

When functioning properly, the gluteus medius:

• Maintains pelvic stability
• Controls lateral balance
• Helps prevent excessive hip drop during walking
• Assists in reactive balance when we trip or lose stability

Research from Chi S. A.  et al. (2016) did show that older adults with degeneration or atrophy of the gluteus medius are more likely to fall and fracture a hip.

These findings, together with other studies, highlight the crucial role of this muscle in equilibrium and fall prevention.

The Real Danger of Falls as We Age

Falls are one of the leading causes of injury in older adults. But what is most concerning is what happened after the fall.

On top of all, another major complication is osteoporosis, especially in women.
In another blog, we spoke about why women are more likely to suffer from this condition.

So yes, as bone density declines, the risk of fragility fractures increases dramatically.

This creates a dangerous cycle:

1. Muscle weakness → instability
2. Instability → increased fall risk
3. Falls → fractures due to osteoporosis

For many older adults, hip fractures can lead to reduced mobility, loss of independence, and long-term health complications.

Different types of muscle fibres and their importance in fall prevention

Type I – Slow-twitch fibers

The slow-twitch fibres, as the name suggests, are fibres that may help maintain steady contraction but are not responsible for rapid corrections when balance is lost.

Characteristics:

• Contract slowly
• Produce a lower force
• Highly resistant to fatigue
• Rich in mitochondria and oxygen-using enzymes

Role:

• Posture control
• Balance stabilization
• Long-duration activities like walking

And here is an example of muscles where we find these fibres:

• Postural muscles in the back:

  • Erector spinae (longissimus, iliocostalis, spinalis), multifidus, and upper trapezius.

• Leg postural muscles include:

  • Hip flexors and calf muscles

Type IIa – Fast oxidative fibres

Another name for this fibers are intermediate fast-twitch fibres. Their role is to cover the gap between the type 1 fibres, which are more slow-twitch type of muscle fibres, and the type IIx, which are the fastest fibres.

Characteristics:

• Faster contraction than Type I
• Moderate force
• Moderate fatigue resistance

Role:

• Activities requiring both endurance and power, like climbing stairs or brisk walking.

Their presence is distributed throughout many body muscles, including the psoas and gastrocnemius.

Type IIx – Fast glycolytic fibres

In terms of fall prevention, those muscle fibre types are the most important.

Characteristics

• Very fast contraction
• High force output
• Fatigue quickly

Role

• Explosive movements
• Rapid balance recovery
• Reflexive muscle reactions

What Happens With Aging (Sarcopenia)

While we age, we develop what we call sarcopenia, which is basically a loss of muscle mass.

Sarcopinia key changes include:

Loss of fast-twitch fibers

Type II fibres decline faster than Type I.

Effects:

• Reduced power
• Slower reaction speed
• Higher fall risk

Along with the muscle fibres declining, we also have a reduction in motor neuron function, where the nerves controlling fast fibres deteriorate, reducing recruitment.

Other types of degeneration include increased stiffness, as connective tissue reduces elasticity and recoil.

Role of Estrogen in Muscle Function

As discussed in the menopause blogs about the role of hormones in women’s health, Estrogen plays a surprisingly important role in muscle health, too.

This is possible because muscle cells have estrogen receptors, meaning the hormone directly affects muscle tissue.

When estrogen levels fall (during Menopause), several changes occur, starting from:

1. Accelerated loss of fast-twitch fibres.
2. Reduced muscle protein synthesis, which means slower muscle repair and growth signalling.
3. Increased inflammation, which again slows down the muscle recovery.
4. Changes in connective tissue, as Estrogen helps maintain collagen turnover, and here we look more at tendons and Ligaments.
5. Reduced neuromuscular efficiency, including nerve conduction and motor unit activation.

Why Strength Training and Fitness Classes Matter for Longevity

So, the good news is that muscle function can be improved at any age, and plenty of research consistently shows that resistance training significantly improves muscle mass, strength, and functional capacity.

In summary, strength training can help with:

• Increase muscle mass
• Improve neuromuscular coordination
• Enhance balance reactions
• Reduce fall risk
• Support bone density

That’s why at my clinic in Fitzroy North, I encourage my clients to take up fitness classes, to get their body moving under load, because this is the best way to help the body stay active, regenerate and keep up with fall prevention.

Book your 1:1 fitness class now

FAQs — Fall Prevention, Balance, and Muscle Strength