The Flamingo Test: A Quick and Easy Way to Gauge Your Overall Health

It might feel a little silly, but attempting to stand like a flamingo and holding  that position can reveal something very serious about the state of your health.

People 50 and older who try to stand on one leg — in a position sometimes referred to as the “flamingo test”  — often struggle to do so as they grow older, according to a study recently published in the journal PLOS One.

In some cases, difficulty balancing might suggest serious underlying health issues.

How effectively we maintain our balance tells us a lot about how well are body’s systems work together, according to Dr. Taher Saifullah, founder of Spine & Pain Institute Los Angeles.

“Balance — especially the ability to stand on one leg — is like a window into our overall health,” says Saifullah, who was not involved in the study.

What balance tells us about our health

The study found that a person’s ability to balance on one leg falls by an average of 1.7 seconds per decade when they attempt the maneuver on their dominant leg. The decline is 2.2 seconds per decade on their nondominant leg.

The ability to balance tends to deteriorate faster than other muscular functions, such as hand grip and knee strength, the researchers found. Balance is also more likely to fall faster than gait speed.

When we try to balance on one leg, we rely on multiple systems working together, including our muscles, joints, and senses, Saifullah says.

“If you can stand steady on one leg, it shows that you have good strength and control, which are crucial for daily activities like walking, climbing stairs, or even just getting up from a chair,” he says.

As our bodies age, they undergo changes that can negatively impact our balance, Saifullah says.

A loss of muscle mass  means we have less strength to stabilize ourselves. Joints may become stiffer, and the sensory systems that help us maintain balance — such as vision and the inner ear — can decline.

“This deterioration can lead to unsteadiness and a higher risk of falls, which is a major concern for older adults,” Saifullah says.

If you struggle to maintain your balance, it might also signal a number of possible health problems. These include:

• Brain or nervous system ailments, including dementia and Parkinson’s disease
• Heart conditions
• Negative side effects from taking specific medications

What is the ‘flamingo test,” and how long should you be able to balance?

The “flamingo test” is relatively straightforward if you follow these steps:

1. Stand on one leg, preferably on a balance beam.
2. Bend the free leg behind you and grab the back of the foot with the hand on that side.
3. Hold the position as long as possible.

When the raised leg touches the ground, the test is considered to be over.

The researchers say the following are some good rules of thumb for how long should you be able to balance on one leg:

• Ages 69 and younger: 30 seconds or longer
• Ages 70 to 79: 20 seconds
• Ages 80 and older: 10 seconds

“Balance tests are not just a fun challenge,” Saifullah says. “They serve as an important health check that can signal when we need to take action.”

A strong sense of balance is crucial to long-term health outcomes because it reduces the risk of falling.

“Falls can result in severe injuries, such as fractures or concussions, which can lead to long recovery times, and sometimes long-lasting limitations,” Saifullah says.

In 2021, more than 38,000 Americans 65 and older died after falls, according to the Centers for Disease Control and Prevention. That made falls the leading cause of injury death in that age group.

Emergency departments in the U.S. treated nearly 3 million older adults for falls in that same year.

“Beyond physical injuries, the fear of falling can lead to a more sedentary lifestyle, creating a cycle that further weakens balance and mobility,” Saifullah says.

How to improve your balance

If you struggle to maintain your balance, there is some good news: There are things you can do to improve steadiness on your feet.

“Balance is not set in stone,” Saifullah says. “It can be improved at any age.”

Activities such as tai chi and yoga focus on flexibility and core strength, both of which are important for maintaining balance, Saifullah says.

“Even simple exercises at home — like standing on one leg while brushing your teeth or practicing gentle heel-to-toe walking — can help enhance your stability,” he says.

In heel-to-toe walking, you walk slowly while touching your heel to the toes on the opposite foot. The walk should be about 20 paces in a straight line.

Many other types of exercises can potentially boost your balance, such as:

• Back-leg raises, where you hold a chair and lift one leg backward without bending the knee or pointing your toes
• Squats, where you bend your knees and lower yourself as if preparing to sit in a chair
• Knee curls, where you hold a chair and lift one leg straight back while raising your heel toward your rear end
• Toe stands, where you hold a chair and raise up on your tiptoes

Additional activities that can help improve balance include dancing, hiking, or playing with grandchildren, Saifullah says.

“Balance training doesn’t have to be daunting,” he says. “It can be enjoyable.”

A  physical therapist can also design a personalized balance program tailored to your individual needs and abilities.

“The key is to start slowly and build up your strength and confidence over time,” Saifullah says.

Even if you don’t have balance issues now, make sure you are seeing your health provider on a regular basis, particularly if you are a senior.

“Regular check-ups with health care providers can help catch any potential balance issues early, allowing for proactive steps to be taken,” Saifullah says.