Did you know your ears and legs are in constant communication? 

It might sound strange, but your inner ear and lower leg work together like an invisible balancing act. When one struggles– whether from ageing, hearing loss, or chemotherapy– the other has to work even harder to keep you on your feet.

So what happens when both are affected? The risk of falls skyrockets.

Let’s take a dive into this connection and what you can do to stay steady on your feet.

The Vestibular System – in the inner ear contains semicircular canals and otolith organs that help detect motion and spatial orientation. The brain integrates vestibular signals with the lower leg (we know this as proprioception) and vision to maintain balance.

The Lower Leg is a Key player in Stability – Muscle strength, proprioception, and reflexes in the lower leg are crucial for balance.

As we age, we often experience muscle weakness, joint stiffness and reduced sensation in the feet (peripheral neuropathy), these can all affect our balance.

If we can’t hear properly due to the inner ear not working well from hearing loss or damage from chemotherapy, the body will rely more on the lower leg functioning to help us stay upright.

If both systems are in decline, the risk of falls increases dramatically.

Did you know that sarcopenia is the age-related progressive loss of muscle mass and strength. The main symtom is weakness. Weak leg muscles are part of the ageing process and made worse when people stop moving or stair climbing (how many of you or your friends talk about finding a bungalow when they get older)?

Hearing Loss in the UK

Over 18 million adults in the UK experience some degree of hearing loss. 80% of people over 70 have hearing problems, increasing their risk of a fall. Studies have shown that hearing loss increases the likelihood of a fall by nearly 2 1/2 times. 

Why Hearing Loss Affects Balance

   • The brain uses sound cues for spatial awareness.

   • When we lose our hearing, the brain struggles to integrate the inner ear (what we hear), what we see and proprioceptive (what we sense in the lower leg) input efficiently.

   • Reduced hearing = reduced ability to detect changes and that can = risk of missing your step and falling over.

Chemotherapy, Hearing Loss and Balance Problems

Chemotherapy drugs like Cisplatin and Caboplatin can cause damage to the inner ear, leading to permanent hearing loss and balance problems (known as vestibular toxicity).

 Peripheral Neuropathy is a common chemotherapy side effect and this will also impair balance.

When both the inner ear and lower leg proprioception decline, falls become a major concern for cancer patients.

How to Improve Balance and Reduce Your Risk of Falls

For older adults and anyone with hearing loss

   • Regular hearing tests as untreated hearing loss can increase the risk of a fall

   • Do Balance Training Exercise, things like Tai Chi, Pilates, Yoga, and lots of exercises that strengthen the lower leg and foot.

   • Proper Footwear, making sure your shoes have good grip.

   • Use your hearing aids! The number of people that do not put their hearing aids in before getting up and moving around is pretty high (and I include my husband). Improved hearing helps with spatial awareness.

For cancer patients post-chemotherapy

   • Vestibular therapy – this can help the brain compensate for the damage to the inner ear

   • Balance and Strength Training – to help strengthen the lower leg and feet and improve proprioception

   Be proactive– by understanding the connection between the inner ear and the lower leg you have the power to reduce your risk of falling and improve your mobility.

If you are worried about your hearing or balance then the first step is to get checked out by your GP or go back to your cancer team if you are still under their care.

If you would like some exercise to improve your balance and strength I can help get you started. I can see you on a 121 basis either on zoom or at your home and give you a programme to help mobilise and strengthen your feel and legs, and start some balance trining. We can also explore sessions locally that you could join and meet others with similar issues.

Please get in touch I work on a pay what you find manageable rate. 

fi@therapyinmotion.co or call 07767 384983

 Further reading and research

Hearing loss during chemotherapy: prevalence, mechanisms, and protection – (2024 Lexie Kessler et al) 

Walking and balance in older adults with age-related hearing loss – (2024 Sylvia Kolasa et al)

The association between hearing impairment and postural stability in older adults – (2022 – Jacinta I Foster et al)