First, see where you stand, so to speak. Stand with one foot off the floor and not touching the other leg, arms folded across your chest. Do this for more than 30 seconds and you've passed the most basic balance test. Try this exercise with each leg raised and with your eyes closed. Then try it pointing your raised leg to different compass points, or while bouncing a ball, or wearing a backpack and standing on a foam sleeping pad. If you have trouble, repeat the exercise three times a day. Time yourself periodically to see how you're improving.
Opt for boots with stiffer soles instead of those with more flexible soles. One study revealed that thick, soft soles common in "walking shoes" have a negative effect on balance.
Improve your overall fitness, including strength, cardiovascular endurance, and flexibility. Lower-leg strength is especially critical, and Dr. Toole suggests the following at-home exercises:
Ankle raise. Stand on the edge of a step, allowing your heels to drop below the step. Raise your body by standing on your toes, then lower your heels below the step. Do this 10 to 12 times and rest.
Knee extension. Place ankle weights around one ankle. Sit in an upright chair and raise your leg to a count of four until it's horizontal with the floor. Slowly lower, and repeat 10 to 12 times. Do three or four sets per leg.
Knee flexing (hamstring). Stand with feet together and weights around one ankle. Hold onto a countertop or table, and lift the weighted foot behind your back by bending the leg at the knee. Raise the foot to a count of four and lower to a count of two. Put the weights on the other ankle and repeat. Do this 10 to 12 times per leg. Rest, and then do one to three more sets on each leg. You should be able to lift two-thirds of the weight you did with the knee extensions.
Use trekking poles. "Hiking poles greatly enhance my stability on the trail," says Dr. Toole, who was planning a trip to several Colorado 14ers when we spoke. She recommends double poles because "you always have one pole in contact with the ground. When a sudden loss of balance occurs, you have that extra contact point to help you regain stability."
Make sure the weight of your loaded pack is balanced both front-to-back and side-to-side. (For tips on loading a pack for the best balance in any situation, see Technique, October 1998.)
If you're really serious about achieving better balance, try tai chi or hatha yoga. One study of senior citizens suggests that the slow, graceful movements of tai chi, an ancient Chinese fitness exercise, significantly improves balance and coordination. Check fitness and community centers for classes in both tai chi and yoga.