Postural Sway: ADHD, Anxiety, And Their Impact On Balance

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What Postural Sway Means for ADHD and Anxiety

Medically reviewed by Andy Watkins-McCall, MD, MPH — Written by Katey Davidson, MScFN, RD, CPT — Updated on March 25, 2025

What it is
What causes it
With ADHD
Anxiety
How to improve
Takeaway

“Postural sway” is the unconscious, small movements that help you keep balance. People with ADHD and anxiety may have less balance and motor control, aka more postural sway.

Our muscles and brain are both heavily involved in maintaining proper balance and motor function. Essentially, they work as a team to keep us from falling over and help us perform daily activities.

However, staying balanced while standing can be challenging in certain groups of people. In particular, research has found a strong connection between attention deficit hyperactivity disorder (ADHD), anxiety, and increased postural sway.

Though postural sway is a typical part of balance, people who have trouble with balance and motor control may have difficulty standing still. As a result, they may be seen as being “clumsy” or “fidgety.”

What is postural sway?

By definition, postural sway is the horizontal movement around a person’s center of gravity while standing.

A person with greater postural sway will move more while standing. It may look like they’re gently moving from side to side or in small circles, even though their feet are flat on the ground.

Perhaps an easier way to understand postural sway is to feel it for yourself. Stand with your feet hip-distance apart, focus your eyes on something directly in front of you, and close your eyes.

While standing “still,” you will likely feel very small, reflexive movements around your center of gravity — perhaps side to side or front to back — as your body maintains its balance.

What is your center of gravity?

Your center of gravity is the point in your body where your mass is most concentrated.

This hypothetical point shifts and changes as you move, like when lifting your arms overhead or shifting your weight forward or back on your feet.

Anatomically speaking, for a person standing in alignment with their arms at their sides, their center of gravity is right around where their spine meets their pelvis.

Everyone experiences postural sway to some degree.

However, greater postural sway can sometimes indicate poor balance and coordination. It may be related to natural aging, neuromuscular disorders, anxiety, or ADHD.

What causes postural sway?

Our nervous system constantly interprets input received from various sensory systems in the body and adapts accordingly. Our body’s response to sensory input is reflexive, so we aren’t always aware of it.

But to fully understand postural sway, we must broaden our understanding of the senses beyond just the five you learn about in grade school.

Other significant sources of sensory input are considered somatosensory systems. They are:

interoceptive awareness (internal feedback your body sends your brain about how it feels)
the vestibular system (the organ in your inner ear that helps control balance)
proprioception (your body’s spatial awareness relating to its location and movement)

Combined, these sensory bodily systems provide a road map for your brain, helping you navigate, understand, and predict the world around you.

Collectively, the input you receive from all of these systems is called sensory integration. Sometimes, the input coming in from all of the somatosensory systems integrates (connects) cohesively. Other times, however, they misinform each other.

Postural sway is one way our bodies respond to sensory input, and its severity depends on how well the somatosensory systems integrate.

ADHD and postural sway

Research over the past decade has shown a correlation between lack of motor control and ADHD, which may lead to increased postural sway.

In children

ADHD affects approximately 5% of children and up to 50% of those kids experience difficulty with motor control and balance.

Researchers suggest that physical activity programs focusing on balance training and motor control can significantly improve executive function. That’s why it’s recommended as an adjunct therapy for children with ADHD.

In adults

Studies have shown that balance-related challenges associated with ADHD may extend to adulthood.

Many adults with ADHD describe themselves as being “naturally clumsy” or “accident-prone.”

Interestingly, there appears to be a connection between cerebellum volume in the brain and postural sway.

While data shows that one-third of children diagnosed with ADHD retain symptoms into adulthood, many adults do appear to outgrow their ADHD or at least not experience the same type of challenges they faced as children with the disorder.

Anxiety and postural sway

Anxiety has also been linked to increased postural sway in both adults and children.

In children

Though less studied, children with increased anxiety tend to exhibit greater postural sway.

This can have negative effects, such as decreased engagement in physical activity and social interaction with their peers.

To make matters worse, their anxiety may increase in these situations due to fear of judgment or potential injury.

In adults

Anxiety and balance also have a reciprocal relationship for adults, especially for the elderly and adults with motor control issues.

Increased anxiety can potentially lead to issues with greater postural sway. It’s thought that anxiety may lead to balance dysfunction, due to changes in the brain’s ability to regulate balance and motor control.

What’s more, fear of falling or having difficulty with day-to-day activities can lead to worsened anxiety.

Methods to improve postural sway and clumsiness

Because children begin to develop gross motor skills in infancy, developing good somatosensory awareness early on is key in preventing severe postural sway later on.

Several features to look out for in a child with poor postural control and stability are:

slumping while sitting in a chair or standing upright
leaning their head on their hand or desk when writing
leaning on furniture or other people
difficulty with motor activities that require strength (e.g., riding a bike, swimming, walking)
difficulty with balance
fidgeting in their seat and having difficulty paying attention
poor fine motor skills, such as using pencils and scissors
difficulty with dressing skills and other self-care activities, which require a stable posture

Still, even for adults who demonstrate severe postural sway, there are methods to treat the sensory processing challenges that may be part of the root cause.

Since postural sway and balance issues are multifactorial, seeking a healthcare professional for personalized recommendations is best.

Finding a healthcare professional for postural sway

If you or your child are experiencing increased postural sway or other balance-related issues, it’s best to consult a qualified healthcare professional. Ideally, seek out the advice of one or more of the following:

pediatrician or family physician
primary care provider or general practitioner
occupational therapist or physical therapist
child psychologist or behaviorist
other fitness specialists (e.g., personal trainer who specializes in inclusive fitness)

The takeaway

Balance plays an important role in our everyday activities.

Research has shown that those with neurological disorders, such as anxiety and ADHD, may be at an increased risk of poor motor control and balance, which can sometimes manifest as greater postural sway.

If you suspect that you or your child have balance issues, it’s important to work with a trained professional.

They may recommend certain exercises and other therapies to improve strength and coordination and help the body process sensory input efficiently.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

ADHD. (n.d.)https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd
Caldani S, et al. (2023). Motor Capabilities in Children with ADHD Are Improved after Brief Visuopostural Training.https://pmc.ncbi.nlm.nih.gov/articles/PMC10366723/
Cundari M, et al. (2023). Neurocognitive and cerebellar function in ADHD, autism and spinocerebellar ataxia.https://pmc.ncbi.nlm.nih.gov/articles/PMC10321758/
Ellmers TJ, et al. (2021). Consciously processing balance leads to distorted perceptions of instability in older adults.https://pubmed.ncbi.nlm.nih.gov/33141249/
Feldman R, et al. (2019). Gait, balance, mobility and muscle strength in people with anxiety compared to healthy individuals.https://pubmed.ncbi.nlm.nih.gov/31493621/
Ludwig O, et al. (2020). Neuromuscular performance of balance and posture control in childhood and adolescence.https://pmc.ncbi.nlm.nih.gov/articles/PMC7398941/

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Medically reviewed by Andy Watkins-McCall, MD, MPH — Written by Katey Davidson, MScFN, RD, CPT — Updated on March 25, 2025

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Attention Deficit Hyperactivity Disorder

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Treatment

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Types

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Diagnosis

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Support for Caregivers

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What is postural sway?

What is your center of gravity?

What causes postural sway?

ADHD and postural sway

In children

In adults

Anxiety and postural sway

In children

In adults

Methods to improve postural sway and clumsiness

Finding a healthcare professional for postural sway

The takeaway

How we reviewed this article:

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