If you have ADHD, you might have greater “postural sway,” meaning your body sways more to stay balanced.

Whether you’re standing or sitting, your body is always seeking balance. Even without your conscious effort, your muscles and sensory system constantly work to keep you from falling over.

But if you have attention deficit hyperactivity disorder (ADHD), or another neurodevelopmental disorder, you may have some motor control problems, including balance deficits.

In fact, up to 50% of children with ADHD have motor control problems. One such motor deficit involves postural sway, which disrupts the small movements you make to stay balanced.

Postural sway is a term used to describe the small (usually undetectable) side-to-side movements you subconsciously make to stay balanced on your feet in response to your changing external environment. The process involves your muscles and sensory system working together to keep you upright.

To get an idea of how it works, imagine that you’re trying to maintain your center of gravity on a balance beam — it’s like this, but on a much smaller scale and usually without thinking about it.

In a person with greater postural sway, these movements become more visible. You might see them gently moving side to side or in small circles. This can be an indication of poor coordination and balance.

Greater postural sway can be seen in older people and those with neurodevelopmental conditions, including:

According to a 2009 study, evidence suggests that the cerebellum — a brain region linked to gait, balance control, coordination, and cognition — may be involved in both balance problems and ADHD.

Cerebellum development may be delayed in children and adolescents with ADHD, and research has linked low cerebellar volume with more severe ADHD symptoms in people of all ages.

In a 2015 study, researchers compared the postural sway of 32 adults with ADHD to that of 28 non-ADHD controls on a balance board. The researchers wanted to determine if gray matter volume in the cerebellum was linked to postural sway.

The researchers reported that the ADHD group had 12.4% greater postural sway. Sway did not differ between ADHD-combined type and ADHD-inattentive type. Overall, greater postural sway was associated with reduced gray matter volume in certain parts of the cerebellum.

A 2017 study investigated the association between balance and cerebellar functioning in children with ADHD. A total of 62 children with ADHD and 62 typically developing children participated in five tests using the Phyaction Balance Board, an electronic balancing platform.

The findings showed that children with ADHD performed more poorly on balancing tasks with significantly greater sway than typically developing children.

The researchers found that balancing deficits and impaired ability to think were both tied to a common cerebellar dysfunction in children with ADHD.

And in a 2009 study, children with ADHD showed mild balance impairments similar to children with cerebellar lesions. This further supports the role of cerebellar dysfunction in ADHD balance deficits.

Are ADHD and clumsiness connected?

Many children with ADHD also have developmental coordination disorder (DCD), also called dyspraxia. This condition affects physical coordination, causing the person to appear more “clumsy.”

Some evidence suggests that at least 50% of children with inattentive-type ADHD have DCD, and that 50% of children with DCD also have an ADHD diagnosis.

In addition, research has linked adult ADHD with hospital admission from accidents, and many of these individuals were referred to as “clumsy.” While the reasons for these accidents are unknown, poor balance control combined with ADHD impulsivity and inattention could potentially play a role.

Exercises that help improve self-motion and balance might be helpful for postural sway.

In particular, balance board training is gaining in popularity. Balance boards help stimulate the cerebellum, and thus can address certain ADHD symptoms.

In a 2020 study, children with ADHD who performed balance training three times a week for 7 weeks significantly improved in both static and dynamic balance. The study authors conclude that the training may have helped boost cerebellum function.

Balance board training may also enhance cognition. Research on healthy adults found that it can improve memory and spatial cognition.

In addition, the stimulant medication typically used to treat ADHD may help with postural sway. Research from 2016 shows that treatment with methylphenidate (Ritalin) can improve postural performance in children with ADHD due to its effects on the cerebellum.

It may be helpful to speak with a qualified healthcare professional before starting new exercises for postural sway.

Here are a few of the most well-established online resources for ADHD:

  • American Academy of Child & Adolescent Psychiatry. This site includes FAQs, treatment resources, Facts for Families, clinical resources, video clips, and more.
  • CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). This site offers extensive information for adults with ADHD, parents of children with ADHD, and professionals who treat clients with ADHD. It also includes a resource directory.
  • Additude Magazine offers an extensive library of ADHD content.
  • ADDA (Attention Deficit Disorder Association) provides extensive information and a list of support groups for ADHD.

Postural sway refers to your body’s horizontal balance-seeking movements. This involves your muscles and sensory system working together to keep you upright.

Greater postural sway can indicate balancing problems and is commonly seen in people with neurodevelopmental disorders, such as ADHD, autism, and dyslexia. This may be due to abnormalities in the cerebellum, a brain region linked to gait, balance control, and cognition.

If you or your child have ADHD and greater postural sway, discuss your options with a qualified healthcare professional. Some treatment options may include balance board training or ADHD stimulant medication.