I find that I’m tripping more often in the last couple of years. No change in strength, but I’m not paying as much attention to where I’m walking. Duh! No falls, but trips yes. A trip is when you lose your balance and stumble, but don’t end up on the ground. A fall is when you end up on the floor. Minor difference in definition, big difference in real life. Here are some disturbing facts about falls:
- One in five falls causes serious injury.
- The fear of falling can limit activity more than an injury from a fall.
- 74 older adults die every day due to an injurious fall.
- Falls are the #1 cause of death from injury in older Americans.
- Most people who fall don’t tell their doctor.
- 60% of people who fall are women.
- Approximately $50 billion is spent on medical costs due to non-fatal fall injuries per year in the US.
In the US, $754 billion in spent in medical costs associated with fatal falls per year. You just gasped, didn’t you? I know! Those facts and figures are horrifying! So what can we do to prevent a fall injury? Let’s start by talking about why people might fall and then what we can do about it. There are many reasons why people might fall, but there are three general categories:
- Health related risk factors: These are risk factors associated with your physical health. This can be balance issues, muscle weakness, inner ear dysfunction, vision problems, medication side effects, reflexes, chronic illness (heart disease, Diabetes, Thyroid problems), changes in blood pressure when standing up, etc.
- Environmental related risk factors: These are risk factors associated with your living environment. This can include home hazards (throw rugs, cords on the floor, stairs, clutter, etc.), outside hazards (pot holes, uneven surfaces, snow, ice, puddles, etc.), and your shoes (high heels, slip-ons, slippers, etc.).
- Triggers: These are things that will require you to react quickly, i.e. your dog pulls on the leash suddenly, blood pressure drops quickly & you get light headed, etc.
As you can see, there are many reasons someone might fall. Some risk factors are modifiable and others are not. Triggers are not modifiable because you can’t predict a sudden movement pattern. You just have to be strong and powerful enough to sustain one when it happens (thus, our training). Health & environmental related risk factors can be modified. This is good news because we can work on them to help reduce the risk of falling. So let’s talk about how you can reduce your risk factors.
- Exercise: That’s kind of a no-brainer, but not everyone exercises. Improving muscle strength and power can reduce a fall related to a trip and can reduce trips all together. With improvements in strength and proper muscle integration (like we do in class), your balance improves. Tai Chi has also been shown to be tremendously beneficial to reducing fall risk.
- Stay healthy: Staying healthy decreases your need for medications that might impair your balance & increase fall risk. It also reduces your risk for chronic illnesses that impair balance.
- Get adequate sleep: When you are sleepy, you might shuffle your feet from being tired. Getting enough sleep improves your ability to walk with vigor.
- Decrease alcohol consumption: Alcohol can decrease balance and your reflexes, which increases your fall risk regardless of age.
- Test your vision and hearing regularly: Loss of vision and hearing is associated with increased risk. Wearing the proper correctives (lenses or hearing aids) can help improve your vision and hearing.
- Stand up slowly: Blood pressure can drop quickly if you stand up too fast from a lying or seated position. Move from one position to another slowly.
- Wear proper footwear: High heels, although fashionable in some areas, are risky. Because of your foot position, your balance is compromised. Wearing flat, rubber soled shoes that you can tie are more stable and fitting to your foot. Avoid slip on shoes or slippers that provide no support.
- Declutter your home: This may mean getting rid of all throw rugs that slip easily. You may also want to move furniture and cords out of your path so you have a clear walkway throughout your home.
- Be aware of your surroundings: This is applicable for all of your life to most any situation, but especially as you age and start to look down more. Walk as upright as possible with eyes forward, yet aware of the ground under your feet. Watch for holes in the grounds, uneven surfaces, an object on the ground, etc.
I am very fond of exercise as a modality to reduce fall risk (obviously). Exercise can improve your health, strength, power, mobility, reaction time, and balance. All of these reduce your fall risk. And if you are in a group exercise class you also have the added bonus of socialization. This makes your brain work more while you are exercising; doing two things at once. When I was in Atlanta doing research we were looking at Tai Chi’s ability to reduce falls. Research has shown since the 1980’s that it works, but we were trying to find out WHY. Every test had been researched except dual tasking (the ability to do two things at once). Is it because Tai Chi is a mind-body exercise (doing two things at once) that it reduces falls? This is what we were researching and found nothing! Nothing could conclusively say what was going on in the body that made people fall less. Current research is looking at brain images while doing Tai Chi to see if it’s something that is going on in the brain that is responsible for the reductions in falls. Super cool research and so far, Tai Chi is the best movement exercise to reduce falls!
If you’re feeling a little wobbly lately, take a look at your environment or your health. Can you modify something? Be proactive right now so you stay strong and healthy – and hopefully don’t fall.