The CDC reports millions of American adults fall each year leading to millions of Emergency Department visits and hospital admissions. Unknown to many people these falls result in close to 1 million deaths each year. The most common injuries sustained in a fall include traumatic brain injuries and hip fractures. We also know these numbers are likely lower than true estimates due to only half of all adults reporting their falls to their primary care provider.
The single greatest risk factor for a fall is having a previous fall. Researchers report you are twice as likely to sustain a second fall after falling the first time. The reasons contributing to falls are multifactorial and significant individual differences are found including environmental (poor lighting, throw rugs/obstacles, uneven surfaces), physical (vision, strength, and balance impairments), and medical (diseases, medications, disorders). One of the most important areas of consideration after receiving medical care for the 1st fall is to determine why the fall occurred in the first place.
Below are 3 common areas of improvement for individuals at risk of falls. This list is non specific and patients are encouraged to work with their healthcare provider on an individualized treatment plan as a first step.
- Stability – All humans, regardless of age, will lose their balance. In short, falls occur when our center of mass (belt buckle) moves beyond our base (foot position). More stability is found with a wider and lower stance and stability decreases as we move toward a smaller base in single leg stance. Adults at risk of falls must train their bodies to maintain their center of mass over their base to reduce the risk of instability. Many balance exercises are available to challenge the nervous system under various conditions including narrow stances, unstable surfaces, and challenging visual environments.
- Recovery From A Loss Of Balance – One of the key differentiators of those who fall and those who stay upright is the ability to recover from the loss of balance above. The ability to right the ship if you will comes down to movement strategies, such as taking a step, and the force AND speed of the muscle contraction. As adults age they are at an increased risk of weakness due to detraining and muscle atrophy (sarcopenia). Individuals who do not strengthen their muscles are at a higher risk of falls because when instability occurs they are unable to return their center of mass over their base. This correction requires significant muscle strength and speed (power) which can be regained through a strength training program.
- Learn How To Take A Fall – A growing area of research is focusing on teaching older adults to take a fall properly. Watch a high level gymnast, martial artist, or extreme sports athlete take a fall. The strategies they utilize to reduce injury risk when they take fall can be taught to older adults in a safe environment. Landing strategies such as rolling may reduce injury risk during a fall. Classes typically involve falling onto soft surfaces and height progressions, with and without harnesses, may allow individuals to reduce their injury risk if they lose their balance and are unable to regain stability.
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