CONTRIBUTING FACTORS FOR FALLS
First let's examine the type of exercise that improves balance. Here are some general exercise goals, each of which improves stability and balance:
- Improve the strength and flexibility of the legs and feet: Make your foot and ankle joints moveable Stretch the back of the legs and strengthen the thigh muscles (quadriceps).
- Increase core strength: Increase the strength of the abdominals, pelvic floor muscles, gluteals and upper back muscles (rhomboids). Stretch the front of the rib cage.
- Release tension in the lower and upper spine and stretch the spine. Release tension in the lower back by releasing in the hip joints. Stretch the muscles behind the shoulders and neck (trapezius).
- Practice balance using standing balance exercise like safely standing on one foot while holding onto something.
- Improve eye/muscle coordination: Practice focusing your eyes wherever you are facing.
Factors that are common to many falls:
- Environmental hazards are present: No matter where we live or where we are going, there are always environmental hazards in our midst. Some we can get rid of, like screws sticking up through the threshold of our doorway or slippery scatter rugs. But many hazards are beyond our control.
- Shuffling your feet: I believe that the huge majority of falls include the terrible habit of not picking your feet up. Here is one example: Someone called to me as I was crossing a parking lot. I turned my head but did not stop moving. I did not see the pothole coming up. My foot caught it and I fell because I was also shuffling my feet. Even though there were major reasons for becoming disoriented, the only reason that mattered was shuffling my feet. If I had been picking them up I would not have fallen. Stop Shuffling Your Feet.
- Not looking where you are going: Never look away from the direction you are moving in. Learn to walk by looking ahead instead of looking down. This is not easy with all the environment hazards in our midst. I suggest that you examine the path you are about to travel to see if there is difficult terrain ahead. Stop periodically to do this. Then walk with your back straight while looking where you are going. Use your peripheral vision to help identify obstacles. Do not walk and talk at the same time. This is especially important when walking with a caregiver or friend. Walking is not a time to socialize. Where to Look When You Walk.
- Sudden occurrences: Be prepared for something happening suddenly like a loud noise, someone bumping into you or other unforeseen events. The lower your center of gravity and the more you pick your feet up the easier it is to step aside to avoid the fall.
- Wearing loose shoes or poorly fitting clothes: If something sudden happens and your shoes are loose because they are flip-flops or slippers, the likelihood is that you will stumble and probably fall. Never wear backless shoes. In one study, 50% of all fall related hip fractures happened to people who were wearing slippers or slip-ons at the time of the fall.
- Becoming destabilized whether from dizziness or disorientation: There are many causes for loosing your orientation: standing up too quickly, turning your head, looking up or looking down, bending over and many others. 2 sure ways to improve your stability are to focus your eyes wherever you are facing and pull your abdominals in. Either or both will help you regain your center and are fantastic tools to use to prevent a fall from occurring. Getting Suddenly Dizzy.
- Not holding on when you should: Whenever you do something risky, like look up to see the Sonoma County Air Show or to get something from the top shelf in your closet, make sure to hold onto a steady object first. This is especially true in the closet, one of the most dangerous places in the house. Also, do not test yourself if you are feeling unstable. Hold on and exercise safely instead of seeing if you can do what you used to be able to do without assistance. Test yourself only in a safe environment, using a chair or guardrails for support.
- Using canes or walkers improperly: I am actually flabbergasted at how many people use their walkers incorrectly. Most people do not put their brakes on before sitting or standing. The walker can easily dangerously slip away from you as you place your weight on the handlebars. Even though I teach people many times how to properly do this, invariably they forget to. Canes placed too close to your feet can become a contributing factor for a fall. As one student was entering my class, someone greeted her, she looked up to see who, lost her orientation, tried to pick her feet up to regain her balance but ended up tripping over her cane because it was too close to her feet. If her cane was placed correctly she would not have fallen, even though the other risky factors took place.
- Rushing: THE ONLY TIME YOU SHOULD RUSH IS IF SOMETHING IS URGENT, like your home is on fire. Do not rush for ANY other reason.
- Not listening to the voice inside our head that tells us not to do something. Perhaps you are reaching further than normal to pick something up or maybe we are rushing when we shouldn't. ALWAYS LISTEN WHEN YOUR BETTER JUDGEMENT TELLS YOU NOT TO DO SOMETHING.
Let's examine a few typical falls:
- Environmental hazards are present: Parking lots are dangerous places that are often not as well maintained as sidewalks.
- You no longer are looking in the direction you are walking: You turned you head.
- You are shuffling your feet.
Example 2: You are walking down the sidewalk. You keep your feet close to the ground because you are fearful. You look at the ground because there may be cracks in the sidewalk. A tree branch blows down right in front of you. You trip and fall.
- Environmental hazards are present: There are plenty of cracks and tree roots and uneven surfaces around.
- You no longer are looking in the direction you are walking: You are looking down instead of out ahead.
- You are shuffling your feet.
- Something sudden happens: The tree branch appears out of nowhere.
Example 3: You go to reach for something on the top shelf of your closet. You get dizzy and trip over some shoes on the floor of your closet. You fall over backwards.
- Environment hazards are present: The closet is one of the most dangerous places in your home. In this case there is clutter on the floor of your closet.
- You look up and get disoriented.
- You are not holding onto something solid.
Example 4: You are in your bathroom and there is some water on the floor. You throw down a towel to mop up the water. You become unstable and fall.
- Environmental hazards are present: The bathroom is the most dangerous room in your home. It is a good thing that you are mopping up the water on the floor. It is a good thing that you throw a towel down to do it.
- You stand on one foot while you mop up the water with your other foot.
- You are not holding onto something. (ALWAYS hold onto something while standing on one foot in the bathroom, as you get into and out of the shower or tub for instance.)
There are so many other ways to prevent falls from happening. I have written about this quite a bit. Be sure to look for my other articles on the subject on the Balance News page of my website www.building-better-balance.com.