The Therapist Is In...Falling Back and Springing Forward

Falling Back and Springing Forward
A primer on preventing falls and improving balance in seniors
by Shannon Murphy, MPT

Anyone can fall at any age - we have all been victims of a clumsy moment here and there. In most cases, people pick themselves up with little injury beyond pride. As we age, however, our balance often declines, leading to an increased likelihood of falling.
As bodies age, they become less resilient and more prone to disease. Sometimes unsteadiness is related to medical problems like diabetes that interfere with normal feeling in the feet, or neurological disorders like Parkinson's that change the way people move. But most of the time, balance problems develop as a combination of systems grow older - we need sharp eyes, ears, and motion receptors to perceive the constantly changing conditions around us. We also need quick reflexes, smooth joints and strong muscles to react to those changes. It is normal for those systems to get a bit rusty over time, but having small problems develop across multiple areas can create big problems for balance.
A Safer & Softer Home
The risk of fracture, head injury, or other serious complication increases significantly after reaching age 65, and over 70% of falls happen in the home. Since environment is half the battle, there are a number of steps that seniors should take to safeguard their surroundings:
* Keep homes well-lit-- with nightlights in the bedroom, bathroom and hallways
* Keep floors uncluttered - secure rugs, move cords, and find storage for non-essential items
* Keep pets away from feet - if unable to train them, create pet-free areas with gates
* Install railings - along any indoor/outdoor steps, and in bathrooms
* Use color - mark steps and paint walls to improve contrast between surfaces
* Limit sharp edges - replace glass furniture and pad sharp corners
Use It or Lose It
The other half of the battle is physical. While the body may age against our wishes, it remains an amazing machine. Even at advanced age, all systems improve with training-- but movement is essential. Sedentary lifestyles dull the mind, slow the body, and increase the chance of sustaining an injury that will even further limit mobility. That downward spiral can be fatal, whether directly related to a fall or to some later consequence. Fortunately, an upward spiral of health and vitality can be created if problems are caught early. Five of the most common culprits seen in clinical practice include:
* Stiff ankles
* Weak 'core' muscles
* Delayed reflexes
* Inefficient postural strategies
* Sluggish "position awareness" in the feet and legs
When ankles lack flexibility, they become ineffective in keeping center of gravity - well, centered. When trunk muscles grow weak, the body loses a stable foundation for movement. When reflexes slow down to "dial-up speed", the body fails to react in time - and when position receptors (known as "propioceptors") lose sensitivity, the body doesn't even realize it should be reacting in the first place. When people add a few bad habits to the mix (reaching for items too far away, looking down while walking, etc), it doesn't take much to trip the threshold for falling.
The good news is that exercise helps! Coupled with sensible shoes, routine vision exams, a healthy diet, and regular medical check ups (particularly important for reviewing medication side effects and evaluating candidacy for Vitamin D supplementation), movement is a key ingredient in the recipe for a steady life. For more information on falls prevention, home safety and exercise -- talk to your physical therapist.

This series of columns are by Shannon Murphy, MPT, Owner/Director of BodySense PT. 9 Saint Paul St, 3rd Floor, Boonsboro, MD 21713. 301-432-8585 phone, 301-432-1987 fax,