Falling Down Can Be A Big Deal

In Canada, falls are the leading cause of injury-related hospitalizations and injury deaths among people aged 65 or older.

According to the World Health Organization, about a third of older adults fall each year.

Injuries from falls reduce older adults’ quality of life, increase caregiver demands, and precipitate admissions into long-term care. The cost of treating fall-related injuries is high.

These are sobering statistics and have serious outcomes. I have had numerous conversations with older folk who admit that they avoid getting down on the floor because of difficulty with getting back up or fears of not being able to get back up. Consider an unpredicted fall that could have an accompanying fracture, the outcome is weighty indeed.

As a responder I have attended calls to assist an individual who needed urgent care after a fall. Some had even spent prolonged time on the floor (hours to days) before being discovered in need of help. 

While we would hate to hear that a loved one has suffered such an injury, most of us know or know of someone who has had a fall injury. 

While it may not be possible to achieve a 0% fall injury stat there are ways we can reduce the occurrence and potential damaging outcome. 

This post will discuss some important elements of addressing falling risks and solutions. If you would like a more hands-on experience with the topic, we will be hosting a Fall Prevention Workshop at Stone Brook Strength on Friday March 14 from 2:30-4pm. Attendance will be capped at 12 participants so register as soon as possible to save your spot. 

Now, let’s look at 3 ways to tackle this issue: prevention, practice and training.

To start, the most short-term consideration is avoiding a preventable fall from happening in the first place. This involves taking measures in our immediate environment which are under our control. Look around the rooms in our homes. Find and correct trip hazards like stray cords and area rugs. Make sure staircase railings are in good repair and keep walkways clear and dry. Even proper lighting helps and having nightlights in hallways and bathrooms can help us be more sure-footed. An ounce of prevention is worth a pound of cure definitely applies here!

Next up is building confidence with both getting up and down and that calls for practice. Putting the work stress on the body to get down and up with control actually conditions the body for the task. There is a saying – the body becomes its function, so to have a body that won’t get stuck on the floor means we need to keep these ups and downs a regular practice. Find a place in your home that is relatively clear and accommodating to weathered knees and other joints, a carpeted room or get an exercise mat. We don’t necessarily get to choose where we fall, but knowing your body’s ability to move through different positions in training makes it easier to apply that knowledge elsewhere. At first you may need to practice close to some stable furniture, like a couch or coffee table, to give additional support. That’s OK, we likely will have something nearby if we fall indoors. 

When you are lying down practice performing a “system check” by moving each of your limbs to get a sense of normal function. In a fall, it is possible to have a break and that will affect your ability to support  yourself and stand. It’s important to know what normal feels like, to then identify if something is not normal. In the event of an actual fall, you will want to do this “system check” before attempting to get up, and also note your surroundings to become aware of any additional hazards. 

It is helpful to think of getting up as a series of smaller movements – going from one stable position to the next. This may look like rolling onto your dominant side so that you can put an arm or knee into a position to support your weight before moving into the next position. Or bracing on a coffee table or couch so you don’t have to lift your entire bodyweight at one time. 

Practice may feel difficult at first, but as your reps accumulate over time you should start to notice it getting a bit easier. This is your body getting stronger to the physical demand you are placing on it, which is what we want. Note: don’t overdo your practice reps, you are better off doing only a couple every day instead of doing, say 20 at once, and then being too sore to move properly for the next few days. 

The third consideration is training. Specifically resistance strength training. This approach has short term benefits but a longer-term adaptation is how it strengthens the muscles and especially the bones. We want the bones to be more resistant to breaking in the event of a fall. There is no quick fix for this. The best way to counter fragility in the bones (osteopenia) is to make them more dense. And that comes from making them resist stress that is more than what they normally experience daily. Everyone needs to lift weights 2-3 times/week, and this is even more important as we get older. 

Let me put it this way, we must train now for the movements we want to keep and do later in life. 

Learning how to use dumbbells and barbells while sitting/standing, picking objects up from the floor/setting them down, reaching up and pulling down, this is time well spent because these motions carry over into all the physical movements we do. And the repeated exposure is what builds up that bone density to make them more robust and injury resistant. 

I have seen recommendations for taking up jogging, dancing, pickleball, etc, and while those could be fun options they also don’t have an intensity gradient. By this I mean, you are either jogging or you are not, you are either playing pickleball or you are not. It is harder to moderate building up to the intensity for a very detrained person, but strength training is very simply customized and progressive to the individual’s starting abilities. You start light and build up from there. And, you will be better at playing or performing those other activities when you are stronger.
If you would like to attend our Fall Prevention workshop on Friday March 14 2:30-4pm, register HERE. Space is limited, cost is $45, SBS members $30.