By: Nathan, DPT

Have you ever put a box down and turned around only to trip over that very box? How about having a child or pet dart underfoot causing you to face-plant! I know everyone has slipped and fallen on ice at some point in their lives (usually in front of a non-symapthetic friend who's ready with zinger). According to the CDC, "more than one in four older adults aged 65 and older will fall...falls are the number one cause of injuries and death from injury. This represents 29 million falls, 3 million emergency department visits, 800,000 hospitalizations, and 28,000 deaths."¹ Now not every falls results in injury, usually only a bruised ego, but as we get older you can definitely see that a small trip can lead to severe injury.

Well, that's depressing, am I destined to fall, break a hip, and spend my well-earned retirement complaining about the weather making my "joints act up", Nathan? Glad you asked, imaginary reader in my head. The answer is a definitive NO! You don't have to live in fear of falling, and the solution isn't some antigravity belt or covering youself in bubble wrap. Physical therapy offers many interventions and training that can make you less likely to fall and improve your gait on all surfaces.

The first step (no pun intended) in fall prevention is understanding why we fall. The environment you walk in can make it difficult to maintain your balance. Like I mentioned in the intro when I was trying to grab your attention, a cluttered environment, moving obstacles, and unstable footing can all contribute to a fall. In physical therapy we can give you an objective evaluation of your home set up and offer suggestions to decrease your risk. Bear skin rug in the den, get rid of it, you're not Burt Reynolds. Tub-shower in the master bath, how 'bout some grab bars or maybe it's time to give Bath Fitter a call and get one of those nice walk-ins. Adaptive equipment like grab bars and toilet risers can navigating the bathroom infinitely easier. Physical therapists have all sorts of tricks to make it easier to get around your home and age in place.

Now before you use this as excuse to get rid of ugly runner in the hallway that your spouse bought, there are also many physical attributes that can lead to a fall. Static balance and dynamic movement are two incredibly complex systems that are too complicated to outline in short sarcastic article, but those nerdy details are what physical therapists love. Arousal (just woke up?), attention (checking the DMs on your cell phone while walking), and cognition (ahem, too many adult beverages) deficits limit your ability to adapt to your environment as you head from your bed to the bathroom for your 4 a.m. potty break. I've told many of my patients, "We are great at compensating for (or ignoring) bad body mechanics". Your gait pattern changes as you age and it happens so slowly that we rarely notice until someone points out that you are walking like John Wayne. Physical therapists evaluate all of these systems when we do your initial evaluation and we track your progress utilizing standardized balance tests like Tinetti, Berg, or timed up and go (TUG). Fun fact: If you come up with a battery of tests that can show statistical improvement in balance you can name it after yourself, no matter how stupid your last name is.

I know I'm being pretty flippant and jokey (see previous sentence) about a serious subject, but sometimes you need to be silly in order to get people to focus on a boring subject. If you haven't been convinced about the importance of balance by the numbers in the first paragraph, then think about the cold cash cost of falls, "Older adult falls result in more than $31 billion in annual Medicare costs"¹. If you have been convinced about the seriousness of falls you may want to consider taking a look at your environmnet and be evaluated by a physical therapist to see if there are areas that could be improved. Well that's it for me and this subject; if you are interested in learning more about balance and how physical therapists help, like or reply, because I can talk about this subject till the cows come home.

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¹ Taking a Stand on Falls, Centers for Disease Control and Prevention. https://www.cdc.gov/features/older-adult-falls/index.html. Updated September 22, 2017. Accessed May 18, 2020.