Ashes, Ashes, We All Fall Down

It is not uncommon to see little (and not-so-little) children fall down. While they may cry for a little bit, most of the time there are only minor “boo-boos.” As we age, however, falling can become a much more serious matter. About 36 million people over the age of 65 report falling each year with 3 million resulting in trips to the Emergency Room. Falls can result in fractures, sprains, bruises, or worse; the healing process for older adults is longer and more arduous than in our younger years.

An article in June, 2023 issue of AARP Bulletin, “How the Pros Fall Safely,” discusses the best way to avoid injury when we are going down. The article is not on-line yet, but it is worth getting a copy of the print edition. There are different strategies depending on whether it is a sideways, forward, or backward fall.

In a sideways fall, bend the knees, tuck in the chin, and lift the head. Keep arms close to the chest and go limp; collapse onto the outside of your bottom thigh, then roll backwards onto the torso and upper back. This protects the head from injury, keeps hands and wrists from breaking, and results in landing on the most padded part of the body, safeguarding the hip.

In a backward fall, stumble backward (rather than just going straight back) while tucking in the chin into the chest and trying to get the body (especially the rear end) close to the ground. Bend the knees into a deep squat so you land on your rear end. Round the spine and roll onto the back and shoulders. Keep your arms at your sides. As in the sideways fall, fragile bones are protected while landing on a padded area of the body.

In a forward fall, go limp, bend the knees to one side, tuck the chin into the chest, keeping the head tilted away from the ground. Try to land on the outside of the thigh. When you hit the ground, keep the momentum going and role onto the side of your torso and upper back. Try to curl your body as much as possible. Again, bones are more protected this way.

Once you are on the ground, do not get up immediately, but rather assess the situation. It is natural to want to pop right up to avoid embarassment, but if there is a broken bone this can make things worse.

As a personal trainer for older adults, I spend a fair amount of time and energy with clients trying to prevent falls. If one should happen, though, these simple pointers can make a difference: “relax, go limp,” tuck the chin in and keep the head off the ground, land where the most padding is.

Be careful out there!

Balance and Longevity

Can you balance on one foot for 10 seconds? Aging adults recognize that as we get older we may experience muscle loss, decreased stamina, and issues with flexibility; balance, however, usually remains unaffected into our fifties and then begins to deteriorate with some rapidity after that. A test of balance that I often use with clients–and this is fairly standard in the fitness world–is a single-leg stance, also known as balancing on one foot. My goals is to get my clients to be able to balance on each foot for 30 seconds; for many of my clients this may never be attainable, but we work our way up as much as we can.

Past research has shown that those who can balance for longer periods of time on one foot are much less likely to experience falls. For older adults, falls can have especially serious consequences as healing takes longer and inactivity takes a greater toll. Falls can also lead to a loss of independence.

The results of a new study published in the British Journal of Sports Medicine suggests that the inability to balance for 10 seconds is linked to nearly double the risk of death from any cause within the next decade. In other words, if you can balance on one foot for 10 seconds you cut your chances of dying in half over then next ten years. A recent article on cnn.com discusses the results. Previous research had linked the inability to balance with fall risk and cognitive decline, but never before with longevity. Of course, the ability to balance may be affected by a number of other health factors; those who failed the test were more likely to be obese, have heart disease, high blood pressure, and type 2 diabetes.

The study does not reach any conclusions about causality. If you practice every day and are able to balance for 10 seconds, does that mean that your longevity will automatically increase? More research will be needed to determine this. More likely, those who are in a normal weight range, have blood pressure and blood sugar under control, and have healthy hearts may engage in more healthy patterns of diet, exercise, and rest. Those who take better care of themselves may therefore be better able to balance on one foot and also live longer. Causality is not yet determined, only linkage.

What does this mean for us? Try the test and see if you are able…or if you are even close; always perform this test near a piece of furniture or kitchen counter, or with someone nearby, rather than in the middle of an empty room in case you fall. If you are unable to pass the test, it may be worthwhile to talk with a medical profession about ways to improve health outcomes. In the meantime, it could not hurt to practice balancing, eat right, exercise, and get plenty of rest; these all contribute to longevity and great enjoyment during those years.

I’ve Fallen and I Can’t Get Up…Or…

One of my top clients was so excited to bring in an article from yesterday’s (June 5, 2019) New York Times, “Rate of Death From a Fall Is Increasing Rapidly for Americans over 75,” by Katie Hafner. Here is the link: https://www.nytimes.com/2019/06/04/health/falls-elderly-prevention-deaths.html .

Let me start out by stating that while I am not a doctor, my many years working as a congregational rabbi and doing hospital visits has taught me a thing or two. In particular, I have seen first-hand that falls are a huge problem for older Americans. There is more than just the physical trauma too. A fall can make a person anxious about falling again so they go out less. Going out less leads to social isolation, can contribute to poor nutrition (ordering in rather than going to a store to get “real” food), and a general decline in conditions.

A new study out by the Journal of American Medicine shows that the rate of death from falls for those over 75 is going up at an alarming rate. There are a number of factors that explain this, but chief among them is that folks are surviving other conditions that might previously have ended their lives; the more we age and the longer we live, the higher a role falls plays in morbidity.

Part of my training as a Functional Aging Specialist allows me to better detect when a person is at a higher risk for a fall. My training has also taught me how to work to mitigate the risk. With some of my clients, this is a huge part of what we do–simply learning not to fall, and what to do if it does happen.

The article suggest that there are a number of factors that can help prevent falls: exercise, being aware of medications and the effect they can have on balance, the clothes and accessories we are wearing (bifocals and high heels are both culprits), tidying up to get rid of tripping hazards, and staying hydrated.

Falls are not inevitable. They can be prevented. When they are, they allow older adults to live longer, more independent and joyful lives. As we age, we need to be cognizant of this possibility and take the steps to make our golden years fall-free.