Fall Prevention & Balance

Perhaps you’ve been diagnosed with low bone density, and avoiding falls is critical to preventing fractures. If you’ve fall-proofed your home, you must also be aware of hazards outside the home. I’ll offer a few tips to avoid falls in various settings outside the home, and I’ll conclude with the importance of balance training and a few tips to help you be steady.

Parks and Playgrounds

Are you headed out for a walk or hike in a park? Your health and safety are of utmost importance. Watch for uneven terrain. Areas to watch for include spots where two types of terrain meet, like a mulchy playground and a walking path. Ensure your footwear is appropriate, such as sneakers or hiking shoes.  If you need a little extra stability, I’m a big fan of hiking/trekking poles.  They not only help with balance but when you use them to propel yourself forward, they integrate upper body strength, a plus!

Public Staircases

Use extra caution on stairs as they might be a different depth and width from the stairs you are used to at home. My number one tip-hold the handrail!   I tore my rotator cuff falling on icy stairs in NY while NOT holding onto a handrail.  My daughter fractured her leg bone when she slipped on our stairs during our remodel when no handrail was present.  Lesson learned.  ALWAYS hold the handrail.

Public Bathrooms

These are notorious for having wet, slippery surfaces that could cause you to slip and fall. In addition, public restrooms often have poor lighting.  Enter with caution and have your phone handy in case you need to call for help.  When available, use the handicapped stall, which has grab bars and a higher toilet.

Stores

Stores often have slippery, smooth floors. When shopping, wear shoes with nonslip treads (especially on a rainy or snowy day).  If you have balance challenges, grab a cart. It will provide support and stability. My mom, at 94 y/o is quick to grab a cart when shopping.  It gives her a sense of security.  If you need to reach for items on a shelf, stand with one foot forward and one foot back at hip-width distance for better stability, or just ask for help!

Consider the weather and how it affects your fall risk

Preparing for the weather before leaving home is an important part of protecting yourself from falls.  As we enter the summer, it can be sunny and hot, making dehydration and overheating a risk. Feeling dizzy from those conditions can make you susceptible to falling.  Wear a hat and keep a water bottle handy to stay hydrated.

Conversely, if it’s rainy or icy, ensure you have the right treaded foot gear to decrease your risk of slipping and falling.

Stop moving before using your cell phone

If you’re looking at your cell phone, you will be distracted, and distractions often lead to falls.    Whether it’s stubbing your toe on an uneven piece of sidewalk, or missing the wet spot in a public restroom, stopping before you look at or talk on your phone is a good rule of thumb!

The Importance of Balance

No matter where your life takes you outside your home, balance training will better equip you to navigate unexpected fall hazards.  Strengthening your hips, legs, and core is one of the best things you can do for your balance.

Your vision, vestibular health (inner ear), and proprioception (sense of where your joints and feet are in space) are also essential for balance.

Ensure your regular exercise routine includes sit-to-stand exercises that strengthen your core and hips. Here, I demonstrate sit-to-stand using a dowel (or any stick you have at home) as an alignment tool. Ideally, you want the back of your head, shoulders and bottom to be in contact with the dowel. Additional exercises such as lunges, leg lifts in all directions, and single-leg balance are helpful. Standing on one leg for 38 seconds is considered “excellent.”  Not being able to stand on one leg for 10 seconds is indicative of a fall risk.

Want an easy way to incorporate some single-leg balance exercises into your day? Stand on one leg for a minute as you brush your top teeth, and stand on the other leg for the bottom teeth. Do that twice a day, and you’ll have four minutes of balance training seamlessly woven into a task you already do every day. You can also balance on a concrete ball in Barcelona, but I wouldn’t suggest starting there!

A final word about upper body strength and balance. 

Although it seems unrelated, having the arm, shoulder girdle, and core strength to “catch yourself” should you slip could mean the difference between a hip or knee injury and walking away intact and injury-free. A great way to train this is with the “Knees Off” exercise, which I teach in all my classes.  While on all fours, spine in neutral, just lift your knees off an inch or two and hold for 10-30 seconds.  I’m using the BoneSmart inflatable core ball here between my knees to activate my inner thigh muscles and deep core and to ensure good hip and knee alignment. This exercise builds core, hip, shoulder, and spine strength. A reminder that if you have low bone density, your spine, hips, and wrists are most vulnerable to fracture when falling.

An extra bonus with the “knees off” exercise is that the weight bearing on your wrists helps build bone there.

In conclusion, when you leave your home, heighten your awareness of your surroundings and how you’re adapting to keep safe.  Research indicates that a fear of falling is a big risk factor for falling.  Do all you can to strengthen your body and improve your balance. A stronger, steadier body will increase your confidence, especially when you’re out and about in the world.