Each year, more than one in four adults aged 65 years and older experience a fall - the leading cause of fatal and serious injuries for older adults. And falling once, doubles your risk of falling again within the same year. Most falls, about 75%, happen in or around our home. Tripping and falling due to throw rugs or loose carpeting cause about 5,000 emergency room visits per year. A few other reasons for falls are wet and uneven surfaces such as defective sidewalks, weather conditions, improper footwear, sedentary behaviors, mobility limitations, visual, vestibular, and cognitive impairments. Most falls are due to a combination of factors and the more risk factors or environmental conditions a person has, the greater their chances of falling.
The most common strategy for reducing the risk of falls is an exercise program that includes strength, flexibility, balance, and gait training. A program that includes these types of activities has been shown to be successful in reducing the risk of falling, but we may still experience a fall. Are there ways to train to recover from a slip or trip? Yes! We can train the body to implement certain recovery strategies so that if we find ourselves tripping over an uneven sidewalk we will know how to recover and prevent the fall from happening.
When we work to recover from an unexpected disturbance in our balance such as a slip or trip, we typically choose one of four balance reactions: ankle, hip, step, or reach and grab strategies. The ankle strategy is the body’s first line of defense against falls. The ankle strategy is made up of coordinated contractions of muscles around the ankle to oppose center of mass (COM) deviations. For example, if the body sways backward, muscles on the front of the ankle contract to pull the COM forward. Conversely, if the sway is forward, muscles on back of ankle contract and pull the COM backward. If the balance challenge is greater than what the ankle strategy can handle then we move into the hip strategy. The hips will move in the opposite direction of the balance disturbance such that a loss of balance going backwards results in the hips quickly extending and creating a back-bending movement. At the same time, the arms quickly elevate up and forward. The result looks like a limbo motion when ducking under a bar, only much faster. If the balance disturbance is large then a stepping strategy is the body’s best line of defense against a fall. As the name indicates, stepping strategies occur when you take a step (or two) to prevent falling. The goal is to change the position of the feet, establish a new base of support, and steady the body. The last line of defense against falls is the reaching/grabbing strategy. This strategy is defined by reaching out and trying to grab anything nearby to keep from falling down. Older adults may attempt this strategy but they may not have the strength or flexibility to complete the movement.
We can train the body to become more proficient at using balance recovery strategies. For example, we can practice body sways where we lean forward and backward from the ankles. To train for the hip strategy, we practice hip extension and hip flexion activities. Stepping strategies include learning how to take quick steps after a large lean either forward or backward. Stepping strategies are best accomplished with the help of a trained fitness professional. If you are a Garage Girls Fitness member, check out this month’s session on Slip and Trip Resisting Exercises for balance recovery strategy activities