No one expects to get seriously injured—or even die—from a fall. But it happens all the time. And while older adults are at greatest risk for falls, there are no age requirements for taking a tumble.
Surprising statistic: Even among adults in their 30s, 40s and 50s, falls are the leading cause of nonfatal injuries (more than 3 million each year) that are treated in US hospital emergency departments. For adults age 65 and older, falls are the leading cause of fatal injuries.
Certain “fall hazards” are well known-electrical cords and area rugs…slippery floors…medications such as sleeping pills and blood pressure drugs…vision problems …and even poorly fitting shoes.
What often gets overlooked: Subtle changes in the neuromuscular system (the nervous system and muscles working together), which helps keep us upright. Regardless of your age, exercising and strengthening this system before you get unsteady (or fall) are the best steps you can take to protect your health. Here’s how…
Does your foot or ankle feel a little wobbly when you stand on one leg? Some of that is probably due to diminished strength and flexibility. After about age 40, we begin to lose roughly 1% of our muscle mass every year. As we age, we also become more sedentary and less flexible. These factors make the body less able to adapt to and correct a loss of balance.
The nervous system also gets less sensitive with age. Example: Sensory receptors known as proprioceptors are found in the nerve endings of muscles, tendons, joints and the inner ear. These receptors make us aware of our bodies in space (proprioception) and can detect even the slightest variations in body positions and movements. But they don’t work well in people who don’t exercise them (see suggestions below)—and these people find it harder to keep their balance.
The other danger: Muscle weakness, even when it’s slight, can lead to apprehension about losing your balance. You might then start to avoid physical activities that you feel are risky–walking on uneven pavement, for example. But avoiding such challenges to your balance actually accelerates both muscle and nervous system declines.
If you’re afraid of falling or have a history of falls, a professional balance assessment, done by your doctor or a physical therapist, is the best way to find out how steady you are on your feet. The assessment usually includes tests such as the following (don’t try these tests on your own if you feel unsteady)…
• Sit-to-stand. Sit in a straight-backed chair. If your balance and leg strength are good, you’ll be able to stand up without pushing off with your hands.
• Stand with your feet touching. You should be able to hold this position for 15 seconds without any wobbling.
• The nudge test. Ask someone to gently push on your hip while you’re in a normal stance. If you stagger or throw out your hands to catch yourself, your balance is questionable. If you start to fall, your balance needs improvement.
Balance, like strength and endurance, can be improved with simple workouts. Incorporate the exercises below into your daily routine—while at the grocery store, in the office, while watching TV, etc. Do them for about 15 minutes to 30 minutes a day, three to four days a week (daily if you have the time). What to do…*
• One-legged stands. You don’t have to set aside time to do this exercise. You simply stand on one leg as you go about your daily activities—while waiting in line, for example. Lift your foot about six inches to 12 inches off the floor to the front, side and back. Try to hold each position for about 15 seconds, then switch legs. This strengthens the muscles in the ankles, hips and knees—all of which play a key role in one’s balance.
• Heel raises. This move is good for balance and strength. While standing, rise up on your toes as far as you can. Drop back to the starting position, then do it again. Try for 10 repetitions. You can make this exercise more difficult by holding weights. Start with three-pound weights, gradually increasing weight as you build tolerance.
Once you have become comfortable with the exercises described earlier, you can up your game with the following to keep you even safer from falling…
• Balance on a Bosu ball. It’s a rubberlike half-ball (about two feet in diameter) that you can use for dozens of at-home workouts, including balance and abdominal exercises. Cost: About $100, on Amazon.com and in some sporting-goods stores.
Example: With the flat side on the floor, start by standing with both feet on the ball. Your muscles and joints will make hundreds of small adjustments to keep you balanced. When you get better at it, try to stand on one leg on the ball. When you’re really comfortable, have someone toss you a basketball or tennis ball while you maintain your balance.
You don’t always need formal balance exercises. Try this…
• Walk barefoot. Most of us spend our days in well-padded shoes that minimize the “feedback” between our feet and the ground. Walking without shoes for at least a few minutes each day strengthens the intrinsic muscles in the feet and improves stability. If you prefer to wear socks, be sure to use nonslip varieties that have treads to avoid slipping on wood or tiled floors.
Also helpful: Minimalist walking/running shoes. They’re made by most major footwear companies, such as New Balance, Adidas and Nike, as well as by Vivobarefoot. Because they have a minimal amount of heel cushioning and arch support, they give the same benefits as barefoot walking but with a little extra protection.
* Do these exercises next to a stable object, such as a countertop, if you feel unsteady. Also, they are more easily done while wearing shoes. When you feel comfortable doing these moves, you can perform them barefoot to add difficulty.
