Which Performance Physical Therapy Techniques Are Best After a Fall?

According to the Centers for Disease Control and Prevention, each year 3 million older adults will be treated in the emergency room for fall-related injuries. One in five of these falls will result in a serious injury, such as a broken bone or a head injury, and can lead to losses in independence, chronic pain, and difficulty participating in activities that bring joy and fulfillment. In 2015 alone the medical cost for falls totalled more than $50 billion.

Sustaining a fall can not only lead to injury and loss of independence but also cause fear and apprehension about being active at home and in the community. Research suggests that a previous history of falls is associated with an elevated fear of falling and that a fear of falling can then be used to predict future falls. In other words, if you are afraid of falling you are more likely to sustain a fall in the future.

Studies show 70% of falls are due to interacting factors such as:

• Muscle weakness
• Impaired balance
• Medication issues
• Vision or cognition deficits
• Depression
• Effects of other medical conditions

Each individual’s risk factors may be different, and identifying those that are top priority to address may take a team of healthcare providers.

Exercise is important for all older adults to promote a healthier life, and muscle weakness and impaired balance are modifiable fall risk factors that a physical therapist can address. While you need to see your primary care doctors or a licensed physical therapist for recommendations on how to treat any injuries you may have sustained in a fall, there are several exercises you might do to address issues of strength and balance to help you get back on your feet and reduce your chances of having another fall.

Keep in mind these exercises are intended as general information and do not serve as individual medical advice. Please meet with your primary care doctors or a licensed physical therapist who can individualize these techniques to your personal needs.

Sit to Stand

This exercise requires only a sturdy chair and targets many of the lower body muscles that can help prevent a fall and also assist you in getting back up off the ground if a fall were to occur. To perform this exercise make sure the chair is secure and will not move away from you. Start by sitting in the chair then rising to stand briefly before sitting again. If the exercise is too hard you can use your hands to assist or use a higher surface. Perform 1-3 sets of 10 repetitions 3-5x a week.

Calf Stretch

Having tight calves and stiff ankles can interfere with the body’s balance recovery strategies. Perform this standing calf stretch daily to help improve flexibility. Standing next to a wall or countertop, take a large step forward and lean forward onto the front leg until you feel a stretch in the calf muscle of the back leg. Hold for 30 seconds. Repeat for a total of 60 seconds 1-2x per day.

Calf Strengthening

Weak ankle muscles can also contribute to falls and difficulties walking. Improve your strength by performing this simple calf raise. Place your hands on a counter or wall for balance, keep your knees straight, and rise up onto your toes holding for 2-3 seconds, then slowly lower your heels back to the ground. Perform 1-3 sets of 10 repetitions 3-5x per week.

Balance

Performing balance exercises is, as you can guess, one of the best ways to improve your balance. While standing, separate your feet to shoulder width and try to hold for 30 seconds. When that becomes easy bring your feet closer and closer together until they touch. Once you can hold this for 30 seconds, practice standing with one foot ahead of the other or standing with your eyes closed.

Remember, these exercises are intended to challenge your balance and can lead to a fall if you are not careful. Standing closely with your back to the corner of a wall with a sturdy chair in front can help keep you safe, but when in doubt have someone you trust stand close by.

Fall-Proof Your Home

According to the National Institute on Aging, six out of every 10 falls occur in the home. We tend to move around our homes without thinking carefully about where we are going and what might be in our way. Not only can a physical therapist help you to build a personalized exercise program to help prevent future falls, but they can also advise you on small changes you can make inside your home to lower your risk for slips, trips, and falls.

• Avoid putting down area rugs and runners as they can be a tripping hazard.
• Ensure you have adequate lighting that is easily accessible throughout the home, especially in high risk areas such as the top and bottom of the staircase and in your bedroom on the way to the bathroom, and that you turn the lights on when it is dark.
• Keep walkways tidy and try not to leave items on the floor that might get underfoot.
• Place slip-resistant mats in the shower and tub.
• Keep an eye out for your pets and know where they are when you are moving around your home.
• Install secure grab bars in bathrooms and handrails near stairs and steps to provide a secure handhold.
• Arrange furniture to allow for a clear path to navigate with an assistive device such as a walker or cane.

If a fall occurs, a medical alert necklace or similar device can help you signal for help as soon as possible.

Taking care of your physical body and the physical space around you are great first steps after a fall to reduce the risk of recurrence. Though we may be unable to slow the passage of time, remember, age is just a number and implementing these steps can help to keep you on your feet and enjoying all the years of your life.