By Nancy Alexander, PT, CSCS
September is National Fall Prevention Awareness Month, a time for you to reevaluate your risk of falling and review ways to increase your strength, balance, and mobility. The CDC (Centers for Disease Control and Prevention) reports that 1 in 4 older Americans will fall this year.
There are many reasons people fall. From medication side effects to various medical conditions. But this article focuses on you. It focuses on how you can prepare yourself to either avoid a fall or decrease your risk of injury should you fall.
I fell last month. As humbling as it is, I fell while walking the streets of New York City. My niece, my husband and I were headed to the Chelsea Market that morning. While walking down an avenue my niece was calling my attention to a building across the street. She mentioned it by name and at first, I couldn’t find it. Still walking, my glance stayed across the street for longer than it should. My bad.
My path drifted just a little to the left. It was then that my left foot teetered on the edge of the cement and my ankle turned – three times as I recall. The sidewalk had cracked and on the other side the surface was dirt, not cement as it should have been. I tried to keep my balance at first, yet in my head I said, I’m going down. I fell forward and as I landed, I rolled. I came to rest on my right side curled up.
It happened quick. Once I realized what happened and knew I wasn’t seriously hurt, I turned to sit up with my knees bent. I skinned my right knee and had a small cut on my right hand. My husband and my niece asked if I was okay. I was and said “yes.” My husband quickly added, “That was the best fall I have ever seen.” I wasn’t sure what he meant by that as I was still stunned by it all. He added, “You could not have fallen any better. You did the right thing.”
He was right. I teach and write about how to fall. In the clinic and in my classes, I educate others how to fall. Could it be that all that education somehow helped me? Maybe and maybe not. But I believe that it did. I tucked and rolled. I landed on a large surface area minimizing a lot of impact in one spot. I had no major injuries. I did not break a bone. I did not sprain my left ankle. I did not hit my head. My shorts and sleeveless top weren’t even torn. All of that was important since we were just starting our day of exploring New York. Not to brag, but I went on to walk 30,000 steps that day. Yes, I was generally sore later that day and the next day. But I had no serious injury and I didn’t ruin my vacation and that of my husband and niece.
Did all my teaching help me? It very well may have. I was in fairly good physical shape when it happened. Did that help me? Absolutely. Here is my point – it is worth it to be physically well and prepare yourself physically and mentally to be safe while you are out there living a life. And maybe having an angel doesn’t hurt either.
As a side note, even in New York City, you can find a helping hand. When I rose from the sidewalk, a woman came over to me and said, “I saw you fall, are you okay?” I said I was and pointed to my knee and hand. I knew I needed to find a drug store to get some band-aids quickly.
She then reached into her purse and pulled out a bag with all sorts and sizes of band-aids in it, and antibiotic cream, too. In my head I’m thinking, Is this for real? She was the real deal. She even put the cream on each band-aid and handed them to me to apply them. “I like to be prepared,” she said to us. “They’re not just for me. I see it happen a lot. These sidewalks are awful.” What a kind soul. I am so grateful for her kindness and frankly, her timeliness. From there our day ensued to exploring and fun.
Later that day, when returning to our hotel near Grand Central Terminal, I saw a man fall stepping off the curb right in front of Macy’s at Herald Square. Unlike when I fell, this time there were a lot of people around rushing to get home. He must have been looking at his phone because it went flying through the air as he fell forward. Someone retrieved it for him and I went to him and asked if he was okay. He stood up awkwardly and replied he was fine. I guess it does happen a lot.
Replay in your mind how to fall. I published the following information last year and I am including it now for your review. Rehearse it in your mind. Talk it, teach it. Because I am evidence that it may just help you when all you have is an instant to react.
Here are six ways to improve fall safety:
- Protect your head.
The most important body part that you need to protect in a fall is your head. Head injuries can be very serious, even deadly. Make sure you prioritize protecting your head as you fall by properly positioning it.
- Tuck your chin down, lowering your head.
- If falling down face first, turn your head to the side.
- Bring your arms up to head level for additional protection. Put them in front of your head if falling forwards or behind your head if falling backwards.
2. Turn as you fall.
If you are falling either straight forward or straight backwards, try to turn your body so you land on your side. (I would also add to use your arms to protect your head, versus crossing your arms like the picture shows.) Falling directly on your back can cause serious injury to it. A frontal fall can cause damage to the head, face, and arms. By landing on your side, you can reduce the chance of injury by landing on more soft tissue and dispersing the impact. (See #5, Rolling).
3. Keep arms and legs bent.
It may be tempting to try and catch yourself fully as you fall with your arms. However, landing with your arms straight out and absorbing the full force of the fall with them can cause injury. Try to curl up keeping both arms and legs slightly bent as you fall. If feet are still on the ground, try to squat down. Landing fully on your arms straight out can break both your wrists and arms.
4. Stay loose.
This is perhaps the hardest thing to do. Tensing up during a fall can increase the chances of sustaining an injury. The tension in your body won’t allow for the absorption of force from the fall. Instead of spreading the impact out over a flexible body, the parts that were kept taught are more likely to break instead of going with the motion. You can try breathing out as you fall to help keep your body relaxed.
5. Roll out of the impact.
If you are able, a good technique to dissipate the force of a fall is to roll into it. By rolling, you send the energy of the fall into the roll, rather than having your body absorb the impact. Rolling to one side (versus a somersault as shown here) can help distribute the impact where there is more soft tissue.
6. Spread out the force of the fall.
A big part of falling safely is to spread out the force of the impact over a large area of your body. Falling on a single point will result in that area taking most of the damage. By spreading out the impact, you reduce the chance of serious injury to a single part of the body. If falling backward, try to squat first and bring arms to the back of your head.
Keep Moving
Move frequently and regularly. Exercise and commit to being as physically fit as you can be. It will help you when external forces act upon you.
Now is the time to take control. Now is the time to prepare yourself and protect yourself from serious injury. Please share this with others and support the efforts of the CDC during National Fall Prevention Awareness Month.
Be well friends.
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