Turn Doubt Into Doing

By Nancy Alexander, PT, CSCS

September is National Fall Prevention Awareness Month and that brings me to this month’s topic. When you think of fall risks, I’m sure there are some things that come to mind right away like scatter rugs, poor lighting, lack of grab bars at your bathtub or toilet. But I bet there is one risk you might not think of. And, it’s both a cause and a result of a fall. Have I stumped you?

Here it is: A recent fall is a predictor of a future fall. Simply put, falling increases your fall risk. The facts back this up repeatedly. And in the clinic, one of the first questions we ask our patients as a screen to see if they are at risk for falling is if they have already fallen.

Why is this so? Aside from physical factors, this riddle is about fear. Fear of falling happens after a fall and, unfortunately, can lead to a second fall. But it doesn’t have to be this way. You can stop this cycle in its tracks. Here, I explain how to get your power back.

Have you have fallen recently? In the last 6 months? In the past year? Be honest. Have you? Falls hurt and they can cause serious injury. You can typically see serious injuries. You see a bruise on your skin, you see a fracture on x-ray. You see a dislocated shoulder with imaging. Unfortunately, you risk even more severe injury from a fall if you’ve been diagnosed with osteoporosis or osteopenia (low bone density).

Sure, these can be serious but there is also a very important injury you cannot see.

Let me explain with an excerpt from my book, Get UP! Defy Aging with Movement:

Falls are all too often associated with injury. Have you had a fall in the past year? Were you hurt? Do you worry about falling? Do you feel unsteady when standing or walking? If any of your answers were yes, do you limit activities as a result? Think about this, do you? You might and may not even realize it. Injury or not, you might have a lasting fear of falling. I call this the injury you cannot see.

Fear of falling is a lasting concern that may cause you to stop doing activities you remain able to do. In some respects, this is a valid fear as one of the best predictors of a future fall is a past fall. And the more recent the fall is, the higher the chance. Most don’t like to talk about it. This may be due to embarrassment and fear of losing your independence. Thus, you ignore it. You brush it under the rug, and many times adults don’t even tell their physician about it when asked directly. If left unchecked, your fear can turn into reality. You need to address it, correct it, move, and resume your life.

Why does fear of falling matter? It may stop you from participating in your favorite activities even while you still have the capacity to do them. Legs weaken with inactivity. And inactivity leads to falls. Eventually it can cause you to feel alone. It can even make you depressed. Don’t enter this cycle of disability. Don’t go down that road, friends.

I first heard about Sharon through her daughter, Lisa. Her daughter called me because she was concerned for her mother’s health. “She fell a couple weeks ago and she just hasn’t been the same since,” Lisa said. “She was pretty banged up, but thankfully had no injuries,” Lisa added. “But now she’s staying to herself more. She declined meeting us for dinner on Sunday and she always does that,” said Lisa. “She’s not playing cards with her friends either,” she said. “I’m worried about her.” Lisa added, “At least she is using a cane now. I think that helps.”

At Lisa’s request, I called Sharon to meet with her to see how she was doing. She welcomed the visit. That is always a good sign. Some people refuse the help.

I met Sharon at her home. It is a fairly new manufactured home with a few steps to enter. Once inside, she lived on one floor. The home was clean and well kept. Sharon explained that she lost her balance in her living room and remembers falling toward her large picture window. She showed me where it happened. She has carpet there, and it was well lit. She denies any clutter there when she fell. There was nothing unusual about the area. “I go by this window all the time,” said Sharon. “I don’t know why it happened.”

What she did remember is that she wanted to avoid landing on that window at all costs and ducked. She succeeded and hit a sill that runs along the bottom of the window. She hit it so hard it broke off the wall. She has bruising on her ribs to show for it. Luckily, she didn’t fracture them. Sharon has a cardiac history, and I asked her if she was lightheaded or dizzy. She said no. I then performed a physical exam, which revealed some findings that potentially could have contributed to what happened. She had tightness in her lower legs, preventing her from walking normally. This could have played a role. She had some weakness in her legs, which certainly could have contributed. There were other factors in her history that when combined with the physical findings, could have compromised her balance.

I provided some exercises for Sharon to do, and she performed them when I was there. She did well with them. I could see some relief on her face then. I asked her what she thought about the program I was setting up for her, and she was on the verge of tears. “I can do these things,” she said. “Maybe I can recover from this.” Sharon regained some hope. Just by welcoming me in and being honest about what happened, she opened herself up for healing–emotional healing. She had been suffering both physically and emotionally. The emotional injuries are much harder to see though her daughter saw them and acted.

Sharon was entering that disability cycle we talked about. With action and movement, she got out of that cycle. Sharon is currently doing very well and no longer needs a cane. There are no more falls, and she is out and about with family and friends routinely now.

The fear of a future fall is the injury you cannot see. The truth is, you have the power to act now to improve your health, fitness level, and your quality of life. Meet your fear head, on and do it early. Take action to improve your mobility. Keep moving.

This had a great outcome and thankfully I’ve seen it play out many times before. Even if there are no obvious injuries after a fall, look within. Is fear holding you back? Let’s focus on the positive and find ways to boost our balance right now. Let’s take some control back.

You can improve your balance at any age. You can improve your strength and flexibility at any age, too. And there is no time like the present to start. Improve your physical health so you can reduce your risk for falls and lead a fun and independent life. Search out activities in your community like classes, workshops, and courses that fit your health and fitness level. Some options include:

• Classes at your local fitness center. Attend in person or seek out options online if that is your preference.
• Classes that include balance training like Matter of Balance and my Buff Bones® classes, the latter are safe for those with osteoporosis and osteopenia.
• Tai Chi
• Aquatic exercise or class in a pool
• A referral to physical therapy for a specific plan to fit your needs

There are so many options out there so take the time to find the ones that are right for you. The key is to move. Move in a way that is fun and meaningful to you. Feel free to consult your local Office for the Aging or your local senior fitness center for a listing of options in your community. If you are unsure where to go, you can start by discussing this with your physician or physical therapist. Reach out to me and I’d be happy to help you. Just start.

Improve your fitness level, your balance, and your health. Why? Because you can. You have the power to improve your flexibility, strength, and balance at any age. Face your fears head on and act now. Keep your fall risk low and lead an independent life with the freedom to do what you want, when you want. You can do this.

Be safe. Be well. Keep moving.