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Fall Prevention
Fall Prevention

Avoiding Humpty Dumpty's Dilemma

by Lance P. Van Arsdell, P.T., M.S.P.T.

"Fall" is the four-letter word seniors fear most.  Over ninety percent of hip fractures are the result of falls.  Most of these falls are preventable but typically nothing is done to prevent them and their devastating, painful, and even life threatening consequences.  One in five people who break a hip dies within one year and many never walk following a hip fracture.  Many simple actions can be taken to avoid having a fall.

First, do the easy things.  When rising from bed take your time. Sit on the edge, straighten your elbows, shrug your shoulders, and fully straighten your knees while pointing your toes toward your nose.  Smile and repeat a favorite quote before getting out of bed.  Such activities prepare your joints and mind for a good day and while giving your blood pressure time to adjust to a new position.  Remove electrical cords and throw rugs from pathways.  A slippery bathroom throw rug or poorly placed electrical cord can cause a lot of pain and grief if it causes a fall.  Use sufficient lighting especially between your bed and bathroom.  Eat a good breakfast daily, quit smoking and stop, or significantly limit your alcohol intake. Always wear comfortable and sensibly low and broad-heeled shoes.  If you know have fallen because you got dizzy or faint, make an appointment to see your medical doctor.

Secondly, if you don't know why you've been feeling weak and have nearly fallen a few times, make sure you see your doctor soon.   Your doctor can screen you for multiple infections, abnormal blood pressure, thyroid disorders, diabetic neuropathy, decreased vision, and many other silent causes as well as refer you for appropriate follow up care if needed. (Contact the American Academy of Orthopedic Surgeons or the American Physical Therapy Association's web-site for more details).   

Finally if you are in good health and your doctor approves, get started on an exercise plan.   "But last year, as instructed on TV", you puff,  "I started out to exercise six days per week for at least 30 minutes keeping my heart rate at 80 percent of my maximum heart rate.  I made it…'til Tuesday".  "I just can't keep up with that schedule and besides, I have other things I like to do!"  

Scores of well-meaning health educators have unwittingly kept scads of couch potatoes firmly planted in their sofas by recommending exercise programs designed for athletes.  In twelve years of physical therapy practice as well as my own life I have learned that the only effective exercise program is the one that is actually performed and carried out year round.    What if I told you that you could achieve most of your needed stability improvement from 30 minutes of strengthening three times a week?…OK, twice a week. That still works.  And you could do it at home?   Now what if I said you could watch your favorite TV show at the same time?   Deal?  Good!  Begin by doing strengthening exercises twice a week for no more than thirty minutes.  For a good program read Strong Women Stay Young (Revised Edition) by Miriam Nelson Ph.D.  That program is similar to the program I teach clients in their homes and faithfully do myself.

Start with these important exercises for your anterior tibial and quadracep muscles:  

1)  Sit in any chair, straighten your knees fully, bend your ankles so that your toes point toward your nose.  If you bend forward slightly from the hips you will feel a stretching behind your knees and if you're bending your ankles enough you will feel a "pulling" sensation in your calves.  Hold this position for 30 seconds and repeat daily.  Stop if there's any pain. Most seniors gradually lose the passive range of motion and strength to hold their toes and forefeet up as they swing their leg forward while walking.    This weakness and stiffness causes the trips and falls which this exercise is designed to prevent.  2)  To strengthen your quadriceps never let yourself "plop" down in a chair again this year.  When you sit by dropping suddenly your quadriceps are weakening and are sort of "on vacation."  Picture your legs lolling out at the beach and gradually getting washed out to sea rather than working to help you.  Instead, lower yourself down into your breakfast, lunch and supper chair in ten seconds only releasing your effort when the cushion won't let you down any farther.    At the end of your meal try to get up on the same slow count of ten.   For increased challenge keep your shoulders from going in front of your toes.  

Now those are two exercises and some good references.   Will you do it?  I've kept it up for over two years.  I've lost 15 pounds, and feel great.  When I put my own parents on the program I bought them weights for Christmas and took the program to them twice weekly.  My parents made excellent gains and we had lots of fun.  Everything went great until they went home to Illinois for the summer.   If you'd like help in making sure your walking health improves this year call me at 602-619-8582 , or remember this website  Short waiting times are available in Mesa, Scottsdale, and Paradise Valley.    Mention this article and I'll donate the proceeds of your first visit to your favorite charity.  At Restoracare, with good exercise and lots of fun, "no pain" can and will equal "lots of gain".

This article was adapted from a lecture entitled "Help, I've Fallen and I Can't Get Up".  Additional presentations given by physical therapist Lance P. Van Arsdell, MSPT, PT include,  "Living (Lifting) and Loving Without a Pain in the Back", "How to Avoid Living with Art (Arthritis)", and "How to Make Your Bones Last a Lifetime" (Osteoporosis Care and Conservative Treatments).  Mr. Van Arsdell is president and chief physical therapist of Restoracare, Inc..

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