Preventing Falls

Katie Nieman, student physical therapist, performing tandem stance, a high level balance activity, on an uneven surface with Sarah Amesbury, physical therapist.

This past fall a friend of mine was doing what she does every day – walking to her sink. This time, however, her sandal caught the edge of the throw rug in front of the sink and Boom! She fell down hard on her hip. It broke and she had to have a partial hip replacement from which she is still recovering. Others are not so fortunate. Katherine Graham, the publisher of the Washington Post, died from head injuries sustained from a fall in 2001.

Both my friend who is 75 and Graham who was 84, became part of a grim statistic. Every year one in four people age 65 and older experiences a fall, according to the Centers for Disease Control and Prevention. One out of five of those falls causes injuries such as a broken bone or head trauma. For many of those who fall and don’t get injured, the fear of falling again can limit their everyday activities. What’s even worse, falling once doubles your chance of falling again. However, the fate of older adults is not sealed, nor is the outcome inevitable. There are many ways to counter the inflexibility, instability and muscle deterioration that contributes to incidences of falling.

Katie Nieman, physical therapy student, performing a balance activity (tandem stance on an uneven surface) with Sarah Amesbury, physical therapist.

Why Do We Fall?
As we age we don’t move as much. Let’s examine a typical life progression: children play, run jump, fall easily and get up; teens are moving all day in school from class to class and usually participate in extracurricular activities; college students are running all over campus. Once we begin careers most of us sit eight to 10 hours or more a day, not only in front of the computer but also in front of the steering wheel or on public transportation commuting. Then we sit in front of the TV. Just as a car rusts and doesn’t work if you don’t use it, so do our bodies.

Falls often begin when parents start having kids. They don’t sleep, eat or hydrate well, they get stressed and when they try to participate in sports or exercise activities as they did when they were younger, accidents happen. A student of mine recently returned from an extended visit to her son’s home to help care for her grandchildren. Her daughter-in-law had taken, not one, but two falls – one in her house on her steps and the other outside on the ice. She is 38.

Falling is not limited to age, but can be more dangerous for older adults. By the time we get older, our bodies are stiff, achy, arthritic, and we often have chronic pain. We don’t feel like moving.

Falls result from a variety of reasons. The inability to correctly transfer or shift our bodyweight caused 41 percent of tumbles, according to a study released from Simon Fraser University in 2012 that examined 227 falls among 130 residents in two nursing homes. The falls involved a body movement that caused the center of gravity to change improperly while walking or standing. The researchers called them ‘misjudgments or overcorrections. Other causes include: dizziness, overtiredness, rushing, multi-tasking, texting and walking, lack of focus on the present moment, deconditioning, low blood pressure or muscle weakness.

Prevention is the Key
I always tell my students when we do a core exercise, “All of us are going to trip and stumble, but not all of us will fall.” We all want to be in the group of non-tumblers. How do we do that? I asked Sarah Amesbury, physical therapist and center manager at NovaCare Rehabilitation on Capitol Hill. She says that changes to your environment and changes to yourself can help keep you from falling. “In your home, add adequate lighting, get rid of any throw rugs, make sure stairs have railings and wear supportive footwear. Loose slippers are not good nor are heels or soles of shoes that are too slippery or too sticky.”

Pattie Cinelli demonstrating one of Sarah Amesbury’s favorite balance exercises.

Sarah also said it is helpful to practice mental imagery or visualization. “If I do fall, what would I do?” Try to be specific and positive and create several scenarios. She also said it’s important to make safe choices when deciding how to proceed when the weather is bad. For example, last month I knew there would be ice overnight so I diligently coated my sidewalk with salt. The next morning when I went to walk my dog, I didn’t give it a second thought. It looked clear. I took one step and slid, twisted and stumbled on black ice but didn’t fall. When I stabilized myself I took a deep breath, calmed myself and made a decision: I could either walk with the dog or drive to the park where we could walk on the grass. I chose the latter.

Knowing where your body is in space (proprioception) and having the strength, flexibility and reflexes to right yourself when you get out of balance requires making exercise a priority. “It has to become an integral part of one’s life and fit into one’s lifestyle,” said Sarah.

Sarah recommends exercising three to four times a week optimally but two times a week at a minimum. Exercises must include challenging your center of gravity and learning how to engage your core muscles while doing exercises. “Working to correct poor posture is also very important as are strengthening the glutes,” she said.

A few of Sarah’s favorite exercises include: sit to stand and standing hip extension both to the back and side. Each exercise can be repeated for two sets of 15 or three sets of 10 repetitions. Another favorite is tandem stands – holding on while lifting one leg and counting to 30.

Many aging characteristics are those that we can’t change and can only embrace. Falling is not one of them.


Pattie Cinelli is a holistic fitness professional has been writing her health and fitness column for more than 25 years. She writes about new and innovative approaches to staying well. Pattie works with clients in their home, office or at Sport & Health Gym. She can be contacted at: