” I’ve fallen down, and I can’t get up!”
This is a tagline from a popular commercial that probably that you probably laughed at, and then felt bad because you found it funny. It is for a company that provides a service for people who are at medical risk for falling and other sudden problems that need help when there’s no one around. The commercial shows a woman lying on her side unable to get help after a fall in her home. This commercial has been around for over 10 years and it’s been effective because people remember it. It also is every person with an elderly parent living alone’s nightmare. Over time, however, it becomes something of a wake-up call for all of us. The reality is the older we get the more prone to injury related falls we are. Such falls as those depicted in the commercial are a serious medical risk to people over the age of 65.
Studies indicate that falls in people over 65 can be devastating. It is the number one cause of injury and injury related death in that age group. In the United States there are over 300,000 hip fractures annually in people over the age of 65. A quarter of those patients with hip fractures will die within one year and half will suffer a major decline in independence, requiring long-term residential care.
What causes these falls? A study by Simon Fraser University in Canada of 300 incidents occurring in Canadian nursing homes revealed some surprises. Victims usually believe that falls occurred because of tripping or slipping over something in the environment. Video cameras of the incidents showed that slipping or tripping accounted for approximately 20% of the falls. Much more common, was “incorrect transfer or shifting of body weight,” which accounted for 41% of the incidents. And most of these involved a body movement that caused the center of gravity to improperly shift while transferring to a bed, chair, or from one piece of furniture to another. Only 3% of falls occurred from tripping over or slipping on something.
Many believe that older persons cannot react quickly enough to a fall to brace themselves and break the fall. The Simon Fraser study showed that this was not the case either. 75% of the falls involved hand impact, indicating that victims could react quickly enough. The study concluded that upper body injuries are not from lack of reaction time but from lack of physical strength. In other words, there is not enough upper body strength to sufficiently break the fall.
There are a number of short-term and long-term solutions to the prevention of falls. Obvious short-term solutions involve checking the environments for hazards. Throw rugs, unstable surfaces, furniture that is either too high or too low, ice, stairs, etc. are among the more obvious. Less obvious and more long-term are careful attention to physical preparedness for the aging person. Osteoporosis is a major physical problem for the elderly. Although usually associated with women, it also is problematic for elderly males. Diets rich in calcium and vitamin D while helpful are not sufficient to prevent it. One of the most effective ways to prevent osteoporosis is through weight bearing exercise such as weight training, calisthenics, and any form of resistance exercise. 15 minutes or more at least three times a week will maintain bone health and strength as well as improve muscle tone and coordination. Walking alone is not enough as upper body strength is not sufficiently stimulated.
An overall program of wellness to combat age related problems should include both cardiovascular activities, weight bearing exercise, and exercise that improves coordination. Walking is probably the most convenient as it can be done virtually anywhere. Treadmill, exercise bikes, and other cardio fitness machines are good but walking tops them because of its convenience. Convenient activities are more likely to be done consistently, and are therefore more effective. Weight bearing exercises can be done anywhere as well. Too often people set a goal of “going to the gym” two or three times a week. It soon becomes an all or nothing thing where if they can’t get to the gym then they don’t exercise. Life usually gets in the way and the 2 to 3 time per week plan fails. Home equipment, while helpful, is not necessary for a good in-home weight-bearing workout. Push-ups, dips between chairs, sit ups, and light dumbbell work done at home consistently is much better. Even going to the gym may not be productive. Most gym goers gravitate towards weight machines and exercise machines. Machines build strength but are not as effective for coordination as exercises where you move your body through space. A combination of strength training, cardio, and a mind-body activity such as yoga, tai chi, or karate is the ideal.
Of the simplest ways to develop coordination to protect from falls is the simple act of learning how to get off the floor. Google “corpse pose yoga” and start from that position. (Yeah, I think the name is creepy too.) Lie flat on your back on the floor and simply rise from the floor to a standing position. Get back on the floor and repeat, working up to sets of 10 or more varying the way that you rise as often as possible. You’d be amazed at how effective this simple activity can be. Highly effective, doesn’t cost a dime, and no equipment necessary. Any exercise where you are lying on the floor, moving through space, and using multiple muscle groups at the same time is perfect. Yoga or a simple routine of stretching where you alternate being on the floor and standing is best.
Exercises that improve balance while challenging are easy to do. Use a chair to practice standing on one leg as part of a regular routine. Think yoga “tree pose” or karate “Crane stance” to get an idea of what you’re shooting for. Use a chair or wall for assistance, and build to the point where assistance is not necessary. Another highly effective easy to do, simple activity.
It’s never too late to incorporate some of these ideas into your exercise regimen. The best time to introduce these concepts is while young. Making these exercise principles part of your lifestyle increases the probability that they will become habits. The goal here is consistency, action, and enjoyment of body movement and awareness. Asian culture has numerous examples of successful aging due to lifestyle. (See also “Mind, Body, And Mr. Miyagi” January 31, 2014.) Functional, useful, fitness should be our goal. Exercise, if pursued in a mindful manner, can be productively done throughout the lifespan.
So next time you see that commercial maybe you’ll think a little bit about how to protect yourself from being in that situation. We all will get old but perhaps we can age at our own pace. Get started as soon as possible, NO EXCUSES!
“Growing older isn’t for the weak.”-Unknown
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