Falling. The leading cause of death due to an injury in adults over the age of 65. One out of every 3 older adults will fall this year. Falls account for 25% of all hospital admissions and 40% of those individuals are unable to return to independent living. $34 billion annually is spent on medical costs due to falls. Why risk the chances of a life threatening injury from something that can be managed effectively with therapy?
Here at the FYZICAL Wellness Institute, our FYZICAL Balance team is always looking for evidence based methods to effectively reduce the risks of falling and injuries suffered from falls. We know that falling can be something that is quite scary for the majority of the population. For some people, they don’t want their families to know that they fall. For others, they don’t understand why they are falling. Wherever you fall in this spectrum, we understand your concerns and worries. We are here to help you get back on your feet!
To understand falls, it is helpful to understand the physiology that leads to our fall risk. Our balance ability consists of three separate systems that create stability in our body: the vestibular system, the somatosensory system, and our vision. As we age, each of these systems becomes less sensitive and less reliable.
1. Vestibular system: Made up of three canals in the inner ear, one for each plane of movement: up and down, side to side, and forward and backward. Within these canals are crystals that are suspended in liquid. In a normal inner ear, the crystals fall towards gravity. This means, when we tilt our head, the crystals will move accordingly and send a signal to our brain telling us which direction gravity is coming from, and thus, which direction is upright. When this system is not working correctly, the result is vertigo. The crystals can get stuck, which sends the wrong signal to the brain for what is up and what is down. This creates dizziness and a sense of spinning that will increase falls risk.
2. Somatosensory system: consists of mechanoreceptors (pressure sensors) on the bottom of our feet. With increased pressure on these receptors, a signal is sent to our brain and our body naturally activates the muscles to even out the pressure. This is all done in a split second without any conscious effort. For example, if we start to lean forward, more pressure will be put on the sensors in the front of the feet and our calf muscles automatically contract to bring us back to neutral, and even out the pressure. With decreased sensation on the bottom of the feet, as with neuropathy, or impairment in the brain where the signal is processed, our reactions may become delayed and impaired. This increases our chance of falling.
3. Vision: Our eyes send a very clear signal to the brain of what is up and what is down. It also provides a stabilizing effect when we focus our eyes on one location. If you try to stand on one foot with your eyes open, it may be easy; but when we close our eyes, it becomes very challenging. This is why it is easier to lose your balance while washing your hair in the shower, or pulling a shirt over your head. If you have vision deficits or your eyes closed, you have a higher chance of falling.
Additional factors that increase our risk of falling include:
• Orthostatic hypotension (dizziness/lightheadedness when standing up due to a drop in blood pressure)
• Vitamin D deficiency
• Lower body and trunk/core weakness
• Gait deficits
• Foot pain or improper footwear
• Chronic condition (arthritis, diabetes, stroke, Parkinson’s, dementia)
• Extrinsic factors (lack of handrails/grab bars, slippery surface, trip hazards, improper use of assistive device)
If you have had a fall and/or have a fear of falling, there’s great news! Each of the three systems above can be modified and improved! Our doctoral team here at FYZICAL Balance is here to help you improve your balance and confidence, and return to the healthy, active lifestyle you enjoy! Come see us today!