OK you boomer, you’re probably feeling fit as a fiddle, you’re doing your exercises and eating right, all you have to fear are the diseases of aging (and this year SARS-CoV-2). Right? Not so fast. There is a risk factor that most people completely overlook that can cause serious harm and even death, and it mostly lurks stealthily in your home.  It’s called “falling”.

Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults. According to the National Council on Aging each year 25% of Americans over the age of 65, experience a bad fall.

The Council adds, “Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness”.

A serious injury from a fall can happen in a heartbeat. FitCommerce did some research and uncovered these anecdotes:

• An elite athletic 70-year-old male tripped on the bottom stair in his home and severely ruptured his Achilles heel and was laid up for 4 months.
• Another 71-year-old male, went outside one winter, slipped on the ice, he fell back and struck his head on the pavement. He died the next day in the hospital.
• A 55-year-old woman was taking the trash out to the container in the garage and fell on the single step, broke her leg and walks with a severe limp to this day.

The list goes on, but these aren’t race car drivers taking calculated risks, these are ordinary people doing ordinary tasks and, in a heartbeat, their lives were uprooted, and in some cases lost.

Risk of Falling Increases with Age (Add to the List)

Falling is something people just don’t factor into their behaviors but the odds climb the older we get.

“As people age, changes in flexibility, muscle strength and power, body sensation, reflexes, and even mental function all contribute to declining balance,” says Dr. Brad Manor, of Harvard, “You need to work on all these factors to maintain a strong sense of balance.”

Loss of Strength Due to Aging Increases Fall Risk

Like it or not, as we age, we lose muscle strength. The cause is age-related sarcopenia. Physically inactive people can lose as much as 3% to 5% of their muscle mass each decade after age 30. But even if you are active, you’ll still have some muscle loss. Sarcopenia typically happens faster around age 75. But it may also speed up as early as 65 or as late as 80. It’s a factor in frailty and the likelihood of falls and fractures in older adults.

In particular it’s not necessarily the obvious loss of the major muscles in our body like arms, back and legs. Of the 600 or so different muscles, there are a few critical support muscles that help to keep us erect and prevent toppling over, when these get weak, we’re at risk of falling.

Loss of Core Strength

Joseph Pilates is credited with identifying our core and key to vibrancy in health. As the name implies, the core consists of the muscles surrounding our mid-section that can counterbalance our upper body mass to one side or the other if we’re about to topple. Unfortunately, without concerted effort these muscles too will atrophy and present risk of falls.

Simple Changes to Make the Home Environment Safe

The fastest way to mitigate the risk of falls in your home is to take inventory of all the risk points: stairs, floors, lights, etc.

Lighting

In this day and age, there are multiple ways to assure your pathways are sufficiently lit. First led light technology has made lighting your home affordable, so be generous. Secondly, have your grandchildren help you set up lights that are connected to your smart speaker. “Hey Alexa put the kitchen light on.”

Motion detector lights targeting your outside doors serve a dual purpose, they automatically make it safe for you to see where you’re going and they provide added security to your home.

Make Stairs Safer

Stairs are a very critical area and need you to be on your toes (just figuratively speaking). We learned of one case where a 60-year-old woman in the darkness fell down her stairs and broke the C3 vertebrae in her neck.  She survived, but now 10 years later she can barely walk and has no sense of upright balance.

Sturdy Handrails

The universal solution is to have sturdy handrails. If you have space, have them on both sides, and for God’s sake use them.

Automatic Lights

There are any number of battery powered motion detection lights that can be attached to wall along the stairs. They will automatically illuminate the stairs as you traverse them – easy peasy.

The Debate on Stair Carpeting

One school of thought is that carpeting is more slippery than wood and should be removed to prevent slips and falls.  Then the other school feels that carpeting that is not worn is not that slippery and can cushion a fall.

It’s your assessment of your home, but FitCommerce generally recommends removing carpets from stairs. And if it meets your aesthetics install anti-slip stair treads.

Make the Shower Safer

Footing is key to preventing falls. But, in a shower there is water and soap that make it very slippery. Hopefully you already have a sturdy shower mat to get good traction with your feet. But you really should add grab rails

Grab rails should be on all 3 sides of your shower area. They should be installed professionally so that they can absorb the full weight of a human that may be falling.

If you’re worried about aesthetics, they make hand rails very attractive in stainless steel or chrome. They will shine in your bathroom and actually beautify it.

Wear Sensible Shoes

Now that we have you thinking about not slipping in a shower, think about not slipping everywhere you go. Shoes can cause or prevent a fall.

Walking shoes should have  non-skid, rubber soles. They should be light and easy to put on, fit securely on the foot and not be too tight. As we age our feet lose the natural padding from the heel and ball of the foot. Arches may become flatter and less flexible. Aging feet become wider and longer. The pair of shoes that fit perfectly ten years ago may no longer be a good fit. The Health in Aging Foundation reports that three out of four seniors are wearing shoes that are too small.

Respect Ice

For those of you living up north in the winter time have to pay special heed to ice and snow. Talk about losing your footing, ice is supreme in trying to upend you.

We already mentioned about that 71-year-old Colorado man who slipped on the ice in his own driveway, struck the back of his head and died the very next day in the hospital. Don’t let this happen to you.

One rule of thumb is to just not walk on ice. Period!

But if you must, learn from the NFL football players that have to play the Packers in Green Bay Wisconsin. They’re taught to keep their feet under them, take shorter strides.

That translate to us as walking the “penguin shuffle”. That is, shuffle with short strides, hands out of pockets to catch you if you do fall. It’s key not to have your feet fly up in front of you where you fall backwards, this presents the danger of striking the back of your head. Keep your upper body weight slightly forward. That way, should your feet slip, they go backwards and you fall forward where you can break your fall with your hands.

Benefits of Balance Training

First a quick understanding of how your body maintains balance in the first place.

Your brain has a balance control center called the cerebellum, a small part of the brain positioned at the back of the head, where it meets the spine. It works through a constant process of position detection, feedback and adjustment using communication between the inner ear, eyes, muscles, and joints.

The most notable is the inner ear. Here, the vestibular system is designed to send information about the position of the head to the cerebellum. There is fluid in semicircular canals that quickly detect movement in any direction.

The cerebellum can detect when there is an undesired motion, like a fall and quickly calls on counter measures by muscles to prevent such. That is, provided the muscles are quick enough and strong enough to respond in time.

This mechanism loses efficacy as we age, hence the importance of adding balance training to your fitness routine.

Develop a Strong Core

Core strength is very important for balance. If the abdominal muscles in your core are weak, they cannot support your limbs, especially when you’re walking.

If the gluteal muscles in your buttocks and hips aren’t strong, they won’t be able to propel you forward,” says Liz Moritz, a physical therapist at Boston’s Brigham and Women’s Hospital.

Moritz suggests starting with gentle core exercises like a pelvic tilt (lie on the floor with your knees bent up, then roll your pelvis up) and then moving to more intense exercises such as wall planks (stand six inches from a wall, keeping your body rigid, then lean forward with your forearms flat against the wall, and hold the position for 20 seconds). Leg lifts will strengthen the gluteal muscles, and adding resistance bands to leg lifts makes the exercise even more effective.

Simple Goals of Balance Training

Strengthen major leg muscles most notably the quads, glutes, hamstring and calves. This basically gives to the power to overcome gravity that wants to pull you down.  Squats are the best exercise even without weights.

However, as spaceships have tiny retro rockets that fire in a perpendicular direction to the intended flight to stay on course, you also have retroactive muscles to do something similar.

If you can pay attention to these stabilizing muscles, you will have better balance and remain upright. There is a smaller Gluteus Medius muscle that helps to stabilize you hip. The Soleus muscle below your calf muscle helps to flex your foot for stability

Simple Balance Training Exercises to Incorporate in your Week

Simply Stand on One Leg

Sounds simple enough, stand up straight and lift one leg. You’ll find your standing leg wabbling as it corrects.  You tend to lean to one side or the other. This is good. Your strengthening those support muscles and giving the communications to your cerebellum a workout.

Take it up a notch

OK, getting bored just standing there on one leg? Now try it with your eyes closed. It’s a little harder isn’t it. But keep working it.

If you’ve taken a yoga class, your teacher would instruct you to focus on an object to maintain your balance. But we want to challenge our system, so try standing on one leg and move your head from side to side.  Challenging isn’t it?  When you get really good at that, try moving your head and closing your eyes.

The below image summarizes how the balance system works.

The Cerebellum takes data from your eyes, ears, and muscles and instructs body to stay in balance.
Credit Royal Victorian Eye and Ear Hospital

So, if you can not use one of the pathways, it will strengthen the other pathways.

Balance Exercises to Prevent Falls

Squats

Strong legs mean strong balance. Squats are the king of leg strengthening, they exercise your quads, hamstrings, and gluteus. Regular exercising with squats will keep you off the ground.

Simple Squat Exercise

Squats can be performed with or without weights. From strictly a balance training perspective, squatting with just your body weight is sufficient.

Stand with your feet shoulder-width apart. Bend your knees and imagine you are sitting down on a stool. Lower down until your thighs are parallel to the ground, or as far as is comfortable.

Keep your weight on your heels. Extend your arms forward or place your hands on a chair, counter, or table for stability. Pause for a second or two, then rise back to the starting position. Do this up to 10 times.

Gluteus Medius stabilizes you hip

Everyone is focused on a strong firm butt, i.e., the gluteus maximus, and rightfully so. But, from a balance perspective the gluteus medius is equally as important. It’s the muscle that stabilizes your hip from side to side.

Simple Hip Exercise

Lie on one side with the bottom leg bent to 45 degrees and the top leg straight. Stack the hips and shoulders directly on top of one another. There is a strong tendency to roll the hips forward or back here.

Lift the upper leg toward the ceiling; squeeze and hold the top position and then slowly lower the leg. Avoid any crunching with the trunk and lift the leg just high enough to feel the gluteus medius engage. For an additional challenge, add an isometric hold at the top.

Soleus Calf Muscle Flexes your Foot for Stability

On the topic of stabilizing muscles, the soleus is another overlooked but key muscle. It plays an important role in maintaining standing posture, making sure your body doesn’t fall forward. It runs from just below your knee to your heel behind your leg, attaching at the top of the tibia and fibula leg bones (at your knee) and inserting at the Achilles tendon (by your heel).

Body Weight Soleus Exercises

One of the basic soleus exercises are simple calf raises. Begin this exercise with the ball of your foot on a step with your heel hanging over the edge. Slowly lower the heel until the ankle is fully flexed. Then raise up onto your toes, keeping the knee straight. You can perform this exercise with both legs or one leg at a time.

Start with one set of 10 repetitions and add additional sets as your strength increases.

Airplane Pose

The airplane pose is an excellent all-round balance trainer.  It not only triggers your cerebellum but also strengthens key support muscles to keep you steady on your fee.

How to Practice the Airplane Pose

Stand with feet together, arms at sides, and gaze at a spot on the ground about 5 feet ahead for balance.

Lift one foot back, bending forward until left leg and chest are parallel to ground. Extend arms out as shown, if needed, extend arms out like wings on an airplane.

Hold for 10 seconds and try to build up.

Repeat by lifting the other foot.

Be sure to keep a flat back (parallel to floor) and concentrate on keeping abs tight.

Advanced Balance Training Modalities

Tai Chi

Participating in a Tai Chi class is an excellent, gentle way to improve balance. Plus you get the bonus of mind-body.

In Tai Chi, you work on transferring weight from one side to the other while you move your legs, arms, and upper body. The slow, flowing sequence of movements also forces you to pay attention in order to perform the action accurately and remember what comes next

Yoga

Yoga is a whole-body fitness exercise. Outstanding for improving balance. Plus you also get the bonus of mind-body.

Classes are everywhere: Gyms, YMCAs, Senior Centers, Town Parks & Recs, private studios. Take your pick.

Pilates

Pilates is also excellent for balance training as it strengthens the muscles of the spine and trunk for an upright posture as well as working on the lower body, especially the feet and ankles.

Training balance in different body positions not only challenges the body but also results in improved balance, coordination and reaction time.

Similar to yoga, Pilates classes are offered both privately and in certain YMCAs.

Lotte Berk Method

The Lotte Berk Method is a time-tested exercise protocol for total body strengthening and toning. Since its origin is in spinal rehabilitation, it particularly strengthens the core muscle groups, glutes, and legs which are key to keeping you upright.

Lotte Berk Method studios are difficult to find, some mask their name as barre exercise classes, or you can score DVDs online.

Go Foreword  with your Life in Balance

The first step to prevention of unwanted events is awareness of the risk. Hopefully you are now aware of the insidious risk of just how tragic a bad fall can be to you or someone in your family and how it can disrupt your life. You may not be able to reduce the risk to zero, but just some intelligent actions taken today can significantly reduce that eventuality.