What is a ‘Fall’? -April Falls part 1
In the spirit of April Falls Month, we have written this blog to explain what makes a fall a ‘fall’, the “types” of balance we use on a daily balance and what can be done to improve your balance.
When do we stop calling it ‘tripping over’?
Work, health and safety legislation neatly classifies the difference between tripping, slipping and falling.
A trip is when your foot makes contact with an obstruction and there is a loss of balance, but you are able to regain control of your balance.
A slip is when there is not enough friction between the ground and the footwear resulting in loss of balance, such as when the floor is wet or slippery.
A fall is when you have experienced a slip, trip or loss of balance that results in an uncontrolled, rapid descent to the floor.
Am I at risk of falling, and am I likely to injure myself if I fall?
The above breakdowns can be used to determine if you have fallen, however there are some extra considerations to be had when deciding whether you have “hit the age, I now call any stumble or trip a fall” - Quote, my lovely Mum. Technically speaking, everyone falls! However, it is important to identify if you are at a higher risk for falling or if you are likely to have poor outcomes after a fall due to your current health status.
Some of the things we take into consideration when determining your risk of falls or adverse outcomes are;
Age
The age bracket that is at highest risk of falling is 60+
As we age, our muscle and bone mass decreases. Therefore, we are not as strong and may have difficulties staying upright
Our inner ear and eyes will also deteriorate as we age, which reduces
Bone density
When looking at falls, it is important to know the potential outcome of the fall. If you have a low bone mineral density, you are at a higher risk to fracture your bones if you fall down
Fear
Has this fall scared, hurt or worried you? If so, this may impact your behaviours around completing the task that you were doing when you had a fall, or at the location that you previously fell
These behaviours could be detrimental to your physical abilities, increasing your risk of falling, which is why we, as allied health professionals, address your fears around movement if you have fallen.
“Near misses”
If you or your loved one are having a few ‘near misses’, this may be an indicator that something is astray.
As the frequency of ’near misses’ increases we are at a higher risk to actually make it to the ground!
Eye and ear health
Being unable to see obstacles or hazards means we are more likely to crash into things
Our ears are crucial for our balance skills. When we have ear infections or something is amiss within our inner ear, we are more likely to be off balance and take a stack
Cognitive function
People may have difficulties performing more than one task at a time. For example, walking while holding a glass of water or trying to pick something up and hold a conversation, which can put us at a higher risk of falling
Look out for times where in order to do a thinking task, your body stops, and be mindful of if it stops while you're in a steady position or if it is in the middle of walking/stair climbing etc
For people with dementia and/or Alzheimer’s, they may forget that their body cannot do what it used to and venture out without their walking aid or attempt a challenging movement beyond their physical capabilities. These cognitive conditions can also mean that coordination and reflexes are not at sufficient levels to effectively prevent falls putting them at further risk, of guess what? FALLING!
‘Furniture surfing’
This term describes when a person is constantly reaching for something to hold onto to move through their home.
This is a safety mechanism people may develop as they feel their balance declining or if they have had a fall in the past. This method is not foolproof and can go wrong if the furniture is not stable or it is too far out of reach so the individual leans too far over
Other medical conditions
There are an array of medical conditions that may affect your balance depending on the impact it has on your function abilities, your physiological responses or your body structures.
If you or your loved one fall into one of these categories, it may be worthwhile to seek help from trained professionals, to reduce your risk in the areas that are modifiable, and improve your balance capabilities.
What are the “Types” of Balance
Static Balance
This addresses any time you are holding still or attempting to stay in the same position, while keeping an upright posture. Some examples include any time you’re standing up on different surfaces or needing to reach for things without moving your feet.
Dynamic Balance
This addresses any time you are needing to remain balanced while moving. This includes when walking and changing direction, but can include any task with translation (movement from point A to point B).
Reactive Balance
This addresses balance that involves reacting to internal or external stimuli that ‘throw you off balance’. The internal may be that you have lost concentration, or directed focus to a second task and lost balance but regained it.Think of the external stimuli as the times you have slipped, tripped or been bumped into and you have had to regain balance.
How does my body keep me balanced?
There are three main systems that help to keep you balanced.
Eyes
The ability to see obstacles in the world is very important for balance. It also allows you to see any changes in surfaces which might make balance harder
2. Ears
Your inner ears are your body's spirit level. They tell you where your head is in relation to your body and in space to keep you balanced.
3. Touch/Feel
Being able to feel the ground under your feet, as well as where the rest of your body is, is vital to staying balanced. Your body is able to recognise where it is in space in relation to itself which is why you can touch your nose with your eyes closed!
Each of these systems work together to keep you balanced and regain your balance if you have been ‘knocked off’ balance. If one or more of these systems becomes less effective, it places extra stress on the other two, which can make it more likely to lose your balance and fall.
For a comprehensive understanding of each of these systems read the second part of this blog “Balance Systems”
What can I do to improve my balance skills?
Luckily for us, balance can be trained! Here is a small collection of some of the ways you can improve your balance (under individual advice or supervision of an Exercise Physiologist or Physiotherapist if you are someone who is prone to falling or highly likely to fall). Please ensure if you try these at home you do so in an area that has easy ‘grab sites’ such as the kitchen bench in the corner, at a rail, or in front of a heavy chair.
Practice standing in positions where you have a reduced base of support. This means narrowing your feet position while you are standing. This will help train static balance!
Add forwards, sideways or backwards movements with these smaller bases of support. This will help to train your dynamic balance skills
Add head movement to these tasks to start to train your reactive balance skills
For a more individualised approach to improving your balance, reach out to WHAM today to book an appointment with our Exercise Physiologist who can assess your current balance skills and provide a challenging but safe program for you to complete!
Happy April Falls Month! Stick around to see part 2 “Balance Systems”
We encourage you to seek professional advice if you wish to begin therapy to assist in retraining your balance capabilities or identify any balance issues you may be experiencing. If you have a history of falls and wish to engage in some of the tasks listed above we ask that you do so under the supervision of an Exercise Physiologist, Physiotherapist or appropriately trained healthcare professional.