Women know to get their first mammogram at age 40. What test are we supposed to get when we’re 50? If you said, "colonoscopy", you’re right. What test should we get when we’re 55? The problem is that there isn't one, but there should be. With falls being such an epidemic, I wish our health care system would encourage us to get a thorough balance evaluation. I don’t mean the kind where you stand and reach or stand on one foot. That’s not good enough. I’m talking about one that includes things such as (but not limited to): past medical history, medications you currently take and obtaining your blood pressure while seated and standing… If an evaluation like this was in place, the incidence of head trauma, fractures, hospitalizations and deaths from falls would drastically decrease!
Do you know which governmental agency agrees? The CDC (Centers for Disease Control & Prevention) does. The CDC is a division of Health and Human Services. They began an initiative to prevent falls called STEADI. The acronym stands for STopping Elderly Accidents, Deaths and Injuries from falls. Here are the questions they ask older adults to help them assess whether they’re a fall risk. So go ahead, and give it a try yourself. Grab a pen and paper and tally the number of yeses that you answer.
The CDC reports that people with more yeses to the statements you just read are more likely to fall compared to people who answered “no” more frequently.
When we compare fall risk to the list of top fears among older adults, what emerges is a correlation. Global studies have been done, and no matter which industrialized areas people live in, their fears are exactly the same. This isn’t the full list, but I’d bet you’ve worried about some or all of these:
Because you're responsible, you've likely decided to protect your financial security and home by getting help from accountants, attorneys, financial advisors, investment brokers and insurance agents. Now let me ask, how many people do you have on your physical wellness team? Do you see the imbalance? And guess what? It’s not your fault. Our health care system has trained us to think this way. Our parents and extended family may have lived this way.
This is where the correlation I previously eluded to regarding the CDC’s fall risk questions and the top fears among older people emerges and collides. Some of you are at risk of falling, you’re afraid of what might happen, and the major problem is that no one is there to direct you as to how to prevent the fall so you can stay healthy, happy and lead an independent productive life.
That’s what Lisa and I do with our program, Boost My Balance™. You don’t have to be afraid. You can continue doing the things that bring you joy rather than to decline because you’re afraid you might fall. You’ve worked hard so that you can enjoy this part of your life. Let us help you safely navigate that journey.
Most times reasons for falls are excuses for bigger, less obvious underlying causes. So when people tell me about their bungled balance, I dig deeper to help them decipher the truth. My goal is to help people make some tweaks in their environment or their behavior to avoid the consequences of what happens when we fall.
Let's go over the top 10 reasons why people fall and what the real cause of the fall could be:
My foot caught on to the edge of a carpet. Throw rugs, tattered, torn and uneven rugs cause so many falls. The problem isn't solely based on the fact that you didn't lift your foot up enough, but that you need to replace, tack-down or remove carpets that are a safety hazard.
I slid down a couple stairs, but I caught myself on the railing. Carrying things that obscure your view of your feet is a major reason for falls on stairs. This often happens when people carry laundry baskets or other large items. Too often, reaching out with your arm and grabbing a railing as you fall contributes to shoulder dislocations and rotator cuff tears. For this reason, I'm never pacified when people say they reached out for a railing to catch themselves before they fell.
I'm just a clumsy person. This tells me the person has likely had multiple falls and is a major reason why they need to learn strategies to improve awareness of their surroundings, to quicken their reflexes and to improve their physical strength to avoid falls in the future.
I tripped and fell, but I landed on something soft, so it's okay. It's only a matter of time before the landing site isn't so comfy, so we need to discuss how to identify and remove trip and fall hazards in the home and ways to improve balance so falling isn't so commonplace.
I didn't lift my foot up high enough when I stepped up the curb. This takes some investigation on my part because maybe it was a simple misstep, but not being able to lift one's leg or foot could be due to an underlying condition including things like arthritis, disc herniations in the low back, muscular weakness, neuropathy, spinal stenosis, etc...
My house was too dark and I couldn't see where I was going. This requires a multi-faceted solution. Light-activated night lights leading to bathrooms are a must. Having your vision checked yearly is another. If you wear glasses, you should put them on, even if you're only walking a few steps. It's a fact that most falls happen in our homes, and it's because we're most comfortable there, which results in our being less aware than if we were in a new place.
I was exhausted that day. Here's where I need to make sure the person is sleeping adequately. Sometimes a referral to the PCP and then a sleep study reveals apnea, which often explains why people are feeling such extreme fatigue. I need to assess whether the person is staying hydrated and if their diet is balanced and their caloric intake is sufficient. Underlying medical conditions must be reviewed, and sometimes I need to encourage the person to schedule an appointment with their physician to have a physical examination, to have the doctor review medications, dosages, interactions and side effects, and/or to get blood drawn.
I wasn't paying attention to where I was walking. The most commonly stated positive feedback we've received from the participants of our Boost My Balance™ classes is the new-found awareness not only of people's surroundings, but also of the awareness of their bodies and how they move about in the world. Being aware of how to properly move and navigate from one position to another makes a huge difference in improving one's sense of balance.
I usually fall up my stairs and not down them, so it's not a big deal. In my opinion, if a person is so unsteady that they can't walk up stairs, then I'm not confident they can navigate very well going down them either. It's only a matter of time before a fall occurs while going downstairs, which is when more serious injures take place.
I was wearing flip-flops...new shoes...slippers...high heels... I discuss how wearing one shoe over another affects our sense of balance. Sometimes we feel the Earth better under our feet when we're barefoot, but that changes when I'm talking to a person with conditions such as M.S., spinal stenosis, Parkinson's Disease, diabetic neuropathy, etc. People with underlying medical conditions require the stability of a shoe while they're moving about. So as you see, I've heard a myriad of reasons as to why people fall, but deeper investigation uncovers hidden, underlying truths that have to be addressed so falls and their unnecessary complications can be avoided in the future.
Have you made excuses like these? If so, and if this article has brought you insight, please share your comments below.
My balance class idea actually began as something very different. My patients in their 30's or 40's begged for help to fix their slouching posture. This was a subject I knew well, and I was certain I could help.
When I first began in practice, I performed a visual examination where I'd describe postural imbalances. I'd say things like, "Your head is tilted to the right. Your right shoulder is elevated. You're leaning forward at your waist." To me it meant a lot because posture abnormalities are an outward manifestation of what's happening with the muscles and joints inside the body. To patients, it hardly phased them because they already knew they were tilted, slumped or shifted one way or another.
I needed a way to impact people to change, and I found it one day when I did a health fair for employees at the Bucks County Courthouse. I don't know what prompted me to bring my iPad that day, but I did. Thankfully I decided to take pictures of people's posture rather than to simply tell them what I saw. This was a pivotal moment because the look on people's faces when I showed them their front and side pictures is something I'll never forget. People said things like, "I stand like THAT? Yuck!" or "THAT'S what I look like?" The pictures couldn't lie nor could they exaggerate.
And that was the moment I learned my first lesson in this journey toward better balance. Lesson #1: People want proof. Show them something so impactful that will motivate them to change. At that moment my mission was to create a program to help people stand taller and feel better.
Then a new trend began to emerge, and it was alarming. My patients over 55-years-old began telling me they had fallen. It would happen infrequently at first. A while after a few more would admit they had fallen. Then a patient who I admired so much for being a hard worker and a woman who lived a happy, full life fell and broke her hip. Her life was forever changed and not for the better. It was as though the Universe was giving me signs - slowly at first, then more and more frequently until the day when a young patient of mine fell, bumped his head and had a stroke. His life might never return to what it once was.
That was the day I scrapped everything I had done with the posture program and shifted all of my attention on fall prevention. Do you know why? It's because our health care system focuses more on what to do AFTER we fall rather than working on strength preservation and fall prevention at the time when we need it most, which is BEFORE we fall. I was tired of my patients not having options, I wasn't willing to hear one more "I fell" story. Lesson #2: Give people something they don't even know they need. That's how Boost My Balance began.
Lesson #3: It took me a while to learn that I couldn't do this on my own. I must admit that I tried, and my balance program was only "good", and "good" isn't good enough for me. I needed to enlist the help of someone with expertise in the field of fitness. Lisa Byrne and I began our journey into creating the Boost My Balance program. Here we are in the midst of it all and loving every step along the way. We're taking baby steps now, but we want our program to grow. It needs to because studies show that EVERY person should work on his/her balance because it starts declining at 50-years-old!
Here's the last lesson, which has many facets: Lesson #4: Teaching is fun, teamwork is awesome, and we're seeing our hard work pay off because our class participants are doing wonderfully! We're witnessing people getting steadier on their feet, having more confidence and being more mindful of the way they do most everything. We've gotten astounding feedback, and we're proud. Our goal is to get the word out: first with a balance class...then a 55+ community...a church group...an active seniors group...we aim to make this program grow far beyond our little community.
And when we grow, we'll want our story to be told in writing because the more people learn about us, the more we'll be able to help others. It won't end there. We'll teach what we know to other practitioners so they can help people in their communities, too. The future of Boost My Balance is bright and we're motivated to help older adults live independent, healthy lives!
-Carla Spinelli, DC
In the 17 years I’ve had my exercise and movement studio, there has been a fair share of folks who admitted to disliking exercise. Maybe that’s you. So let’s take a step back. and start with this: Let's shift the way you think about exercise.
For starters, don’t even call it exercise. I don’t. My education is in Exercise Physiology with a full Pilates Certification and yet I stay far, far away from the “E” word.
Exercise is something you do to your body. Don’t do. Find a way to be in your body. This is a whole different space. And one you might really enjoy. Can you call it movement? Movement allows for freedom. It can be playful, non-exertional, fun, fantastic, engaging, experimental and wholly healthy to your beingness.
Remember, motion is lotion. Lotion in your joints and also as a liquid healer in your ribcage and spine, the very foundational structure from which you move and live life.
In his national bestseller, The Culture Code, Clotaire Rapaille offers us a way to understand our behaviors as human beings and the unconscious codes that drive them. A most fascinating chapter reveals the code for health and wellness as movement. “Movement makes us feel healthy, it confirms we are alive." Oh so true!
Let me ask you to do this for a moment: Imagine not being able to do what you want in life because you can’t take action. You can’t take action because something has happened to you through a trauma or an accident. You’re stuck. You can’t move and do what you want because your life has changed for the short term or possibly even longer. Have you ever experienced that or knew someone who has?
A possible loss of movement can be devastating. It makes a drastic statement about your own health and well-being. It robs you of opportunities and possibilities. It’s downright frightening! I’m not trying to be an alarmist by any means. But think about it. We want to believe that if we live active and engaged lives, we’ll stay healthy. And you can.
What’s included in active engagement? Mobility, agility and resilience. You’re able to move, you’re nimble and you can bounce back (all without using the word “exercise”). Now you’re workin’ it. Can you feel it? Becoming a better version of yourself is about enjoying life without heaviness or the burden of “have to”. It’s learning how to weave in a slow, sustainable build.
A slow build like this can sneak under your radar in a good way. Over time that slow sneak will build and become a good, solid habit. This sort of build takes time. And it should if you want quality. It’s about making small, consistent shifts.
Another word to omit is the word ‘change’. Change can be daunting. Let’s use ‘shift’ instead and use it as a precursor to change. Change sometimes feels too much like a force if we try to drive it in at the beginning of anything. Sometimes trying to force something feels like pushing or even shoving. And that’s an effortful expenditure of energy. Don’t push – rather consider the act of pulling. There’s your shift.
Pulling has a precious power to it. It requires you to be grounded or you're going to fall. Making these small, consistent shifts is a simple, sensible and practical way to feel better about your personal progress. Pulling is like teasing it along. Slow and steady is a win-win. It’s not about forcing change and making headway. You’re not steering a big ship on rough seas. You’re in this for the long, productive, sustainable haul. Be the slow and steady pull.
It will be rewarding when you begin to see how you’ve acclimated to new choices through the small, consistent shifts you set up. And here’s where you can become a better version of yourself. Be accountable. Experience the fruits of your own solid efforts because you have stacked up the conditions to make it happen for yourself. That's the cornerstone of a successful conversion.
Self-accountability is one of the best sustainable resources for personal, authentic success and one that can help you have a clearer, more meaningful and enjoyable journey.
Show up for yourself. You’re worth it. Now get out there and create a new you 2.0.
I found myself gleefully jumping up & down and sideways when I read this article in the NY Times. You know why? Because it speaks a message that has been slowly gaining meaningful strength and one you should take seriously.
It has to do with balance, motor skills, your brain and real world usage.
Even though the message headlines as "Balance", the author unpacks it brilliantly by admitting something we do a lot – isolate balance exercises.
Isolating is okay, but when all you do is practice exercises that confine you, you're not serving yourself in a well-rounded way, which includes your brain. There's an emerging body of meaningful research you should pay attention to (no matter what your age).
And it aligns with the message in the NY Times article: http://www.nytimes.com/2015/06/07/opinion/sunday/finding-the-right-balance.html, which is this: It is a “suite of abilities and gross motor skills” that rewires our brains for physical improvement and NOT buzz words and pieces & parts – like "cardio, abs and strength training. Improving your balance is trickier than you think. Simple balance exercises alone won’t achieve what you want – it is novelty and unpredictability, rather than repetition, that are essential to keep your brain engaged.”