The Balance Problem

Falls affect a surprising number of people! One in 3 adults aged 65 years or older fall each year, and 1 in 2 adults aged 80 years or older fall each year. However, just because falls are common, doesn't mean they’re normal or inevitable! There are lots of factors, other than age, that contribute to balance such as environment, health, comorbidities, medications, strength and flexibility. 

If you’re worried about your balance or fear falling, there are four easy steps you can take to decrease your risk! We’ll start discussing home safety, then go through some health and medical tips, and finally talk about the role of physical therapy and exercise. 

Step 1: Home safety 

This is the meatiest of all the steps because there are tons of easy changes you can make to your living space to maximize your safety! So, bear with me as I take you through the list of what to do and why. 

• Clear cluttered floors and tape down rugs: Cluttered floors are a tripping hazard. Make sure the pathways of your home are clear of anything that could catch your feet. Throw rugs are a surprisingly common tripping hazard. All throw rugs should be secured down in place or removed entirely. 
• Stairs: Check to make sure all stairways have sturdy railings and make a plan to fix any wobbly, broken, or absent railings. 
• Showers: Slippery shower floors are an opportunity for a fall. Placing a grip mat at the bottom of the tub can help as well as installing grab bars. 
• Lights: Vision is crucially important to maintain balance so it is important to have good lighting especially around stairways and entrances. We also recommend adding nightlights along the path from your bed to your bathroom. Many falls happen at night when someone wakes up to use the bathroom without turning on a light. Remember this phrase: “you must see before you pee!” 

Step Two: Eye care 

As stated above, vision is very important to balance. If you don’t believe me, try any simple balance exercise once with your eyes open and a second time with your eyes closed (please be safe while doing this and make sure you are holding onto something to prevent a fall!). The task is going to be A LOT harder with eyes closed. This is why good eye care is important. Make sure to attend yearly eye examinations and renew glasses prescriptions as needed. 

Step Three: Understanding your Medications

Polypharmacy, is a fancy term for taking 5 or more prescription medications.  Studies show that taking multiple medications increases likelihood of falls. It's important to talk to your medical providers about your medication and their potential effects on balance. There are some commonly prescribed medications such as some blood pressure medications that can cause lightheadedness and increase falls risk. Older adults on these medications should take their time while changing position especially when moving from lying down to standing up.  Knowledge is power, so ask questions of  your primary care, your pharmacist, or your nurse about your medications and how to manage their side effects. 

Step Four: Physical therapy and Exercises

For obvious reasons, step four is my favorite! Balance is a complex interplay of lots and lots of factors (strength, flexibility, reaction time, body awareness, vision, vestibular system, posture, cognition…etc- the list goes on...). Unfortunately, there is no one size fits all program, however, physical therapists are fantastic at treating balance impairments. We know which muscles need to be stretched, which need to be strengthened and how to prescribe tailored balance exercises that meet you at your exact need level. After a course of physical therapy, you will be armored with a manageable list of home exercises and options for community classes or programs that will help you maintain the progress made during PT. 

The Takeaways

Fear of falling affects far too many people and it doesn’t have to! Simple changes to your home environment and support from Physicians and Physical Therapists can help. If you live in the Washington DC area and you are struggling with balance problems, the team of physical therapists at Sports Therapy and Rehabilitation are here to help you get back on your feet with confidence.

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