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Falling Facts

NY Times Article on Fall Prevention

When discussing fitness goals, most people never mention fall prevention, but I suggest that it is more important than fat loss or improving your cardiovascular capacity.  Please take the time to read Gretchen Reynolds excellent article; Falls Can Kill You. Here’s How to Minimize the Risk.  In the article, Ms. Reynolds presents several good lifestyle modifications and medication precautions that will help prevent a fall.  Try adding some of my long standing fall prevention training tips.

Exercise in a standing position. 

If your goal is to move better and remain free of injury, then 90% of your exercise activity should be performed in standing.  Developing better kinesthetic awareness, strength, and coordination in a standing posture is the crucial component of training that prevents a fall.  During my visits to commercial gyms, most of the exercise activity I witness is performed in a supine, seated, or supported position.

Practice moving in all directions.

Fall prevention training involves improving multi-directional movement skills.  Most falls happen from an unexpected disruption of your equilibrium.  You get pushed to one side, twisted off center, or a foot slides from under the body.  Most gym activities are predominantly sagittal plane- forward and backward.  We need to be able to move well in all directions.

Practice moving faster.

Fall reaction training should focus on exercise activities that make you quicker.  Research on falls has shown that a gait pattern (how you walk) that starts to slow down is the best predictor for a future fall.  Agility ladder footwork, medicine ball throws, and hurdle drills are examples of faster paced training activities.  Yoga, Pilates, recumbent bicycle riding, and muscle isolation exercises will not make you better at moving faster.

Stand on one leg.

A simple and proven fall prevention activity is single leg stance balance training.  Single leg balance is a skill that tends to deteriorate with age, injury, and a sedentary lifestyle.  Stand on one leg for twenty seconds.  Stand on one leg and turn your head side to side.  Stand on one leg and then close your eyes.

Practice getting up and down off the floor. 

One of the best anti fall training activities is consistent practice of getting up and down off the floor.  Moving gracefully from standing to the floor and back up again is a life skill that keeps you independent and safe.  As a Physical Therapist, I frequently find people who are very impaired in this basic task of mobility.  They crawl to a piece of furniture for an assist and transition from the floor in an unsteady and unsafe manner.  Most of these patients are not elderly, they are tight, weak, and deconditioned.

Perform single leg strength training. 

We are monopods.  We absorb and then create force one leg at a time.  During activities of daily living, one leg is loaded more than the other.  It only makes sense that we train our legs the same way we use them.  Work with a trainer and learn how to perform step ups, single leg squats, rear foot elevated split squats, single leg deadlifts…

Become a better shock absorber.

Fall events often occur because of an impact.  The force of the impact causes our body to give in to gravity and down we go.  Just like any other physical attribute, impact resilience can be trained.  Mat work, medicine ball throws, and rope drills are some of the activities that can be used to improve impact resilience.

Make balance practice a daily event.

Integrate anti-fall training into your lifestyle.  Stand on one leg while you brush your teeth–right leg thirty seconds then left leg thirty seconds.  Perform multi directional exercise as movement preparation before a bike ride or run.  Get some instruction on a program of exercise that improves agility, single leg strength, and power production.

Someday, somehow, and when you least expect it, you are going to have an unplanned interaction with gravity.  Your fitness program should make you more responsive to a fall event and less likely to be injured.

Link to article: here

Michael S. O’Hara, PT, OCS, CSCS

The Wisdom of Frank–Part IV

“Change It Up”

I met my friend Frank when I was 21 years old and working out at a local gym.  Frank was sixty-eight years old and in great condition.  He had been a professional boxer, army fitness instructor, and then a physical education teacher.  Frank was an incredibly well read student of fitness and human performance.  He was stronger, more agile, and fitter than most people in their twenties.  Success leaves footprints, so I was eager to learn from a master.

Frank was big on developing one set of skills for a defined period of time and then switching to performance parameters.  We would work hard on improving strength with squats, cleans, and pull ups for six weeks and then take a break.  The next six weeks would focus on speed and endurance–lots of jump rope, sprinting, and medicine ball throws.  I never got bored and I never got hurt.

The best injury preventative for athletes and fitness enthusiasts is a consistent change in activity.  Look at your training / competition schedule and alter your activity every six to eight weeks.  Better yet, take a week or two away from running, dance, yoga, lifting, baseball, or Zumba.  If you are older or more injury prone, that rest period might need to be stretched out to three weeks.

The popularity of the club system has young athletes playing the same sport year round.  In the clinic, we are treating young athletes with “old person” overuse injuries.  Playing multiple sports is infinitely more beneficial.  Taking layoffs from overused movement patterns and participating in a variety of athletic endeavors gives the body a chance to rebuild and recover.  It is no coincidence that successful professional athletes are the product of multi-sport participation.

Michael S. O’Hara, PT, OCS, CSCS

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