Standing Tall to Prevent a Fall
By: Jessica Pinkowski

Did you know that 20% - 30% of aging adults have a fear of falling?  Falling, even with no injury, can have a negative impact on a person’s health and wellness.  Many experience a loss of confidence that can easily lead into restricted activities of daily living.  Once a sedentary lifestyle has taken place, a person’s risk of falling increases.  Falling is not part of the aging process, rather it is due to a series of risk factors. Risk factors that contribute to falling include biological, behavioral and environmental.  Some risk factors cannot be changed, however improving posture is a risk factor that can be changed.  Having the strength to carry out daily tasks in proper body alignment is not an easy job. Balance control requires our bodies to use different approaches to help prevent us from falling and include ankle strategy, hip strategy and step strategy.  When a person is not able to regain stability and place their body back up into the upright position, the end results could be devastating even fatal.

Biological Risk Factors

Biological risk factors that increase our risk of falling are sex, age and race.  These factors cannot be changed or modified.  Chronic diseases such as Parkinson’s, arthritis and osteoporosis can also be categorized as a biological risk factor.  These diseases strongly increase a person’s chance of falling due to the negative effects on balance and mobility.  There are other symptoms to consider as well such as joint pain and decreased range of motion.   These symptoms may cause a person to change their behavior and choose a less active lifestyle.

Behavior Risk Factors

Behavioral risk factors that increase a person’s chance of falling include the use of multiple medications, excessive intake of alcohol, sedentary lifestyle, poor nutrition, improper footwear and risk taking behaviors.  Living a sedentary lifestyle or an inactive lifestyle with no weight bearing movement decreases a person’s muscle mass and flexibility.  Weakened muscles of the shoulder, core, pelvic and leg area disable a person’s ability to stand tall in good posture.  All adults need to engage in physical activity most days of the week in order to age optimally and improve their health and wellness.  Eating a well-balanced diet is another change in behavior needed to improve one’s body composition.

Environmental Risk Factors

Environmental risk factors have to do with physical hazards we are exposed to in the home and outside the home.  Loose rugs on the floor and clutter contribute to environmental factors that raise the chances of falling in the home.  Poor lighting can also enhance the risk of a fall.  What about outside the home?  Sidewalks that are poorly designed or cracked, steep driveways and the weather conditions are also contributing environmental factors of falling.

Strategies to Prevent Falling

There are 3 types of strategies the human body performs to control body sway and prevent us from falling.  Ankle strategy is subconsciously used when a person is slightly pushed.  The body moves as a whole and the ankle joints allow the body to restore balance and proper body alignment.  The next strategy the body uses to prevent a fall is hip strategy.  Hip strategy involves the use of hip strength when the body’s center of gravity is shifted in any direction and the body has to correct posture at a faster rate.  Imagine running to the end of a cliff and abruptly stopping right at the end.  Your body will bend in from the hip joint to counteract balance and keep you from falling.  The use of hip strategy, rather than ankle strategy, requires more strength in the hip joint and adequate flexibility.  When a person’s center of gravity has moved beyond the limits of using ankle and hip strategy, the body uses step strategy for postural correction.  This allows a person to engage in a different base of support with their feet to gain better balance and control.  Step strategy requires the body to have ample amount of lower body strength, power and flexibility to stop the body in motion and regain flexibility.  It requires a quick response to the loss of balance and the ability to initiate a change in their base of support by stepping to prevent them from falling.  All 3 strategies are used every day when we engage in activities of all levels. 

Posture Improvement to Prevent Falling

Posture is defined as the position or attitude of the body or bodily parts that require minimum muscular energy to maintain mechanically efficient function of the joints with musculoskeletal balance.  Upright posture keeps a person’s center of gravity from deviating out of postural control.  For example, if a person is sitting for longer periods of time in poor static posture, their hip flexor and chest muscles become tight and the posterior part of the body becomes weak. Less flexibility within the hip joint, weakened leg muscles and poor ankle articulation also occur over long periods of time.  The loss of strength and flexibility will no longer allow this person to stand tall in proper posture. The body’s center of gravity is then forced to shift forward outside its support base and without the proper strength to regain good posture, the person will fall forward.  Dynamic posture impairments such as this limit a person’s ability to control changes in direction quickly and efficiently.  They are not able to regain their balance when moving around obstacles in their environment intensifying their fears of falling.

Science has proven that improving posture helps the body to stay in better balance.  After the age of 50 muscle strength and power start to weaken.  Older adults with low muscle mass have a difficult time with individual daily chores and their quality of life begins to diminish.  Engaging in proper weight bearing activities to improve posture is important.  No matter what your age, remembering the four points of posture can help improve balance in the body. 

• Stand tall

• Hold chest high

• Retract your shoulder blades as if you were squeezing a pencil between them

• Contract your abdominals

The fear of falling has increased in the last decade within our older adults. There are multiple factors that cause a person to fall, but improving posture is one of the ways to help prevent a fall.    With better posture the body is in better balance therefore allowing a person to move safely and with more confidence.  Improved health and wellness of a person increases their desire to be more physically active raising their quality of life.  

REFERNCES

1. Debra J. Rose. “Fallproof!  A comprehensive balance and mobility training program” / 2^nd ed. (2010)
2. Joseph F. Signorile. “Bending the Aging Curve”.  (2011)
3. The Journal on Active Aging July/August 2011 Vol.10 No.4

About the Author

Jessica Pinkowski, NPI-Certified Posture Specialist™, CPT, AFAA Group Fitness, is a contributing writer for the National Posture Insitute.  Growing up in a dance studio combined with over 16 years as a certified fitness professional, Jessica Pinkowski has a lifetime of experience with movement.  A National Posture Institute – Certified Posture Specialist, AFAA certified in group fitness and personal training, Jessica’s focus is special populations. As a member of the GeoMotion fitness team Jessica regularly develops and presents youth fitness programming. Currently a curriculum specialist for On Top of the World Communities Inc., Jessica teaches and lectures on the importance of health and wellness for active aging adults.