By Sheri R. Colberg, PhD
Just the other day I heard someone who was kidding around facetiously say to his colleague, "Help, I’ve fallen and I can’t get up!" That phrase is actually a registered trademark of Life Alert Emergency Response and commonly joked about, but it’s no laughing matter.
Even you likely have fallen down at one time or another, even if you accidentally tripped over your own feet or your dog. Once you fall, however, you earn the designation of "faller" for a full year, which puts you at greater risk of falling again.
Even if you have been fortunate enough to stay on your feet or to fall and not get injured, there’s no guarantee that your good fortune will continue as you reach and pass the 60-year milestone, particularly if you’re a younger woman with osteoporosis or osteopenia. If you do experience a hip fracture related to falling down, you may not be able to get up on your own. Other individuals simply lack the strength or agility to do so, particularly if they have suffered from significant muscle wasting (sarcopenia) over a period of time.
Admittedly, no one likes to consider the possibility of reaching a physical state that would not allow independent living, but both falls and frailty can make this a reality. Even fewer of us want to end up living out the rest of our lives in a nursing home, away from our family and friends and cared for by relative strangers. Even if you’re still feeling young and good enough to not have to worry about these possible scenarios yet (although you may have parents or older relatives who are being affected), it’s still better to know which path to follow to prevent them altogether.
Falling down occasionally is inevitable at any age. In fact, the more active you are, the more likely you are to fall down at some point, even if you’re currently in good shape and have excellent balance. Most falls actually occur indoors at home, mainly in the bathroom, bedroom, and kitchen. Ten percent of falls occur on the stairs, particularly during descent, with the first and last steps being the most dangerous. Therefore, it’s best to try to minimize the impact of falls (both the number and the potential injuries) rather than to ineffectively attempt to lower the risk of falling by becoming more physically inactive (which is extremely counterproductive).
About 95 percent of all hip fractures result from falls and are the major cause of hospital emergency room visits for injuries. In addition, the psychological aspects can be equally damaging. Fear of falling, which may cause individuals to choose to become less active and socially-oriented, can lead to social isolation, depression, and impaired activities of daily living from further declines in strength. Although falls are less common among adults in their middle years, one in three people over 60 years of age falls each year. The major risk factors are quadriceps weakness, balance problems, gait disorders, sensory loss, dizziness, recent changes in medication(s), upright posture, ill-fitting glasses or new bifocals that affect downward vision, other sight issues, low blood pressure, frequent urination, and a history of falls.
You can minimize the potential impact of falls by keeping yourself healthy, strong, stable, and physically active, particularly focusing on daily balance and strength exercises.
How frequently or urgently you have to go to the bathroom also, strangely enough, affects your falling risk. Making frequent trips to urinate at night sets you up to fall, as can incontinence at any time of day. If you’re rushing to make it to the bathroom in time, you’re more likely to fall due to your altered gait and abnormally rapid pace; in addition, poorer lighting during the night increases the risk when you get up then.
You should keep your feet in good shape, too, because bunions, calluses, and deformed toes also can modify gait or inhibit adequate movement, thus heightening your risk, and you should just forget wearing wobbly high-heel shoes if you want to stay on your feet. People with diabetes need to be particularly careful if they lose sensation in their feet due to peripheral neuropathy or have other foot changes (like Charcot joints).
Many of the potential risks arising from physical changes as you get older can be substantially lowered by doing strengthening, balance, and flexibility exercises. Our recent studies have found that even six weeks of low-level balance training can greatly reduce a diabetic individual’s risk of falling. Balance exercises can be as simple as practicing standing on one leg — while holding on and eventually without support, and then with your eyes closed. All lower body and core resistance work can help improve balance and improve gait, further reducing falls risk. Furthermore, you can prevent falls by properly lighting areas where you’re walking (particularly at night), wearing good shoes, correcting your vision (e.g., cataract removal), resting when you get tired, controlling incontinence, and removing floor clutter and throw rugs. Finally, if you’re prone to falling frequently, you may also want to look into wearing hip pads to soften your landings and lower the potential for hip fractures. Whatever you do, though, don’t stop being physically active due to fear or falling or it will become a self-fulfilling prophecy!
Sign up for the Diabetes "Fit Brain, Fit Body!" fitness/lifestyle programs or for 5 free Healthy Living Reports at www.lifelongexercise.com, and access more articles and information at www.shericolberg.com. If you need tips for getting safely started on an exercise program, check out The 7 Step Diabetes Fitness Plan. For people with any type of diabetes who are already more active, consult the Diabetic Athlete’s Handbook.
Copyright © 2012 Diabetes In Control, Inc.