Typically, a fall is the end of action, not the beginning. What may have started as a walk, climb, or run becomes a trip, slip, stumble, misstep, loss of footing or other blunder. And then comes….the fall, resulting in bumps, bruises, sprains, strains and sometimes even breaks.
In younger years, falls are generally not a big deal. You often simply get up, dust yourself off and move on with an ego that hurts more than the body. Time passes and things change.
As we age, balance diminishes, muscles weaken and become less flexible, bones become more brittle and the overall healing process slows. By older adulthood, falls become a serious concern, and for good reason. What was a simple trip and fall in younger years can have catastrophic consequences.
A 2010 study revealed 30%-40% of community-dwelling adults 65 years of age or older fall at least once a year and the risk increases with age. The estimated direct medical costs for fatal and nonfatal fall-related injuries among community-dwelling persons 65 years or older in 2000 was $19.2 billion with a forecast of being “as high as $43.8 billion by 2020.”
Sadly, things have not improved since then. As the population ages, fall incidences and fall death rates are increasing. A 2019 report revealed that there is a fall-related fatality every 19 minutes in the U.S. They report that 3 million people over 65 had to seek emergency room care as a result of a fall. Contrary to the forecast of $43.8 billion by 2020, the annual cost of fall injuries topped $50 billion in 2015!
The CDC (Centers for Disease Control) currently reports:
- Over 800,000 are hospitalized due to their fall injury with most common injuries broken hips and head injuries
- Over 95% of hip fractures are a result of a fall
- Falls are the most common cause of traumatic brain injury (TBI)
- Medicare and Medicaid shouldered 75% of the cost for falls injuries
There are multiple risk factors for fall injuries among older adults. Among them are impaired mental status, medication side effects, taking multiple medications, environmental hazards, poor vision, lower extremity weakness and/or dysfunction, and impairments in balance, gait and activities of daily living. Multiple studies have shown a strong connection between older adults exercise habits and their fall risk.
A 2017 review and meta-analysis included 88 trials with over 19,000 total study participants. They found that overall, the rate of falls among community-dwelling older adults was reduced by 21% for those who exercised. When the exercise program included activities to challenge balance and more than 3 hours a week of exercise, there was a 39% reduction! They even saw some improvement for those with Parkinson’s disease or cognitive impairment! They do note that individuals must continue to participate in their selected exercise routine or risk losing the benefits.
Don’t Lose Your Balance
One of the primary contributing factors for balance impairments is a sedentary lifestyle. Therefore, a simple, inexpensive way to combat the risk is to get moving! An important thing to remember is if you wait until your balance has been compromised and you are already unsteady, then you are at a higher risk of falling. Therefore, it’s important to take proactive steps to preserve your balance.
While exercise can be done alone, with a trainer, or in a group, it is important to consider variations in individuals health. This may be especially important among community-dwelling older people who may already have health concerns or risks. They may need modifications for certain activities or need additional therapies for other conditions.
For these reasons, a healthcare provider, such as a doctor of chiropractic, should be consulted before beginning a new exercise plan. Part of the exam and consultation will involve your doctor of chiropractic evaluating muscle strength and balance. This enables the doctor to provide recommendations for what exercise plans would be best suited to each individual’s health status and goals.
If you are already experiencing balance problems, contact your chiropractor for an exam now to rule out concerns such as neurological, muscle strength issues, medication side effects or inner ear issues. Based on your exam and medical history, your doctor can determine the probable cause of your balance issue as well as what course of action is needed to restore your balance.
Chiropractic is Safe and Effective for Older Adults
Utilization of Complementary and Alternative Medicine (CAM) allows patients to receive health benefit without the risks associated with many medications and more invasive procedures. A review of 188 articles revealed that CAM utilization (including herbal remedies, chiropractic, massage, and acupuncture) is high among older patients. Among older adults, the most common complaint that CAM was sought for was pain-related syndromes, especially arthritis.
One of the articles they highlight reports on a large practice-based clinical trial evaluating 2 different schedules of care as compared to no schedule for patients with dizziness, balance difficulties and spinal pain. The Limited Schedule group received chiropractic care for 8 weeks, with 2 visits per week. The Extended Schedule group received the same care for 8 weeks with 2 visits per week followed by 10 months with one visit per month. The No Schedule group was provided with brochures containing lifestyle advice and instructed to do home exercise.
Patients who were experiencing dizziness showed improvement in balance in both the Limited and Extended schedule groups. The improvement continued throughout the study time period. However, the No Schedule group showed no such improvement. Additionally, while both Schedule groups experienced an improvement in pain, there was greater improvement in the Extended Group, even at 1 year, than the other groups.
The CAM review also assessed safety of the various treatments. They determined chiropractic, care, specifically spinal manipulative therapy, to be safe for older patients. They highlighted a study which the authors concluded “not only do older patients not experience more injuries than do younger patients they may actually experience fewer.” They attribute this to heightened caution of the provider who may alter techniques specifically to accommodate potential frailty and/or greater joint stiffness of an older individual.
Chiropractic care involves multiple types of interventions, including not only spinal manipulative therapy, but also physical modalities, exercise and nutrition counseling as well as preventive strategies such as fall prevention. The natural approach of chiropractic care also helps patients reduce or eliminate the need for pain medications. This can directly play a role in reducing the 1 in 25 older adults that is at risk for a major potential drug-drug interaction.
Exercise Helps Adults Maintain Function And Stay Active
The health benefits of exercise do not cease as we age, and regular chiropractic care can help maintain function, enabling patients to stay active longer. For example, exercise is recommended as a key factor in managing Osteoarthritis, a common cause of pain in older adults. Reducing activity levels due to pain is a risk factor for loss of muscle strength. In turn, decreased muscle strength is a risk factor for falls and as it progresses can become a limiting factor for independent living.
Here are a few activities that your chiropractor may suggest for you to stay active, and maintain balance and function.
- WALKING For many people, improving balance can be as simple as taking a walk around the block. It is a good low impact exercise that strengthens muscles. If you want to focus on balance, slow down the pace and walk in different directions; walking backwards, sideways, or in a curve will activate the muscles differently.
- STAIRS There’s a reason many health clubs include machines that allow people to climb, climb, climb. Climbing and coming back down stairs requires strength and balance to combat gravity. It builds strength in the legs and core of the body. Each step requires you to control placement of the foot as well as balance on one leg at a time. You don’t have to go to a gym if you have a set of stairs in your home. Just make a few laps there. Start off holding a rail while you build strength and then, when your body is able, begin to climb stairs without the aid of a rail to increase the benefits.
- SPORTS A number of sports can be enjoyed into the golden years such as golf and tennis. The frequent weight shifts required in golf, the stop/go, forward/backward/sideways movements as and the hand eye coordination of tennis make those 2 sports great choices for many people.
- TAI CHI or YOGA The exercises of old are still very beneficial, combining postures that require balance and body control along with breathing. The low impact and ease of modifying exercises ensures that nearly everyone can participate, regardless of other health issues.
Your local civic center, YMCA, community center, churches, civic groups or parks service are all great sources of information on classes in your area. Additionally, your chiropractor may give you specific exercises you can do at home to target any areas of weakness that you have.
With their advanced understanding of the musculoskeletal system, chiropractors can help guide patients through health choices such as physical activities, throughout life. When injury or other condition does occur, the chiropractor can help identify the root cause, offer treatment (or referral to another provider when needed) and also help the patient with rehab activities to prevent reoccurrence.
Don’t wait until you’ve had a fall and are also needing to rehabilitate an injury. If you are not having any problems, maintain a healthy, active lifestyle to preserve your balance and body functions. You can find a doctor of chiropractic near you here.
With improved balance, you may be able to keep that slip/trip to no more than a stumble before you regain your balance and continue on your way.
REFERENCE: Harvard Health Letter “Better balance: Activities to keep you on an even keel” Published: October, 2017 Accessed 4/10/2023 https://www.health.harvard.edu/staying-healthy/better-balance-activities-to-keep-you-on-an-even-keel?utm_content=buffer1798b&utm_medium=social&utm_source=twitter&utm_campaign=buffer
Sherrington C, Michaleff ZA, Fairhall N, et al Exercise to prevent falls in older adults: an updated systematic review and meta-analysis British Journal of Sports Medicine 2017;51:1750-1758.
Gleberzon BJ. A narrative review of the published chiropractic literature regarding older patients from 2001-2010. J Can Chiropr Assoc. 2011 Jun;55(2):76-95. PMID: 21629461; PMCID: PMC3095583.
Dougherty PE, Hawk C, Weiner DK, Gleberzon B, Andrew K, Killinger L. The role of chiropractic care in older adults. Chiropr Man Therap. 2012 Feb 21;20(1):3. doi: 10.1186/2045-709X-20-3. PMID: 22348431; PMCID: PMC3306193.
Bolton L. Preventing Fall Injury. Wounds. 2019 Oct;31(10):269-271. PMID: 31730506.
Yvonne L. Michael, Evelyn P. Whitlock, Jennifer S. Lin, et al. Primary Care–Relevant Interventions to Prevent Falling in Older Adults: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Ann Intern Med.2010;153:815-825. [Epub 21 December 2010]. doi:10.7326/0003-4819-153-12-201012210-00008
Centers for Disease Control and Prevention “Facts About Falls” https://www.cdc.gov/falls/facts.html Accessed 4/10/2023.
Centers for Disease Control and Prevention “Cost of Older Adult Falls” https://www.cdc.gov/falls/data/fall-cost.html Accessed 4/10/2023