Fitness After 50: I’ve fallen and can indeed get up – part one
As much as I dislike the scare tactic used in the Life Alert ad, I have to admit, it’s effective and it’s valid. A woman lies helplessly on the floor (or worse yet, in the shower) and cannot get up. She fell and hurt herself.
She can’t walk. Her phone is on top of the kitchen counter, and she has no way of calling for help. She is destined to wait until her children or neighbors notice that she’s missing, which could take days.
“I hate that ad!” my 79 year-old client Josephine said to me with a distressed look. Jo started exercising two years ago because her daughter told her that if she can’t climb the stairs, she has to move in with her. Now, Jo can walk for miles uphill and even jog. She is stronger and more fit than most. Her doctor is amazed. The best part is that she is less afraid to fall because she knows she has the strength to get to safety if she needs to.
Immobility, coupled with the fear of falling are a dangerous duo. And who of us doesn’t have fear? We’re all subject to falling, especially in the shower. Just FYI: The fear itself is misinterpreted. It’s NOT the fear of falling that we feel. It’s the fear of not being strong enough to get up, or to drag yourself to the phone and call for help. It’s the fear of not having enough balance to steady yourself when you stumble.
Jo’s daughter hates the Life Alert ad too, but she knows it happens all the time. People have embraced the notion that when a senior falls, it is the beginning of the end. Well, let’s not put the walker before the horse just yet. It is NOT the end. You just need to prepare. So suit up, and let’s begin with knowledge.
We all know that the elderly have at least a 10 times higher risk of falling than other age groups. The Society of Physical Therapy Science and many other health professionals agree that this is because of age-related physiological changes, especially pertaining to the quality and quantity of skeletal muscle. As people age, the risk of fall increases because a decrease muscle mass leads to atrophy, which decreases muscle function.
The challenge remains that there are few opportunities for seniors over the age of 75 to participate in regular physical activities. Program directors and fitness professionals don’t want to assume the risk of training an older person. Without physical activity, strength decreases. Consequently, there is less chance of muscular recovery due to a fall.
In 2014, The Society of Physical Therapy Science did several controlled, clinical studies with participants age 75+. (Subjects were excluded if they had neurological impairments, severe cardiovascular diseases, persistent joint pain, or musculoskeletal impairment; or required assistance from another person or a device during ambulation.) Basically it was a fall prevention study, specifically designed to increase the balance and strength of those deemed “too old to get stronger”. The groups trained under supervision to strengthen their hip flexors, hip extensors, hip abductors, knee flexors, knee extensors, ankle dorsiflexors and flexors. Their progress was measured by a hand-held dynamometer. After the intervention, both groups showed significant improvement in the strength of all seven muscle groups. The increase in strength resulted in lower extremity balance improvement.
Here’s the best part – the fall index scores of both groups decreased from 59 to 44.5, a statistically significant decrease from a clinical standpoint. How did they do it?
Elastic resistance bands. The brand they employed was TheraBands. They’re cheap, pretty darn safe and easy to use. You can buy a set for less than twenty dollars. According to the Society of Physical Therapy Science, they are practical because they have only a “small risk of injury.” They provide consistent tension, and are easily portable.
“Elastic-resistance exercises help not only in rehabilitation but also in other areas because they have been proven to improve muscle strength and stability. In just 8 weeks, the balance exercises and elastic-resistance exercises conducted in the study helped 75+ seniors improve their leg muscle strength and mind-muscle connection.” (Lee and Park) “We conclude that elastic resistance and balance-related exercises are acceptable as fall-prevention exercises for the elderly. We also suggest that these exercises be used appropriately according to the person’s personal physical characteristics and needs. Fall-prevention exercises for the elderly should not pose injury risks, and should be easy to practice, even at home. The balance exercises and elastic-resistance exercises used in the present study are accessible to the elderly, because they do not need specialized equipment and can be adjusted to personal physical strength.”
The participants spent two days a week under researcher supervision, and then trained on their own for three days a week. If you want to give it a try, YouTube has free resistance band videos for seniors in all states of ability, from active to chair-bound. Just search “Senior Band Training” in the YouTube search bar. OR, if you want free PDF guides, just email me at firstname.lastname@example.org and I’d be happy to send you what I’ve got. I’ve also got a terrific article from Medical Guardian with a step-by-step guide about how to get up from a fall. Next time, I’ll go into detail about how to do these exercises.
Remember, your goal will be to build upper and lower body strength, muscle density, balance and mind-muscle connections (proprioceptive muscle coordination/facilitation) so that you can prevent a fall. If you happen to fall anyway, you’ll have more strength to be able to crawl to a safe place and hoist yourself up to grab the phone. Just to be clear, I think wearing Life Alert or any other emergency wearable is a good idea, not just for seniors, but for anyone who feels vulnerable. Those things, in combination with the physical strength and balance needed to crawl to safety will reduce your fear factor by quite a bit. And who knows? You may get healthier in the process! As a reminder, I’ll go into detail about specific fall prevention/preparedness exercises and how to do them safely coming up in Part Two of this article.
INVITATION TO WATCH JOSEPHINE WORK OUT
Josephine has agreed to let other seniors come watch her exercise! You won’t believe what this 79 year-old can do. Just email me to come watch. No charge, of course!
Vicki Morgan CPT ACTION is a Senior Strength & Fitness Instructor at Flex Gym and Fitness. You can reach her at 719-445-8566 or visit seniorstrength.pro. Remember to consult a physician before beginning any diet or exercise program. If you experience pain or difficulty, stop and consult your healthcare provider. This article is not meant to take the place of any treatment or activity your physician has deemed necessary.
REFERENCES: Society of Physical Therapy Science, Department of Rehabilitation Science Graduate School, Institute for Safety Promotion, Inje University, College of Biomedical Science and Engineering, agingcare.com, silversneakers.com, TherBands is a registered trademark. Life Alert is a registered trademark.