By Dr Danica Newbold, B.HSci (Chiro), M.ClinChiro, Ad.Dip Myo. Certified Cox® Technic Chiropractor and Myotherapist.
As we age, there is often associated deterioration in our balance, strength and coordination, putting older adults at more significant risk of falls, often with serious consequences.
“Falling is the leading cause of injury-related deaths in older adults. For those between ages 70–79 years, 27.7% of injury-related deaths are attributable to falling. This proportion increases to 46.4% for those of ages 80–89 years and 64.8% for those aged 90–99 years. Gryfe et al. reported that 45% of adults over 65 years of age will experience at least one fall per year, and many of these individuals will fall repeatedly1.”
Several contributing factors can place an older person at significant risk of falls; there are, however, two main fundamentals that can ensure decreased falls risks, these are:
- Balance and
- Strength.
BALANCE
Good balance depends on the following:
- correct sensory information from your eyes (visual system),
- muscles, tendons, and joints (proprioceptive input), and
- the balance organs in the inner ear (vestibular system).2
As Chiropractors, we help our patients improve and maintain the optimal functionality of their neuro-musculoskeletal system. Problems that occur in ligaments or muscles of the upper cervical spine (neck) can confuse proprioception3. This is because the muscles and ligaments of the upper neck are sensitive and reactive. Any disturbance or imbalance in this system can result in balance and coordination issues. Gentle mobilisation and treatment using Cox® Flexion-Distraction on the upper neck by a Certified Cox® Flexion-Distraction Chiropractor can reduce the abnormal mechanical stress on the cervical spinal joints (zygapophyseal joints) as we know, these joints are responsible for about 50% of all cervical proprioception and about one-third of balance feedback.
STRENGTH:
While it’s impossible to completely prevent falls, exercise that promotes increased strength and balance can reduce the risks of falls4.
Some spinal conditions can affect our strength, balance and coordination, for example, conditions that compress or compromise the nervous systems which controls our lower limbs, i.e., Lumbar spinal disc bulges and/ or Lumbar spinal stenosis. Disruption to the nervous system that controls the strength and kinematics of our lower limbs can mean older adults cannot control their legs and feet as they should therefore tripping and / or falling may result.
There are some basic exercises you can perform at home:
- Sit to Stand – Aimed at strength, balance and coordination. With your arms across your chest and feet hip-width apart, slowly raise up from a chair. Slowly lower yourself back towards the seat without sitting completely. Once your buttock makes contact with the chair, raise to a standing position again. Repeat 5-10 times5. The goal is 12 repetitions in 20 seconds.
- Knee Raises – Ideal for balance and coordination. Standing beside a waist-height bench or chair as support, ensure your feet are hip-width apart. Focus on a spot in front of you, lift one foot off the floor with the knee bent. Hold this position for 3-5 seconds, return the foot to the floor and repeat with the opposite leg. Continue alternating legs for 1-2 minutes5.
- Heel-Toe Stand/Walk – Great for improving balance and coordination! With fingertips on something solid to help keep balance, stand heel to toe, bend knees slightly and hold still for 10 seconds. Vary the exercise by slowly walking forward, ensuring the heel touches the toe each time. Continue for 1-2 minutes5.
- Heel Raises (See Winter Stretches Below)
- Hip Abductions (See Winter Stretches Below)
- Wall Squats (See Winter Stretches Below)
These exercises, as well as others, are ideal for older adults. Still, it is essential to ensure that all our patients are exercising regularly. Simple activities like walking or even participating in classes such as Tai Chi or Pilates are great for improving strength and conditioning and decreasing the risks of falls.
The Chiropractors at Malvern Chiropractic Clinic and Melbourne Spine Clinic are highly qualified to assess all aspects of falls prevention and prescribe the most appropriate treatment plans for your conditions. Early evaluation can help prevent any serious consequences from falls. Speak to your Chiropractor today or at your next appointment about how you may benefit from falls prevention treatment. Book online here or call (03) 9822 1835 and speak to our friendly staff.
REFERENCES:
- Rogers M. E. et al. 2003. Methods to assess and improve the physical parameters associated with fall risk in older adults Preventive Medicine 36(3):255-264
- http://www.neuropt.org/docs/vsig-english-pt-fact-sheets/how-does-the-balance-system-work.pdf?sfvrsn=2
- Sung Y. Upper cervical spine dysfunction and dizziness. J Exerc.Rehabil. 2020 Oct; 16(5): 385–391.
- https://www.hopkinsmedicine.org/health/wellness-and-prevention/fall-prevention-exercises
- https://www.activeandhealthy.nsw.gov.au/assets/pdf/Falls_Prevention_Home_Exercises.pdf
Top 3 Stretches for Winter
Here are a few exercises that can help you out this season.
Our Practitioners have extra stretches or exercises that might be an appropriate part of your treatment plan, so speak to one of our amazing Practitioners next time you’re in the clinic.
We have Exercise Balls and other equipment available in the clinic, so have a chat with one of our friendly Reception staff about picking up some new items for your rehabilitation programs!
STANDING HEEL RAISE
GREAT FOR LOWER LEG STRENGTH AND MOBILITY
Standing behind a chair with feet hip-width apart and toes facing forward, slowly raise your feet up onto your toes and then slowly return to flat feet on the floor. Repeat this action over a 30-second period and complete 1-2 per day.
HIP ABDUCTION WITH BAND
HELPS WITH HIP STRENGTH AND PELVIC STABILITY
Standing next to a chair, wrap a resistance band around your ankles in a loop. Ensuring your posture is completely upright – no leaning, engage the outer hip muscles and move the outer leg away from the midline of the body. Hold for 3-5 seconds and then slowly return the leg towards the midline. Repeat this action over a 30-second period and complete 1-2 per day.
EXERCISE BALL SQUATS
GREAT FOR BUILDING CORE AND HIP STRENGTH
Placing an exercise ball behind the body against the wall while slightly leaning back into the ball. Ensure the feet are hip-width apart. Slightly engage the core muscles by drawing them inwards and contracting the hip and buttock muscles. Bending the knees into a squat, ensuring you only go down until the thighs are parallel with the floor. Hold for 3-5 seconds and then return to a standing position. Repeat this action over a 30-second period and complete 1-2 per day. This exercise can be performed with or without extra hand weights.
