Jan 17

Fall Risk and Prevention

by Dillon Kato

As they age, many people begin to experience difficulties with balance. This can range from minor to major instability on their feet to feelings of intense lightheadedness or vertigo. In the winter, when snow and ice make walking around even more difficult, these issues can be even greater. Fortunately,these problems often have root causes that can be treated, and regular checkups with a primary care physician, specialists or physical therapists can make reduce or eliminate balance problems.

Our ability to balance is a function of three different parts of our body: The inner ear, our vision, and the sense of touch we receive through nerves in the bottoms of our feet. When any one of these systems isn’t working properly, you will feel off balance, said Helen Hallenbeck, audiologist and owner of Vibrant Hearing in Missoula.

Inner ear issues can damage the vestibular system and can lead to a loss of balance or feelings of vertigo.Decrease in vision can mean a person has a tougher time feeling like their are standing up straight, and as people get older, the nerve signals from their feet travel slower. This delayed reaction from the feet, even though it is a very short amount of time, can create uncertainty and instability.

Hallenbeck said the important thing is not to resign to the idea that balance issues are just another part of getting older. “It it’s odd for you, get it checked out. Many of the underlying causes are manageable,” she said.

Patients who come to see Hallenbeck go through a thorough health history to see if any causes for balance issues can be determined. The more issues or areas that can be ruled out, she said, the more likely a person doesn’t have an underlying medical cause, and their balance issues might be able to be treated with something like physical therapy.

John Fiore, physical therapist and owner of Sapphire Physical Therapy in Missoula, said just like strength,balance is something that can be trained.

One of the signs of poor balance is people walking morestiffly, not able to relax and plan out where their next footfall will land. Cold weather can make people more stiff and guarded, less able to be thinking ahead of where they are going to move next. This is often something people recognize in others but not themselves, Fiore said.

During the holidays and other family get togethers, he said, if a family member sees someone having to move slowly or stiffly, it might be time to have their balance assessed. One easy check he recommended is to have someone stand next to you for safety and close your eyes,to see if your balance can be maintained without the visual aspect of balance.

During the winter Fiore said he often recommends people use a trekking or walking pole to give themselves more stability on slick surfaces, or attach external traction devices such as Yaktrax to their shoes to give them more grip.

For older people who have sustained a fall injury, Fiore designs physical therapy regimens in much the same way he would for a younger person or an athlete. “We just find out what their goals are, what lifestyle they are leading. That can start with being safe in the home, and then expand to the things they want to do,” he said.

Physical therapists can also do a series of muscle tests to determine if a person has a specific weakness that might be holding them back. Kelsey Turner, a physical therapist with Missoula’s Element Physical Therapy, said if this weakness is found, therapists like her can put together a specific regimen to treat it. These include training someone to walk on a variety of surfaces, and the best way to navigate stepping up or down.

“Clients, especially older people, tell us they get nervous when they step off a curb. We put them in controlled situations, with no risk of falling, to help them learn to deal with these movements. We can put joints at different angles so they can learn to react a little quicker to, say,being bumped in a grocery store,” Turner said.

In their everyday life, Turner recommended people having trouble with balance do what they can to eliminate unnecessary risks, especially in the house. She said some of the more common advice she gives is to get rid of throw rugs that present a tripping hazard, and to use night lights to give a boost to vision in the dark. During the winter months, she said to always make sure your footwear has good grip, and that your feet stay warm when you are outside.

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