Falls in Senior Population: Can We Prevent Them?

30% of people over the age of 65 years fall 1 or more times in a year. Falls are the leading cause of death from injury in elderly adults. In 2003, 13,700 people died from falls. A fall is defined as an event that results in a person coming to rest unintentionally on the ground or on a lower level but not caused by an internal trauma (e.g. stroke). Intrinsic risk factors include: Medical Condition, Cognition, Psychosocial, Sensory, Central Processing, and Musculoskeletal.

Medical risk factors include: Co-morbidities (Pulmonary Disease, MS, Prolonged bed rest, Stroke, Diabetes) and Polypharmacy (overmedicated). It has been documented that 4 or more prescribed medications significantly increases risk for falls. Meds used to treat hypertension, heart disease, and depression may cause dizziness. Cognition which includes safety awareness, attention, and judgment combined with Psychosocial (depression, anxiety) attributes can also greatly affect fall risk. Central Processing concerns area of: limits of stability, reaction time, anticipatory reactions, and postural Stability.  Sensory Loss is quite evident in a majority of falls and will encompass losses in one or all of the following: Vision, Vestibular, and Somatosensory (impaired position sense). Musculoskeletal deficits include: Losses in Strength, flexibility, endurance, and postural alignment; Gait (decreased step length, increased step frequency, decreased speed, and increased lateral sway); and Coordination (ability to change directions).

Extrinsic factors include: Environment, Social, History of Falls, and Activity level. History of falls is especially relevant if history of: 1 or more falls in a year, falling indoors, or an inability to get up after fall. Exercises to Prevent Falls include: Tai Chi, Individualized multidimensional exercise program and Exercise in physical therapy sessions with appropriate home exercises will decrease risk for falls and improve Mobility Assessment scores. Loss of balance and falls could be prevented with seniors if adults take measures to protect themselves, much as they do against health conditions such as heart disease. An assessment and treatment by a Licensed Physical Therapist is the obvious choice in obtaining this protection. Loss of balance and limitations in mobility can be effectively prevented, reversed, or delayed by physical therapy treatments. A comprehensive balance assessment performed by a physical therapist can determine the factors as above that are contributing to an individual’s fall risk. A physical therapist plan of care will include exercises to improve strength, aerobic capacity, flexibility, proper gait, and the function of the vestibular system. Balance training and fear management will also be addressed.


For more information on the physical therapist’s role in preventing falls contact:

Greg Sterner, Board Certified Orthopedic Clinical Specialist in Physical Therapy, Owner

San Diego Sports Physical Therapy

2750 Dewey Rd. Ste 101

San Diego, CA 92106

Bone Health

Learn about bone health, what it is, what it is effected by, and how to maintain and promote it. This article gives great insight to the importance of bone health published on moveforwardpt.com, a site created by the American Physical Therapy Association. For more questions call us at 619-756-7500!


Physical therapists are experts in improving and restoring mobility and play an important role in ensuring optimal bone health. Healthy bones can help you stay strong and active throughout your life. If good bone health is achieved during childhood and maintained, it can help to avoid bone loss and fracture later in life. For healthy bones, it is important to maintain a physically active lifestyle and eat a balanced diet with plenty of calcium, vitamin D, and perhaps other supplements as needed. Physical therapists can design a unique program for you to help keep your bones healthy.

Osteoporosis is a common bone disease that affects both men and women (mostly women), usually as they age. It is associated with low bone mass and thinning of the bone structure, making bones fragile and more likely to break.

Some people are more at risk for osteoporosis than others. Not all risk factors can be changed, but healthy habits and a proper exercise routine designed by your physical therapist can keep bones healthy and reduce risk. Risk factors* include:

  • Age: More common in older individuals
  • Sex: More common in women
  • Family History: Heredity
  • Race and Ethnicity: Affects all races. In the US, increased risk for Caucasian, Asian, or Latino
  • Weight: Low body weight (small and thin)
  • Diet, especially one low in calcium and vitamin D
  • History of broken bones
  • Menopause
  • Inactive lifestyle
  • Smoking
  • Alcohol abuse
  • Certain medications, diseases, and other medical conditions

Physical therapists can help prevent osteoporosis and treat its effects by designing individualized exercise programs to benefit bone health, improve posture, and enhance core stability and balance. Most of these exercises are simple and can be done at home with no special equipment.

Fight Fracture with Fitness

Inactivity is a major risk factor for osteoporosis. The right exercises and good habits can keep bones strong and prevent or reverse the effects of osteoporosis. Weight-bearing exercise, such as walking, is an important way to build and maintain healthy bones. Muscle strengthening exercises have been found to stimulate bone growth and can help prevent and treat osteoporosis. These types of exercises are best if started early in life and done regularly. However, it is important to remember that you can begin exercising at any age and still reap great benefits.

If you have osteoporosis, are at high risk for a fall or fracture, or have a medical condition, affecting your ability to exercise, do not begin an exercise program without first consulting your physician and a physical therapist.

Avoid exercises and daily activities, which round the spine, such as sit-ups, crunches, bending down to tie your shoes, exercise machines that involve forward bending of the trunk, and movements and sports that round and twist the spine.

Benefits of Good Balance

Preserving balance and stability with exercises can help reduce falls and resulting fractures. Exercises that improve posture, core stability, balance, and coordination, can also protect the spine against compression fractures. An individualized program may include a walking regimen, Tai Chi, and other exercises geared toward conditioning, balance, and coordination.

Bone Health Begins With Good Posture

Physical therapists recommend good posture and safe movements to protect bones from fracture during daily activities. Using proper posture and safe body mechanics during all activities protects the spine against injury. Here are some tips:

  • Keep your back, stomach, and leg muscles strong and flexible.
  • Keep your body in alignment, so it can be more efficient when you move.
  • Do not slouch. When sitting, keep your spine and head straight. Put a small pillow behind your waist to keep your spine in a good position.
  • Use good body positioning at work, home, or during leisure activities.
  • When lifting or bending forward, bend your knees, keep your back straight, bend forward at the hip crease, and lift with your legs. Keep the load close to your body.
  • Ask for help or use an assistive device to lift heavy objects.
  • Maintain a regular physical fitness regimen. Staying active can help to prevent injuries.

Physical Therapy for Shoulder Impingement & Tendonitis

Shoulder inflammation can be painful, and should be taken care of. It is common among swimmers, or sports where arm swings and shoulder rotation are used consistently. Here are a few exercises explained by Jessica Wellons in an article posted on Livestrong.com, to help strengthen your shoulder and thus prevent shoulder impingement and tendonitis. For questions, call us at 619-756-7500!
Physical Therapy for Shoulder Impingement & Tendonitis

The rotator cuff consists of four muscles and tendons that cover the head of the humerus and attach it to the shoulder blade, or scapula. They provide stability and strength during rotational movements in the arm. Shoulder impingement refers to mechanical compression or inflammation of the rotator cuff tendons. This occurs when the space in the shoulder joints narrows and the rotator cuff tendons or bursa, lubricating sacs located over the rotator cuff, become compressed, irritated or damaged, resulting in pain, inflammation and reduced mobility. Exercises that target the rotator cuff will strengthen the surrounding muscles and tendons, improve circulation to the joint, flexibility and range of motion.

External Rotation

Stand with your back against a wall, ensuring that your torso and shoulders remain straight. Bend your right elbow to form a 90-degree angle and bring your arm across r youabdomen, remembering to keep your thumb upright and flattening your palm against your stomach. Perform an external rotation by moving your arm and forearm away from the abdomen, remembering to keep your elbow bent. Continue this external rotation until the back of your arm is flat against the wall. Hold this position for five seconds and rotate your arm back to the starting position. Perform one set of 10 repetitions on both arms, once daily.

Supraspinatus Stretch

You will need two dumbbells to perform this exercise. Standing upright, holding a dumbbell in each hand with thumbs pointing down. While keeping your elbows straight, slowly bring your arms outward to form a 45-degree angle. Hold this position for five seconds and slowly return to the starting position. Perform three sets of 20 repetitions, once daily to strengthen the muscles and tendons in the rotator cuff, thus stabilizing the shoulders and restoring mobility.

Triceps Stretch

Stand upright and bend your right elbow to form a 90-degree angle. Raise your right hand so that your forearm forms a 90-degree with your shoulder and place your opposite hand over your elbow. Using your left hand, grab the opposite elbow and gently pull that arm down behind your head. Continue this gentle pull until you feel a stretch in your shoulders. Hold this stretch for five seconds and relax. Perform one set of 10 repetitions on both arms, two to three times daily to stretch the tendons and joints in the shoulder and help restore your range of motion.

Scapular Squeezes

Lie on your back and bend both knees. Plant your feet firmly on the ground and extend your arms away from your body, with palms up. While maintaining contact between the ground and your lower back, begin squeezing your shoulder blades together, downward and toward your spine. While performing this exercise, try to not shrug your shoulders and remember to relax your neck. As your perform this exercise, the lower muscles between your scapula should be contracting. Hold each shoulder blade squeeze for five seconds and relax. Perform one set of 20 repetitions three times a day to strengthen the muscles in the shoulders and prevent further injury.