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

How to Avoid Overtraining Injuries

Overtraining is a common concern, and something that we should all be aware of (both physical therapists and clients). Learn more about overtraining injuries, how to prevent them, and get the right guidance for training from this article published on MoveForwardPT.com, an informational site created by the American Physical Therapy Association. For more questions please call at 619-756-7500.

 

Overtraining is a concern for all people pursuing fitness – from recreational or elite athletes to people who exercise to lose weight and stay in shape. Overtraining injuries are musculoskeletal injuries that occur due to more activity or exercise than your body is used to, and may happen to anyone who increases intensity or changes type of activity. Overtraining syndrome includes overtraining injuries, but also encompasses general fatigue and other symptoms.

Signs and Symptoms

If you experience any of the following after working hard to meet advanced fitness goals, overtraining may be a cause.

  • Physiological: increased resting heart rate, increased blood pressure
  • Physical: decreased appetite, upset stomach, insatiable thirst, sleep disturbances, increased frequency of sickness and infections, general feeling of increased difficulty and fatigue throughout the day, abnormal muscle soreness, pain occurs that is different than typical muscle soreness
  • Behavioral: personality changes, decreased motivation, altered concentration, lowered self-esteem, decreased ability to cope with stress
  • Performance: Increased heart rate during activity, decreased strength or endurance, impaired movement and coordination, multiple technical errors.

Avoiding Overtraining Injuries

No matter the activity (running, swimming, weight lifting, etc), when working to improve your fitness you need to push yourself in order to see results. But pushing yourself too hard can result in injuries that are detrimental to your fitness goals. Here are some tips to avoid overtraining injuries:

Don’t increase exercise difficulty level too quickly. Exercise needs to be progressed steadily at a gradual pace. Following a structured plan that increases your activity incrementally and safely can help you stay healthy and pain free. For example:

  • For running, increasing difficulty may include increasing speed, running up or downhill, increasing duration, and use of intervals, where you alternate intensity over time.
  • For resistance training, increasing difficulty may include increased weight, repetitions, sets, and decreasing the amount of time to perform the same amount of exercise.

Pay attention to your body.Your body is smart. If it feels like you are developing signs of overtraining, then take a break, lessen your activity, or rest.

Ease into it. Particularly if you are new to fitness or altering your exercise activities, take it slow. Don’t expect to make up for several months of inactivity with a few weeks of exercise. Aim for long-term consistency, not overnight success. People who try to do too much too soon often end up injured or frustrated and give up on their fitness goals altogether.

Avoiding Overtraining Syndrome

Overtraining syndrome occurs when an active individual or athlete increases activity faster than the body can adapt or is unable to recover from a sustained high level of activity. Your body then lets you know that you’ve done too much too fast through a variety of physical responses.

There are several signs and symptoms that may indicate overtraining syndrome but are also symptoms of other problems

Every active individual is unique. Your pain may be due to overtraining, but it also may be due to other health issues. For example, heart rate changes, general fatigue, and other systemic symptoms may be due to a more concerning condition. Physical therapists are educated to evaluate and treat a variety of conditions. If you have any of the above signs a physical therapist can help to determine the seriousness of the signs and what your next course of action for your health.

Here are some tips to avoid overtraining syndrome:

Take a break. If you have a scheduled rest day in your plan, use it, you’ve earned it!  Your bones, joints, and muscles need rest days to stay healthy.

Get rest. Recent studies are supporting the important role of sleep in the health of active people and athletes.  This is when our bodies’ build and repair and our immune system recovers.

Eat well. Proper nutrition is essential to the health of your body. Do not severely restrict calories when exercising. Make sure to eat proper nutrients, including plenty of lean meats, fruits and vegetables.

How will a physical therapist help me meet my fitness goals?

Physical therapists are movement experts, and work with people of all ages and levels of activity. During a visit, a physical therapist can:

  • Check your flexibility, strength, and endurance of muscles to support your desired level of activity.
  • Ensure that symptoms are due to overuse or overtraining and not something more serious.
  • Identify training errors to ensure a safe fitness plan, no matter your previous level of activity.
  • Correct biomechanical problems in form with your chosen activity to avoid overuse of a susceptible body part.
  • Provide appropriate training plan to minimize risk of injury and help you safely meet your fitness goals.