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.

Golf Injury Prevention

Although golfing does not involve high intensity cardiovascular activity, injury is still possible. Give this article a read to learn more about golfing injuries and ways to remedy them. Then come to see us at San Diego Sports Physical Therapy to rehabilitate your injuries today – 619.756.7500

Many people consider golf a low-level physical activity without much risk for injury. Many injuries can be caused by playing golf, however, including injuries to the ankle, elbow, spine, knee, hip, and wrist.

According to the US Consumer Product Safety Commission (CPSC), there were more than 55,000 visits to hospital emergency rooms for golf-related injuries in 2009.

Types of Golf Injuries
Most golf injuries are the result of overuse. By repeating the same golf swing motion over and over again, significant stress is placed on the same muscles, tendons, and joints. Over time, this can cause injury.

Golfers most often experience hand tenderness or numbness, and may also have shoulder, back, and knee pain. Golfer’s elbow and wrist injuries, such as tendinitis or carpal tunnel syndrome, may also occur.

Golfer’s Elbow
Leading the list of injuries is golfer’s elbow, technically known as medial epicondylitis. Golfer’s elbow is an inflammation of the tendons that attach your forearm muscles to the inside of the bone at your elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the inside of the elbow.

One of the best ways to avoid elbow problems is to strengthen your forearm muscles and slow your golf swing so that there will be less shock in the arm when the ball is hit.

The following simple exercises can help build up your forearm muscles and help you avoid golfer’s elbow. For best results, do these exercises during the off-season, as well.

Squeeze a tennis ball. Squeezing an old tennis ball for 5 minutes at a time is a simple, effective exercise that will strengthen your forearm muscles.

Wrist curls. Use a lightweight dumbbell. Lower the weight to the end of your fingers, and then curl the weight back into your palm, followed by curling up your wrist to lift the weight an inch or two higher. Perform 10 repetitions with one arm, and then repeat with the other arm.

Reverse wrist curls. Use a lightweight dumbbell. Place your hands in front of you, palm side down. Using your wrist, lift the weight up and down. Hold the arm that you are exercising above your elbow with your other hand in order to limit the motion to your forearm. Perform 10 repetitions with one arm, and then repeat with the other arm.

Low Back Pain
Low back pain is another common complaint among golfers. It is often caused by a poor swing. The rotational stresses of the golf swing can place considerable pressure on the spine and muscles.

Also, poor flexibility and muscle strength can cause minor strains in the back that can easily become severe injuries.

Here are some simple exercises to help strengthen lower back muscles and prevent injuries.

Rowing. Firmly tie the ends of rubber tubing. Place it around an object that is shoulder height (like a door hinge). Standing with your arms straight out in front of you, grasp the tubing and slowly pull it toward your chest. Release slowly. Perform three sets of 10 repetitions, at least three times a week.

Pull Downs. With the rubber tubing still around the door hinge, kneel and hold the tubing over your head. Pull down slowly toward your chest, bending your elbows as you lower your arms. Raise the tubing slowly over your head. Perform three sets of 10 repetitions, at least three times a week.

Yoga and Pilates. These exercise programs focus on trunk and abdomen strength, as well as flexibility.

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General Injury Prevention Tips
One of the best ways to get ready for your golf game might be considered old-fashioned. Before your round of golf, do some simple stretching exercises, focusing on your shoulders, back, and legs. Then get a bucket of balls and hit a few golf balls on the driving range. It not only will help your game, but will make you healthier in the long run.
Protect your skin by using sunscreen. Wear sunglasses to filter out UVA and UVB rays, and wear a hat with a visor to shade your eyes and face.
Make sure you are well hydrated before, during, and after your game. Replace your fluids, whether you feel thirsty or not.
When riding in a golf cart, keep your feet inside the cart. Players have broken ankles when their feet have gotten caught under moving golf carts.
Always be aware of your environment and other players on the course. It is possible to sustain a soft-tissue injury by being hit by a golf ball.
Source: US Consumer Product Safety Commission (CPSC), 2009; Agency for Healthcare Research and Quality.

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Last reviewed: August 2011
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS “Find an Orthopaedist” program on this website.