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.

Workplace Wellness

A lot of us have to work, but how can we stay healthy while on the job? Take a look at this article from MoveForwardPT in order to help improve your posture and mobility at work! If you’d like to see a physical therapist today, come visit San Diego Sports Physical Therapy in Liberty Station!

Working at a computer work station all day can take a toll on the body. Repetitive activities and lack of mobility can contribute to aches, pains, and eventual injuries.

Sitting at a desk while using the keyboard for hours on a day to day basis can result in poor circulation to joints and muscles, it can also create an imbalance in strength and flexibility of certain muscles, and muscle strain. These issues can be easily remedied by taking frequent short breaks, or “micro breaks,” throughout your day.

Get out of your chair several times a day and move around—even for 30 seconds
Roll your shoulders backwards
Turn your head side to side
Stretch out your forearms and your legs

Additionally, specific guidelines for your work station can help maximize your comfort and safety.
Your chair should have the following:

Wheels (5 for better mobility)
The ability to twist freely on its base
Adjustable height
Adjustable arm rests that will allow you to sit close to your desk
Lumbar support
Seat base that adjusts to a comfortable angle and allows you to sit up straight

The position of the keyboard is critical:

The keyboard should be at a height that allows you to have your forearms slightly below a horizontal line—or your elbows at slightly more than a 90 degree angle.
You should be able to slide your knees under the keyboard tray or desk.
Avoid reaching for the keyboard by extending your arms or raising your shoulders.
Try to avoid having the keyboard on top of your desk. That is too high for almost everyone—unless you can raise your seat. The elbow angle is the best test of keyboard position.

The position of your computer monitor is important:

The monitor should be directly in front of you.
The top of the monitor should be at your eye level, and at a distance where you can see it clearly without squinting, or leaning forward or backward.
If you need glasses for reading, you may need to have a special pair for use at your computer to avoid tipping your head backward to see through bi-focals or other types of reading glasses.

How can a physical therapist help?

Many physical therapists are experts at modifying work stations to increase efficiency and prevent or relieve pain. Additionally, if you are experiencing pain that isn’t relieved by modifications to your work station, you should see a physical therapist who can help develop a treatment plan to relieve your pain and improve your mobility.

Here are a couple of exercises you can do right at your desk!

Desk Exercises