Breaking the Fall Cycle for Fall Prevention Week

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist and Owner: Healthy Aging PT

Falls are a significant health concern for older adults, often initiating a dangerous cycle that can lead to more frequent falls and serious injuries. This Fall Prevention Week, we’re focusing on how the Cycle of Falling works—and, more importantly, how it can be broken with the right interventions.

The First Fall and Fear of Falling

The cycle often begins with an initial fall, leading to significant fear and anxiety about falling again. This fear impacts confidence in movement and results in avoiding daily activities. Nearly 50% of older adults who have fallen report limiting their physical activity afterward, which increases their likelihood of future falls.

At Healthy Aging Physical Therapy, we go beyond traditional therapies by teaching fall preparedness skills, including how to land safely and recover from a fall. Evidence shows that learning these techniques, along with the ability to get on and off the floor, reduces the fear of falling, which in turn lowers the risk of future falls.

Reduced Physical Activity

When fear limits physical activity, muscles weaken, and balance worsens. This sets the stage for more falls, as musculoskeletal strength is essential for stability.

We provide tailored programs that encourage safe, gradual increases in movement, helping individuals regain strength and reduce their fall risk.

Musculoskeletal Decline and Gait Instability

Reduced activity leads to muscle loss, joint stiffness, and decreased mobility, which all contribute to gait instability. This unsteady walking pattern makes falls even more likely.

Our therapists focus on improving strength, flexibility, and gait stability through evidence-based interventions like the Otago Balance Program, a proven exercise regimen designed specifically for fall prevention in older adults. By incorporating Otago exercises, we help patients maintain steady movement, balance, and mobility, significantly reducing the risk of future falls.

We also offer Strong and STEADI balance classes, which focus on improving balance, coordination, and strength to help reduce fall risk. These group classes create a supportive environment for patients looking to improve their mobility and confidence. You can find more information about these programs at Healthy Aging PT Group Classes.

Increased Fall Risk and Repeated Falls

As the cycle progresses, the likelihood of repeated falls grows, leading to a dangerous pattern. Breaking this cycle requires a comprehensive approach.

At Healthy Aging, we offer personalized fall risk assessments and targeted interventions, focusing on balance, mobility, and confidence to stop repeated falls before they happen.

One key aspect of our intervention is the Home Safety Evaluation. Our therapists assess your living environment to identify potential fall hazards and provide practical modifications. These changes, such as securing rugs, improving lighting, or installing grab bars, are crucial in creating a safer home, reducing fall risk, and promoting independent living.

How Healthy Aging Physical Therapy Can Help

We offer a variety of specialized services to address the Cycle of Falling, including balance and fall prevention programs, gait retraining, and strengthening exercises. Our team is committed to promoting safety, independence, and confidence for each individual. Check out more about our Balance and Falls Program here.

If you or a loved one are at risk of falling, take the first step towards breaking the cycle. Call us at (617) 398-4508 or fill out our New Patient Registration Form to schedule a fall risk evaluation.

May Staff Meeting Updates

Did you know that HAPT meets monthly to review patient cases and provide feedback and ideas, as well as for in-services and education? (Ten heads ARE better than one!) As much as I love learning, I love teaching even more, so thought I'd share a few lessons learned with you.

This month we were lucky enough to have two great presentations. First, Dahlia Cohen, Registered Dietician, spoke to us about Nutrition in Parkinson's Disease. We learned that weight management, in particular keeping weight ON, is a big issue for people with Parkinson's Disease. Not only are there changes in taste, swallowing and digestion that can be problematic, but due to the extra movement and muscle resistance that occurs in movement disorders, individuals with PD are often burning way more calories than normal during the day. This creates an energy deficit and this leads to weight loss. How can we help our patients with this problem? Here are a few ideas Dahlia gave us:

• Encourage 3 meals a day + 3 Nutrient Dense snacks (like greek yogurt, or nuts).
  

•  Make sure to get adequate amounts of protein throughout the day. Your body can only digest about 30 grams at one sitting, so one big steak at dinner won't cut it. Try adding in smaller amounts, more frequently, making sure to time around your meds (levodopa competes with protein for receptor access, so it can make your meds less effective if taken with protein!). Protein is best eaten 30 minutes before taking levadopa or 60-90 minutes after taking meds.

•  Don't forget your fiber! We need 25-30 grams of fiber/day for optimal digestion and bowel management, and constipation is even more common in PD because gastrointestinal motility is slowed. Adding in green vegetables, whole grains and beans to your daily diet is helpful, and supplementing if needed with something like Metamucil can be helpful when needed.

After we finished learning about what to take in, we talked about 'how it comes out' with our staff PT, Katie Moulison. Katie just finished a great course in Pelvic Health and shared some helpful considerations for working with individuals who may be experiencing incontinence as they age. Here are some helpful take home messages:

•  Incontinence is common, but not a normal part of aging and there is a lot we can do about it. Wondering if how often you wake at night to 'go' is normal? Normal nocturia (peeing at night) is waking 0-1 times to get up. If it's more often than that, it can disrupt sleep cycles, leave you more tired during the day and lead to increased risk of falls.

•  Dehydration, constipation and bladder irritants are all common causes of increased frequency, urgency, nocturia and leakage (PS. the acronym FUNL can help you remember what to ask your patients about!). 

•  If you're wondering about your own bladder habits, or trying to help a patient problem-solve their incontinence troubles, start by keeping a Bladder Diary and share it with a pelvic health specialist to get their take. There may be some simple strategies we can try to make it better!

Who are we and where do we go?

Healthy Aging Physical Therapy provides Physical and Occupational Therapy in the comfort of your own home (“Outpatient at Home”). We accept Medicare B, Blue Cross Blue Shield and most Medicare Advantage Plans and provide care in the following communities: Concord, Arlington, Belmont, Lexington, Winchester, Woburn, Stoneham, Melrose, Medford, Malden, Wakefield, Lynnfield, North Reading, Reading, Middleton & Peabody, Massachusetts.

We specialize in caring for the older adult, people with Parkinson’s Disease and other complex medical and neuromuscular conditions.

How NOT to Fall on the Ice this Winter

It’s Black Ice Season here in Boston and time for me to share my best tips for how NOT to fall on the ice.

But before I do, I have to share my #1, Hands-down, favorite video on the internet. This came across my feed years ago, and I still watch it every so often just because it cracks me up every time. I don’t know if it’s the dad’s laugh, or the fact that I so relate to spending hours waiting in pick up lines outside of schools, but it is absolute gold. Don’t worry, no teens were harmed in the making of this film.

Now, onto the good stuff. What is the best way to avoid taking a digger on the ice this season? Here are my Top 5 Tips to Keep You on Your Feet (and off your rear!) this Winter:

1) Invest in a pair of Ice Cleats:

These come in various brands, shapes and sizes, but a good pair of ice cleats can be your best friend. They are generally mesh and can wrap around whatever shoes or boots you are wearing to give you better traction on the ice. I typically recommend Yak Tracks (See on Amazon here), but LL-Bean also sells their own version (LL Bean Stabilizers), as does REI and other Outdoor stores.

2) Ice-Proof your Cane:

Whether you use a cane on a regular basis or not, it can be a helpful tool in the winter, especially if you add on an Ice-Tip (See Vive Ice Tip on Amazon here). Another great alternative is a hiking pole, and these generally come with a set of tips for various conditions as well (this one is the kind I typically use). Having something to ‘grab’ the ground with, in case of a slip, can be the difference between a ‘phew’ and a hard landing.

3) Walk like a Penguin:

When you’re out there trying to get from Point A to Point B, walk like a penguin! Take wide, short steps and avoid pushing off at the end. Basically, waddle like a penguin! It may seem silly, but it works:

4) Bulletproof Your Balance:

We all know that Prevention is the best Medicine and when it comes to walking around this winter, this is especially true. We all have these automatic fall-prevention reflexes, called Reactive Balance Strategies, that are designed to help us regain our footing after a loss of balance. Whether that is a little ankle rock, bending over at the trunk to lower your center of mass, or getting a foot out there to step and prevent a fall, these need to be practiced to remain effective! If you’ve been having falls, or even find yourself having a lot or near misses, it may be a good time to see a Physical Therapist to work on your balance. Even if you feel like your balance is pretty good, as you age, it’s a good habit to do some regular balance exercises to keep it up to snuff. Check out our Otago Exercise Page for a routine you’d an try at home, or join us at one of our Strong and STEADI sessions if there is one available near you. Looking for 1:1 Balance Training? Contact us today to see if we can help.

4) Stick the Landing:

Slips, trips and falls happen, so if you’re going down, you’re better off knowing how to land. We’ve put a page together with helpful tips on how to land safely to reduce risk of fractures and other injuries and practice this skill often with our patients. If it can mean the difference between a bump or bruise and a hip fracture or head injury, believe me, it’s well worth it. Check out our How to Fall Safely page here.

We hope these tips keep you on your feet and off the ice this winter! Physical Therapists like us are Fall Prevention Experts and we love to help. Read more below to learn about our practice, meet our therapists and find out how to get in touch so we can help you stay safe this winter.

Who are we and where do we go?

Healthy Aging Physical Therapy provides Physical and Occupational Therapy in the comfort of your own home (“Outpatient at Home”). We accept Medicare B, Blue Cross Blue Shield and most Medicare Advantage Plans and provide care in the following communities: Concord, Arlington, Belmont, Lexington, Winchester, Woburn, Stoneham, Melrose, Medford, Malden, Wakefield, Lynnfield, North Reading, Reading, Middleton & Peabody, Massachusetts.

We specialize in caring for the older adult, people with Parkinson’s Disease and other complex medical and neuromuscular conditions.

Healthy Aging Tip of the Week - FALL PREVENTION !

ALWAYS TELL YOUR DOCTOR IF YOU'VE HAD A FALL - ESPECIALLY IF YOU HIT YOUR HEAD !!!

Only about half of all falls are reported to the right people (doctors, therapist or the ER.) This means half of all people are putting themselves at risk of head injury or death.

Bob Saget was back in the news this week after autopsy reports showed his cause of death was likely a fall, that caused a brain bleed. Initially, it seemed like he may have fallen backwards, thought nothing of it, and went back to sleep. However, given the fact that he had fractures at the back and front of his skull, it looks more like he had a BIG fall (down a set of stairs, possibly?) and this likely caused what is called a coup contrecoup head injury. These types of injuries can cause major swelling that can put pressure on the respiration centers and other critical areas of the brain. At best, they may cause temporary brain damage that can be reversed with the proper care (draining, shunting, surgery etc), but at worst, they can cause permanent brain damage or death.

As we age, blood vessels become more friable, and taking aspirin or other blood thinners make it more likely to have bleeding in the brain if you hit your head. This is why it is CRITICALLY important that you report any fall in which you hit your head to your doctor right away. I can’t say this LOUD ENOUGH. If you fall, and hit your head, PLEASE TELL YOUR DOCTOR OR VISIT AN ER! There are plenty of good reason to report falls, but this is arguably the most important. Even if you fall, and feel fine, and don’t hit your head, it is still a good idea to let your doctor know. Why? So they can call helpful people like ME to come check your balance, assess your fall risk and help you make a game plan that will help you stay on your feet (and be ready to land safely if you do head for the floor!).

Healthy Aging Physical Therapy takes pride in not only teaching our patients how to prevent falls, but how to be PREPARED for them. Chances are, if you’ve fallen once, you’ll fall again (#facts), so you are better of being ready for it, than going through life scared or trying to avoid any and all potentially fall-causing scenarios (when a new patient tells me proudly ‘oh I haven’t fallen, but I’m REALLY careful’ I know we have problem…). There are ways we can teach you to fall SAFELY with reduced risk of head injuries and fractures, and ways we can teach you to GET BACK UP so you can get on with your day.

There are three questions you can ask yourself to help determine if you are at risk for falls - and whether you may benefit from seeing a physical therapist for fall risk assessment and a course of therapy:

1. Have you had a fall in the last year?

   (If you’ve had a fall, you are 3x more likely to have another).

2. Do you feel unsteady while standing or walking?

   (This speaks to your balance perception - lack of balance confidence, leads to increased risk of falls)

3. Do you worry about falling?

   (Fear of falling = fear avoidance behaviors = reduced activity = increased risk of falls)

If you answered YES to any of these, we would LOVE to help you. And I’m not just saying this to drum up business (we are full and waitlisted!) but seeing stories in the news like Bob Saget’s untimely death just reminds me how important it is to spread the message that FALLS ARE AVOIDABLE and everyone deserves the chance to live life without fear of falling.

Actual Healthy Aging patient REDUCING her risk for falls!

If you are reading this and we don’t see patients in your area, reach out anyways - I’d be happy to try to help you find a good physical therapist near you. There are also GREAT resources out there for education on Fall Prevention and Fall Preparedness, including the CDC STEADI programs which we use to drive our fall assessment and intervention and the Stay on Your Feet AU program, that has some great printable resources.

If you live in and around Wakefield, Massachusetts, consider joining me at the new FUNctional Fitness class starting up at the Wakefield Council on Aging. We’ll meet every Tuesdays from 9-10AM staring March 1st to work on increasing our strength and balance exercises so we can stay ACTIVE and RESILIENT and FALL-FREE. This class is FREE for the month of March, and registration is required ahead of time by calling (781) 245-3312.

If you live further out, or prefer to take classes virtually, I also offer Strong Bones, Strong Life classes through the Steinberg Center for Mind and Body. These classes run in 8-week sessions and are offered Mondays from 1:15-2:15PM and Thursdays from 9-10AM. Focused on Osteoporosis Prevention and Management, we work on strength, postural control and balance designed to improve bone health and prevent falls and fall-related injuries. Next session starts up in March, and we kick off with a FREE Strong Bones, Strong Life workshop on March 3rd, from 7-8PM.

So, remember, if you’ve had a fall, don’t let pride or embarrassment get in your way of saving your life! Let your doctor know ASAP so they can make sure you’re okay and help you get on the path to Fall Preparedness!

See, therapy isn’t that bad…we actually have FUN!

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📆Upcoming Events:

🌟POWER over Parkinson's Class - Wednesdays 10:30-11:30 @ the Americal Civic Center in Wakefield, MA

🌟Strong Bones, Strong Life - Mondays 1:15-2:15PM and Thursdays 9-10AM Online through Steinberg Wellness

🌟Staying STEADI - Starting April 2022!

🌟FUNctional Fitness - Tuesdays 9-10AM @ the Wakefield Council on Aging staring March 1st, 2022

🔗Learn more @ www.healthyagingpt.com/classes

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⭐️Ready to schedule an Evaluation with a Healthy Aging Physical Therapist? ⭐

📞Call or Text: (617) 851 5315

📧Email: Katie@HealthyAgingPT.com

📝or Click the Button below request a Consultation Phone call:

How Can Physical Therapy and Regular Exercise Help Older Adults?

People often think of physical therapists as the go-to people to treat musculoskeletal pain, but physical therapy has much to offer beyond pain management, especially when it comes to the older adult. Read on for 5 Ways Physical Therapy can help you live your best life as you age.

Why is exercise important for older adults?

Inactivity is associated with most of the diseases we commonly associated with getting older. Inactivity increases your risk of diseases like heart disease, stroke and dementia. It also increases your risk of fall and resulting hip fracture - a major concern for many older adults! However, only 20% of older adults participate in adequate amounts of regular exercise. A Physical Therapist who specializes in Geriatrics can help you learn how to exercise safely - and use exercise to stay healthy and active as you age. Regular, moderately-intense exercise can reduce your chance of a premature death by up to 30%! Exercise is safe and beneficial for adults of all ages and in all conditions.

How does exercise reduce the risk of falls in the elderly?

Regular exercise can reduce the risk of falls in older adults by up to 20%. Participation in Evidenced-based balance programs (like the Otago Program offered by Healthy Aging Physical Therapy) can bring that risk down even more to 30-40%.

Physical Therapy can help you improve your strength, your endurance, help you mange pain, and improve your balance. We can help you if you’re dizzy or experiencing vertigo (Vestibular Rehabilitation). We can help you make your house a safer place to live and teach you ways to modify your movement and mobility to make moving around your home and community safer and easier.

However, falls are an unfortunate reality for many older adults, so it’s also important to be PREPARED for falls. Around 36 Million adults fall in the US each year. Learning to fall safely, what to do after you fall and how to get back up is just as important as working to prevent them.

How can Physical Therapy help me stay Independent?

By helping you manage all areas of your health and wellness, we can help you stay strong and fit so you can stay living in your home and be as independent as possible. Physical Therapy and exercise improves your cardiovascular, pulmonary, neurological, metabolic, musculoskeletal and psychological health. The stronger and fitter you are, the better your resilience to disease, decline and disability. If you do need help, we can help you find it, or teach your loved ones how to care for you - while making sure they also take care of themselves. This balance of keeping you as independent as you can, with guiding you towards the support you need is how physical therapy can help you age in place and remain active as you can within your home and your community.

How can Physical Therapy and Exercise help me Walk and Move better?

Physical Therapists are Movement Experts and as you age, it can be harder to get up and down from chairs or the toilet, to walk around the house, access your community or use the stairs. Through movement and mobility assessment, we can identify limitations in your range of motion, strength or muscle balance that may be making these tasks more difficult for you. We help you develop the strength and skills you need to make tasks like walking, using the stairs and getting off low surfaces like the toilet easier - and safer.

Can Physical Therapy and Exercise improve my Quality of Life?

Getting older doesn’t have to be painful, exhausting or depressing. Learning to care for your body better as you age and use Movement as Medicine can help you feel your best, move your best and live your best life. Regular exercise improves your sleep, reduces depression and anxiety and can help you be strong enough to continue living a life full of family, fun and purpose. To quote George Burns, “you can’t help getting older, but you don’t have to be old.“

A Physical Therapist who specializes in working with older adults has the skills necessary to help you live your Best Life, no matter what diseases or disabilities you may be living with - and no matter how old you may be.

Click Here to Request a Physical Therapy Evaluation

About the Author:

Dr. Katie Wadland, PT, DPT is the Owner and Primary Physical Therapist at Healthy Aging Physical Therapy. Healthy Aging Physical Therapy offers in-home Physical Therapy for older adults living in Melrose, Medford, Arlington, Stoneham, Winchester, Reading, Woburn, Wakefield and Lynnfield, Massachusetts. She is licensed to practice Physical Therapy in the State of Massachusetts (License #18193). She has over fourteen years of experience working with older adults with musculoskeletal and neurological impairments and advanced training in the care of people with Parkinson’s Disease, Spinal Cord Injury and Stroke.

Click here to learn more about Dr. Katie Wadland, PT, DPT or here to request an evaluation.