Wellbeing > Strength, Balance & Falls
Strength, Balance & Falls
As part of the normal ageing process, several changes occur to various parts of our body that may increase the risk of falls occurring, including changes to our muscles, our nerves, our eyes and our ears.
Muscle changes
Our muscle cells change as we age, resulting in muscles that become smaller, weaker, more fibrous and easier to fatigue. This results in decreased strength, flexibility and power. Muscle cells also become slower at responding to signals from the nerves, so we take longer to turn our muscles on and off, and therefore cannot move as fast. It is still possible to work on getting stronger - there is no definitive age at which we can no longer build new muscle and improve our strength. However, the strengthening process becomes harder and slower as we age.
Nerve changes
Our nerve cells also undergo normal age-related change, and much like an outdated computer, become slower at sending and receiving messages, and become less sensitive to small changes. These changes are perhaps most apparent in our balance.
Our muscles and joints have many small nerve sensors that tell our brain where our body parts are in relation to each other, and gravity. These sensors allow our brain to keep us upright, and to maintain our balance. This system works very well, and once we learn to walk, we rarely need to consciously think about keeping our balance. As we age, these nerve sensors become slower at reacting to changes in body position, and we may begin to feel unsteady on our feet.
Eyesight and inner ear
We depend very heavily on information from our eyes to help us keep our balance. As we age, our vision becomes less acute and it becomes harder to focus quickly on things around us.
Our inner ear provides specific information about balance, body position and gravity. Normal age-related changes to the inner ear makes it less efficient at sensing and reporting the small changes in balance and head position that help us correct our balance to prevent falls.
Are falls normal, then?
For all of these reasons, there is certainly an increased risk of falls as we age. If paired with the normal age-related decrease in bone density, falls can result in fractures, hospitalisation and decreased quality of life. This is a well-established problem for older adults, and for the wider community.
The good news is that falls are often preventable. It is never too soon to work on improving our balance. An exercise program aimed at gaining or maintaining our muscle strength is a good start. We should make sure we have our eyes checked regularly, and wear glasses or contacts as required. The balance system provided by our inner ear and nerves can also be improved if it is challenged regularly. We need to find a safe way to step outside our balance comfort zone.
There are many community exercise programs targeted at balance and strength which we can get involved in. Speak to your physiotherapist or doctor about finding a program that is right for you.
Some risk factors for falls are not directly related to ageing, including:
History of previous fall
Alcohol intake
Gender (female)
Chronic medical conditions especially diabetes
Cognitive impairment
Dizziness
Depression
Having a fear of falling
Low body weight and osteoporosis
Being on multiple medications
Muscle weakness
Poor vision
Low levels of physical activity
Heart conditions and arrhythmias
Wearing multifocal lenses
Exercise for Falls Prevention:
Type:
Challenging Balance Exercises
Resistance Exercise (lifting weights) for legs
Closed chain exercises such as static cycling are good for preserving and building muscle strength and bulk which is protective for falls
Walking is not enough
Functional task training - standing up from a chair
Dual task training - negotiating obstacles while performing mental tasks
Amount:
Balance Exercises 30-60 minutes on most days
Resistance Exercises 3 days per week
Static bicycle will fall under resistance exercises (recommend three half an hour sessions per week)