Recipe of the Week

Fun, Facts & Fitness from Mary Morris MSc.

Six months ago, in Newsletter Issue 176, I wrote about how we can fall safely with some training. It has since become my pet subject!

I was inspired by a television report showing how older people could be taught how to fall in such a way as to prevent too much damage to the body. A bad fall can result in a serious head injury or a broken hip, which requires hospitalisation and a long road to recovery.

Even if a fall does not result in too much damage the evidence suggests that it can have a long-lasting and significant effect on someone, resulting in a lack of confidence and a reluctance to lead a normal active life, just in case it happens again.

When we read the startling statistics on falls among the elderly we begin to understand the need to take positive action and explore just how much difference some training can make. In England alone there are over 200,000 emergency hospital admissions every year as the result of a fall, with many left seriously disabled and with a considerable reduction in the quality of their life. Also, around a third of over 65s will fall at least once a year and this rises to half of the over-80s.

So, I set about preparing and planning a workshop called 'How to Fall' with my fitness groups. Initially, I had the idea of using a venue that had crash mats available, as they are very deep and soft to land upon. This would have meant they would have to travel some distance, organising car share etc, and it was also a shock to discover the high hire costs of such a facility, so I had a re-think.

Then, whilst exploring the internet for any information on the techniques needed for falling, I came across a chap who keeps a blown-up mattress in a cupboard, takes it out every day and practises falling onto it! I thought this was quite strange at first, but actually that man was doing exactly what is needed - repeating the same move over and over again, so it is embedded in his memory bank and falling well becomes instinctive. Not only did I find this fascinating, it also resolved my problem! I would run my workshop at my regular hall that I hire for my classes, with several 'begged and borrowed' blow-up mattresses available for us to fall on to.   

I have to say this was received with some scepticism by some of my regulars, who felt that there was no way they would have time to fall 'well', as we reach the ground in a flash, without having any time to think about 'how' we are falling. But this is actually not true, as it only takes a split second to react, long enough to position ourself to fall without too much damage. Yes, we will be hurt and bruised and very shaken no doubt, particularly if we have fallen on concrete, but we will have protected our head and fallen in a way that prevents bones breaking. Trust me!
 

Why are Older People More Likely to Fall?

• Sarcopenia.  You have heard it before, but that loss of muscle that is inevitable as we age, particularly in the lower body around the hips, thighs, calves and ankles, is a serious contributor to falling.
• Postural changes.  If our centre of gravity is compromised then we will more easily lose our balance. This is called the Forward Head Position (FHP). Our head is heavy and if it is not sitting on top of our shoulders then the sheer weight of it can put us off balance and make falling more likely.
• Proprioception decline.  There are special sensors through the body in muscle tendons, joints and skin telling us to stay upright. As we age those sensors are not so good at sending messages, particularly from our feet.
• Vestibular system decline.  This is all about our ears, as they play a major part in how well we balance. The fluid in our inner ears shifts constantly to aid our balance and the brain uses that information to prevent a fall. As with many other functions it doesn’t work so efficiently as we get older.
• Vision.  Our balance is heavily influenced by our vision. We only have to try closing our eyes whilst standing on one leg to see what a difference good vision makes! As we age we need regular eye tests to ensure our vision is the best it can be to avoid any hazards that could lead to a fall.
• Reaction Times.  Inevitably, we will not be so quick to react to a fall as we were when we were younger, but many enjoyable physical activities can help you to offset this. Sporting activities, like table tennis, badminton, walking netball or walking football all require good reaction times and even a dance session, keeping up with the beat of the music and some fancy footwork, will all help.

What the Research Says

In a recent research review on studies about falls, 62 different studies were assessed involving more than 45,000 people and the conclusion was very clear:

'... the most critical prevention strategy to reduce the risk of falling relies on building strength and stability.  Therefore, it is likely that exercise is the single most effective strategy for fall prevention.'
 

HOW TO FALL!

Following a short talk on why we need to learn to fall, at my 'How to Fall' session, and after warming up all the joints, muscles and cardiovascular system, we set about falling onto our blow-up mattresses. The technique is very clear:

1. TUCK.
   By tucking our chin to our chest and bending all our joints we are almost certainly going to protect our head. This is vital as head injuries are one of the leading causes of death after a fall.
    
2. SIT.
   Now we are in a tucked-up position we need to 'sit down'. Decent leg strength will always help us to do this – weak legs won't!
    
3. ROLL.
   By rolling we spread the load onto different body areas. The hip area is well cushioned with muscles, and as we roll and twist slightly we spread the fall onto our upper back.

So, we practised for a few minutes and the more each person had a go then the more we realised that the technique can be 'learned', so that it is in our muscle memory and becomes more instinctive. Not everyone wanted to risk doing this part of the session, but I sent them away with a 'Home Programme' designed to improve all those aspects of strength and stability that will not only prevent a fall in the first place but if they do, they will have some idea of the techniques needed. Here is the programme:

1. Go for your 30+ minute walk every day and remember to step it out when the ground is flat and get yourself a little out of breath on the uphill bits.
    
2. For your three Strength workouts this week try the Home Programme for Fall Prevention (above). The benefits are not just for falling but to improve your strength and stability generally for all your daily activities.
    
3. Let’s not forget to Stretch! Always do the Post Walk Stretches every day but try to include the Whole Body Stretch Programme three times this week.

Did you know... 

All UK residents are entitled to a free UK Global Health Insurance Card. (UK GHIC)

This card replaced the previous European Health Insurance Card (EHIC) after Brexit. This new card lets you get necessary state healthcare in the European Economic Area (EEA), and some other countries, on the same basis as a resident of that country. This may be free or it may require a payment equivalent to that which a local resident would pay.

A UK GHIC is free and lasts for up to 5 years and you can apply for a card through the NHS website.

Bear in mind that while a UK GHIC card will help you get an emergency ambulance and immediate care should the worst happen in many countries, it won't cover you for things like airlifting you off a cruise ship if you suffer a heart attack or flying you home from your skiing holiday with two broken legs, so it is no substitute for appropriate and comprehensive private travel insurance!