With autumn gone and winter settling in, wet, cold, and occasionally icy weather leads to a lot of slips, falls, and injuries. People of all ages are susceptible -- and there is no activity more basic than standing upright, and no movement more central to our daily lives than being able to walk safely. The keys to safety and preventing falls in wet weather are the same as those in dry weather, just with more vigilance and care, and the recognition that your surface starts out less stable. If you struggle with balance indoors and in dry weather, winter weather can be a serious risk factor for falls.
Balance relies on the intricate coordination of information from the visual system, vestibular system, proprioception, and musculo-skeletal system. Our brains use information from our vision, inner ear, and joints to determine where our bodies are in space, and to create a motor plan to keep us in an upright position. The musculoskeletal system must then be able to carry out the plan effectively to keep our bodies in an upright posture.
A dysfunction of any of these systems can occur at any age, each patient is different, and many factors contribute to balance and stability deficits: muscle weakness, joint stiffness, slow reaction timing, other medical conditions or side-effects of medications. A physical therapist will do a thorough examination to determine which of these issues are at play, and will coordinate an individualized plan of care to address those issues.
Treatment is likely to include re-education of correct postural elements such as neutral pelvis alignment, erect spine and head posture, symmetrical weight distribution from side to side, as well as identification of each patient’s limits of stability. These corrections are necessary to create the most stable spinal position, and place the center of mass optimally within the center of balance. Without a solid foundation from which to begin even seemingly simple movements or activities may create too great a challenge to balance.
Targeted strengthening exercises are a primary focus of balance training and falls prevention. Exercises are chosen based on the deficits identified during evaluation and are extremely important for maintaining a steady static posture and moving through constantly changing surroundings. Weakness, whether it be in specific postural muscles or large muscle groups may contribute to difficulty remaining stationary, moving through space, or making the necessary corrections when balance is challenged. If range of motion (ROM) limitations affect a patient’s ability to achieve optimal posture, or respond effectively to perturbations, treatment would also include stretches to improve muscle flexibility and joint mobility.
As we age, both balance difficulties and risk of falling increases dramatically. By the age of 70, 75% of Americans are diagnosed as having “abnormal balance,” and nearly half of patients 80 years and older will experience at least one fall this year. As human movement specialists, physical therapists are uniquely trained to address the many factors contributing to balance deficits and help decrease the risk of falling.
With older folks, the risk of broken bones during a fall is a serious concern, but even when no injury is sustained, a history of falling or fear of future falls can make a person more fearful of performing normal activities. In more serious cases, a fear of falls may cause some people to become more sedentary, which can lead to further weakness, depression, or other medical issues associated with inactivity. Whether you are thinking of yourself, or a loved one, you may have already noticed changes in activity level in response to feelings of instability. Physical therapists are specialists in the science of movement, and we would like to keep you healthy, safe, and capable of participating in whatever activities you choose, any season you choose.
Thanks for reading!
Sarah Terpin, PT, DPT
After experiencing a variety of different approaches to physical therapy practice in Oregon and Utah, Sarah found her home in Functionize’s private-pay model giving the direction and decision-making power back to the patient. A firm believer in taking the whole human into account as opposed to focusing on a symptom, she is adept at creative approaches that lead to ah-ha moments around the root cause for pain or limitation.
At Functionize Health & Physical Therapy we work with athletes and active people at all levels to develop individualized treatment plans to help them safely and fully recover from injuries and get them back to the activities they love. If you have worked with us one-on-one, you know that we don’t subscribe to generic protocols or programs; it is never one-size-fits-all, and that applies to these tips as well. If you are recovering from an injury, talk to your PT about how stretching and or foam rolling may affect you.