Falls are the single biggest cause of injuries for New Zealanders across all age groups – not just for older adults. When sustained over the age of 55 years, there’s a much higher risk that falls can lead to hospitalisations and significant physical impairments and limit a person’s ability to stay mobile, independent, and doing the things they love. But with that said, there can be serious consequences for all from having a fall – from fractures to mobility impairments and more.
The good news? Research shows that a person’s fall risk can be reduced by 36% when they work with a podiatrist, so helping a person prevent a fall is an opportunity that our podiatrists take very seriously.
The Impact Of Having A Fall (And Why Prevention Is Key)
Most of us don’t think twice about falling – until it happens. With our bodies taking us from A to B seemingly effortlessly, having a fall isn’t something that stays at the forefront of our minds, especially at a younger age. But when a fall means that there’s a very real possibility of a serious injury like a fracture, which can then leave us weaker and less mobile overall than when we started due to the recovery downtime, a big question for many people and their family members is: how can we prevent another fall, or how can we prevent the first one from happening if it hasn’t already?
And these are very good questions. Across Australia and New Zealand, one in three adults aged over 65 years will experience at least one fall every year. This statistic is massive. Data from across the ditch also shows that 42% of hospitalised injuries and 40% of injury deaths are due to falls. Here in NZ, falls represent 39% of all our ACC claims, with over 785,00 falls-related claims being made in 2018, costing 1.1 billion NZD. If one-third of these were prevented like the data shows that they can be with podiatry, that’s over 200,000 people a year that would benefit here in NZ – and this statistic is based on the claims that are made, excluding the smaller falls that no claim would be lodged against.
With such staggering statistics, the role of podiatry in fall prevention is (we feel) highlighted more than ever – and why we’re putting such a strong emphasis on fall prevention.
How To Prevent A Fall: The Key You Must Know
As falls can be so multifaceted, one of the keys to helping prevent a fall is understanding the two groups of factors that can lead to a fall occurring in the first place:
Intrinsic factors
Intrinsic factors that contribute to falls are those occurring within a person’s body, often related to the ageing process in older adults. This includes changes in balance, coordination and walking, vision changes, muscle weakness, reduced reflexes, other existing injuries or problems, and medical conditions or diseases that may alter proprioception (the body’s ability to perceive its position in space). For example, muscle weakness in your feet and legs can increase your likelihood of falling by over four times.
Extrinsic factors
Extrinsic factors are the environmental factors that contribute to falls. They range from the lighting in your home to rugs that are tripping hazards to taking certain medications or, in many cases, multiple medications. For example, taking benzodiazepines is associated with an increase of as much as 44% in the risk of hip fracture and night falls in older adults. A big extrinsic factor our podiatrists see is improper fitting and heavy or unsupportive footwear.
In older adults, often it’s the combination of both intrinsic and extrinsic factors that lead to a fall – like tripping over that rug as you couldn’t see it well because of vision changes paired with lower lighting, and then not having the reflexes or strength to be able to catch yourself before falling.
In children, it often isn’t the loss of an attribute that contributes to falls – like muscle weakening or balance worsening, but these attributes haven’t fully developed yet as they are still very much growing.
How Podiatry Helps Prevent Falls
The good news is that it is very possible to prevent falls, or at least lower the risk of falling significantly, in children, adults and older adults alike.
Returning to the intrinsic and extrinsic factors we discussed, many of these can be improved with the right care, attention, training and modifications. Strength can be regained, gait and balance can be improved, and confidence on your feet can be restored. Tripping hazards can be removed, better lights installed, extra handlebars fitted, and better shoes purchased.
How To Prevent A Fall For Older Adults And The Elderly
Studies have concluded that effective fall prevention in older adults needs three key elements: exercise, education and home or environmental modifications. Here at Masterton Foot Clinic, our podiatrists work with those worried about falls or that have had a previous fall to reduce their falls risk by:
- Identifying muscle weakness, tightness, gait and balance problems as well as other musculoskeletal issues, then creating exercise and rehab plans to address these factors to help you regain functionality and optimise gait
- Using the EXO-L UP brace if you have foot drop or weakness in your foot, thereby preventing a fall by stopping the foot from accidentally hitting the ground as you walk
- Using the EXO-L brace, which is proven to prevent 90% of all ankle sprains, which could otherwise lead to a fall and an injury
- Helping you make the right footwear selections for both inside and outside of the home to minimise falls risk
- Using custom foot orthotics to aid stability, foot function – and also to offload any painful or stiff joints that may be compromising your mobility
- Treating any existing foot or leg injuries that may be contributing to your falls risk.
- Gait retraining
- Referring you to other health professionals, from occupational therapists for a home assessment, to optometrists to assess any new vision changes
Children’s Falls Prevention
As children are still growing, changing and developing all their senses, they have different considerations when it comes to both their risk of falls and the best approach to fall prevention compared to older adults. We’ve got to consider the (temporary) presence of in-toeing, knock knees, immature fine motor skills, and developing balance, among many more.
For kids who are prone to tripping and falling, we always start by performing a comprehensive assessment to understand what is causing their falls and why. We then make a plan with parents of the best ways to help that child stop and prevent falls. Our goal with kids is to help them walk strongly and confidently for all the years to come, keeping them healthy, happy and active. Any therapies we use are suitable and realistic for the child’s age and development.
Falls Prevention With Our Masterton Podiatrists
If you’re concerned about a family member who has had a fall or is at risk, or you’re worried about falling yourself, we’re here to help. Book your appointment with us by calling 06 370 4057 or book online here.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116775/
https://www.aihw.gov.au/reports/injury/falls
https://pubmed.ncbi.nlm.nih.gov/10855607/
https://www.euro.who.int/__data/assets/pdf_file/0018/74700/E82552.pdf