#003 - Just fall over
Don’t have a fall……just fall over!
We all have an anecdote about someone that ‘had a fall’; a family member or loved one which frequently results in a decline in their self-confidence and/or lifestyle. When we think of falls, particularly in the context of older adults, it's often associated with a sense of vulnerability. The term ‘having a fall’ is commonly used, but there is a crucial difference between ‘falling over’ and ‘having a fall’ that is not only important for understanding risk but also for shaping our approach to health, balance, and longevity.
Falling over vs. having a fall: A subtle yet crucial distinction
The phrase ‘falling over’ may suggest an incidental, controlled loss of balance that doesn't necessarily result in harm. For example, if you trip or slip but regain your balance quickly, you’ve simply ‘fallen over’. This type of fall is often minor, doesn’t lead to injury, and can occur due to unexpected or environmental factors, like a rough patch of ground or a sudden misstep.
On the other hand, the phrase ‘having a fall’ is typically used to describe a more serious incident - one that results in an uncontrolled drop to the ground, often with significant injury, such as fractures, bruises, or more severe consequences. This type of fall is more dangerous and can have long-lasting implications, especially for older adults. The language we use here is not just a matter of semantics; it shapes our perception of falls and influences how we take steps to prevent them.
Yet, despite the differences, we would still refer to 20 year old Maddie who falls and breaks her ankle, even if it is sudden and unexpected, as having ‘fallen over’ vs 83 year old Pat with the same injuries as having ‘had a fall’.
Why older adults are often associated with having falls
The connection between older adults and falls is well-documented, and for good reason. As we age, our balance, coordination, and strength tend to decline. Muscle mass decreases, bones can become more brittle through loss of bone density, and reflexes slow. All these changes can increase the likelihood of losing balance and experiencing falls.
The statistics don’t lie; according to the NHS, in the year 2017/2018, falls were a leading cause of injury-related hospitalisations in older adults. The highest risk of falls is in those aged 65 and above and it is estimated that about 30% people (2.5 million) aged 65 and above living at home and about 50% of people aged 80 and above living at home or in residential care will experience an episode of fall at least once a year. Falls that results in injury can be very serious - approximately 1 in 20 older people living in the community experience a fracture or need hospitalisation after a fall. Falls and fractures in those aged 65 and above account for over 4 million bed days per year in England alone, at an estimated cost of £2 billion.
These falls can result in fractures, head injuries, wounds that are a challenge to heal, and a reduction in the ability for people to live independently which subsequently increases demand on health and social care service. As a result, there is widespread efforts and focus on fall prevention for older people. However, it’s important to recognise that not all falls are inevitable or irreversible. There is a growing focus on proactive strategies to maintain balance, strength, and overall health, regardless of age.
The secret to avoiding ‘having a fall’? - simply maintaining a state where you can ‘fall over’ instead
One key goal for health and longevity, especially as we age, is to move away from the mindset of simply trying to prevent falls altogether. Instead, we should aim to maintain a state where we are less likely to ‘have a fall’ but can instead ‘fall over’ and recover with ease. Achieving this comes down to enhancing three critical elements: balance, strength, and coordination.
Balance: Our ability to maintain our centre of gravity is crucial in preventing falls. As we age, balance tends to degrade, making us more susceptible to unplanned drops. Balance exercises, such as yoga, pilates and regular stretching can help improve proprioception, the sense of where our body is in space, enhancing our ability to react and regain equilibrium before we hit the ground.
Strength: Weakened muscles contribute significantly to falls. Stronger muscles therefore help stabilise our bodies and prevent us from losing control during everyday movements. Strength training, focusing on leg, core, and upper body muscles, is essential for improving posture, preventing muscle loss, and ensuring that we have the force to recover if we start to lose balance.
Coordination: Coordination involves being able to move different parts of the body efficiently and smoothly. Poor coordination can lead to stumbling, difficulty recovering from trips, and an increased likelihood of falls. Exercises that challenge coordination—like agility drills, dance, or complex movement patterns—are beneficial in promoting better control over our movements and preventing serious falls.
Health and longevity: building a fall-resistant body
Health and longevity are deeply intertwined with the ability to prevent falls. People who maintain strong balance, coordination, and muscle strength are not only at lower risk of serious falls, but they also tend to enjoy better mobility and greater overall well-being as they age.
Strength and balance exercises have been shown to improve physical function, decrease frailty, and even reduce the risk of chronic diseases like osteoporosis or heart disease (check out Rich’s article ‘Rethink Osteoporosis’. We have more to come on heart disease in the next few months). Moreover, maintaining good physical health through these exercises improves confidence and mental health, which, in turn, can lead to a more active lifestyle, further reducing fall risk.
Additionally, a focus on staying physically active, regardless of age, can increase longevity. Studies show that older adults who remain active are more likely to maintain their independence, experience fewer hospitalisations, and enjoy a higher quality of life. By investing in exercises that promote balance, strength, and coordination, we help ensure that we stay agile and capable, preventing serious falls while allowing us to ‘fall over’ with greater ease and confidence.
Conclusion: the road to fall prevention and healthy aging
The distinction between ‘falling over’ and ‘having a fall’ is significant. While both terms may seem interchangeable at first glance, the ability to simply fall over without sustaining injury is something we can all strive for, no matter our age. By focusing on enhancing our balance, strength, and coordination, we can significantly reduce the risk of ‘having a fall’ while maintaining the freedom and confidence to engage in life fully.
Whether you're young or elderly, it’s never too early or too late to start working on the pillars of a fall-resistant body. Doing so not only increases your personal safety but also contributes to a healthier, longer life.
James Culmer-Shields - Founder