Falls in the older population are very common – approximately 30-60% of older adults fall at least once a year (1) – and a fall can lead to significant injury. There are many factors that have been shown to contribute to an increased fall risk, including decreased muscle strength or decreased sensation in the feet and legs (2), visual impairments, and diseases such as diabetes (3). Exercise programs, including balance activities and functional exercises (like sitting to standing), have been shown to reduce falls risk (4). Strengthening the lower extremity muscles will also likely reduce falls risk (4). Today, we’ll discuss a sample exercise program that may help reduce your risk of falls. As always, you should consult your doctor before starting an exercise program.
- HEEL & TOE RAISES: Stand while holding onto the countertop with both hands and rise up onto the toes, lifting the heels off of the ground. Slowly lower back down. Then lift the forefoot and toes off of the ground, keeping the heels on the floor. Slowly lower back down. Do 2 or 3 sets of 10 repetitions for each exercise. Getting fatigued in the muscles of the calf and shin is expected.
- SITTING TO STANDING: Sit in a chair (without wheels) near a countertop. Stand up, using as little hand assistance as needed. Squeeze the rear end cheeks together and squeeze the muscle in the front of the thigh (quadriceps) as you stand up. Try not to let the knees come closer together as you stand up. Slowly lower back down. Do 2 or 3 sets of 10 repetitions or until you become fatigued.
- TANDEM STANCE BALANCE EYES OPEN: Stand facing the countertop with both feet in a line, the front foot’s heel touching the back foot’s toes. Try to use as little hand assistance as necessary on the countertop to feel a little wobbly but safe. Try to hold that position for up to 30 seconds. If you do lose your balance, then get back into the starting position and try again for the duration of the 30 seconds. After the 30 seconds, switch your position so that you get some practice with the other foot in front. Do 3 repetitions of 30 seconds on each side.
- TANDEM STANCE BALANCE EYES CLOSED: Follow the same setup as in exercise 3 but close your eyes. This exercise is quite a bit harder than when done with the eyes open so you will likely need more hand assistance on the countertop to remain safe. Do 3 repetitions of 30 seconds with each foot forward.
- MARCHING IN PLACE AT THE COUNTERTOP: Stand facing the countertop, then lift one knee up as if you are about to step onto a high stair. Slowly lower back down. Alternate lifting the right and left legs, keeping your back straight and your body up tall. Try to use as little hand assistance on the countertop as is needed to feel safe.
- SIDE-LYING HIP ABDUCTION/LEG LIFTING: Lie on your side on the bed with the top leg straight and the bottom leg bent. Roll the top hip forward a little bit. Lift the top leg up and slightly backward, keeping the knee straight. Slowly lower back down. You should feel this working in the side of the hip near the rear end. If you don’t feel this working in the hip, try to roll the top hip slightly more forward or lift the leg slightly more backward. Do 2 or 3 sets of 10 repetitions or until you become fatigued.
- BRIDGES: Lie on your back on the bed with both knees bent. Lift the rear end off of the bed, squeezing the rear end cheeks together as you lift. Slowly lower back down. The legs and rear end should be working, not the back muscles. If the back is working a lot, don’t lift as high and make sure that the rear end cheeks are squeezing together.
While it is beneficial to perform exercises on your own to prevent falls, the balance activities performed at home are inherently less difficult than those that may be performed with the support of a physical therapist. While trying to work on balance with a home exercise program, individuals should be challenged by the exercises and feel slightly wobbly but use as much hand support on a nearby countertop to feel safe. Physical therapists design personalized exercise programs and can more adequately challenge a patient while keeping them safe. A physical therapist-guided program can result in a faster and more substantial balance improvement than a self-guided program. Our podiatrist can determine if physical therapy is appropriate for you to help with fall prevention in Illinois, Wisconsin or Indiana.
Additionally, many patients have neurological (ex. multiple sclerosis or a history of a stroke) or orthopedic conditions that inhibit their ability to reach their full balance potential. These individuals may benefit from a custom Moore stability brace. This is a molded ankle brace that has been shown to reduce the fear of falling as well as improve balance and postural stability (5, 6). Our podiatrist can help decide if this may be appropriate for you.
Lauren Eisenberg, PT, DPT, Graston Trained
WFAI, Bannockburn, IL
Schedule Your Appointment for Fall Prevention Today
If you have been experiencing a sense of instability, a recent fall, or fear of falling, consider scheduling an appointment with one of our highly qualified podiatrists at the Weil Foot & Ankle Institute.
- Rubinstein L.Z. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006; 35(Suppl. 2), ii37-ii41.
- Hamacher D, Liebl D, Hodi C, Hebler V. Kniewasser CK, Thonnessen T. Zech A. Gait stability and its influencing factors in older adults. Front Physiol. 2019 Jan 24;9:1955.
- Ambrose A.F., Paul G., Jausdorff J.M. Risk fractors for falls among older adults: a review of the literature. Maturitas 2013; 75, 51-61.
- Sherington C., Fairhall N.J., Wallbank G.K., Tiedemann A., Michaleff Z.A., Joward K, et al., Exercises for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019 Jan 31; 1:CD012424.
- Wang C, Goel R, Rahemi H, Zhang Q, Lepow B, Najafi B. Effectiveness of daily use of bilateral custom-made ankle-foot orthosis on balance , fear of falling, and physical activity in older adults: a randomized controlled trial. Gerontology. 2018; Nov 30:1-9.
- Yalla S.V., Crews R.T., Fleischer A.E., Grewal G, Ortiz J, Najafi B. An immediate effect of custom-made ankle foot orthoses on postural stability in older adults. Clinical Biometrics. 2014; 29:10,1081-8.