> Latest Column

Ask Chris

Personal Training and Rates

Group Classes

About Chris


Public Speaking

Healthy Links

Mailing List

Contact Chris

Reducing Falls

10 October 2005

According to a recent study, one third of adults 65 years of age and older suffers at least one fall each year. And nearly half of these people fall more than once. Falls are the leading cause of injury-related deaths. But even when the fall is less serious, it can still cause pain and suffering, and bring a tragic loss of independence. For many older adults, suffering a fall can mean the difference between remaining in your own home and having to go to a long-term care facility.

But there's good news along with the bad. Studies have also shown that many falls can be prevented by a few simple changes you can make in your life. And it turns out that exercise is the most important thing you can do to help prevent falls.

How Not to Fall

Have you ever tried to stand a chair on two legs? It isn't easy. But our bodies stand us up on two legs all the time, without our having to think about it. As it turns out, there is a lot happening.

Three systems have to be working properly to keep us balanced:

  • Our eyes tell the brain where we are in relationship to our environment and identify obstacles.
  • Our inner ears have special organs (the vestibular system) that tell the brain about the movement of our head in space.
  • Our muscles have special receptors (the somatosensory system) that tell the brain what position our body is in, and detect movement and contact with other objects (such as our feet on the floor).

With all this information, our brains send constant signals to our muscles that keep us standing in balance and that help us react to changes when we move around. So even with all the right information, we still need muscular strength to keep our balance.

Why does getting older increase our risk of falling?

Some age-related changes are inevitable, and ones that affect our vision, inner ears, receptors, brain, or muscular strength will of course affect our balance.

Vision can be affected by glaucoma, age-related macular degeneration, and cataracts. These compromise our ability to perceive hazards and anticipate changes in surfaces when walking. The inner ear starts to lose its motion-sensing "hairs" as early as age 30. Losing too many can result in postural sway. The receptors in our somatosensory system also decline with age, making it harder to sense contact and body position. The brain's ability to control our muscles declines with age. We don't react as fast to changes. Finally, our muscles can get weaker as we age, making it harder to recover balance when we lose it.

Can we reverse some of these changes, which increase our risk of falling?

The answer is yes!

Doing the right kinds of exercises --- ones geared specifically for balance, strength, endurance, and flexibility --- can improve balance, increase mobility, and reduce falls. Programs such as FallProofTM and Standing StrongTM target the sources of the impairments, which contribute to postural instability. However, there are a number of exercises you can do on your own, with a trainer, or in a class that can also help.

These should include balance specific exercises, which train your centre of gravity, the three sensory systems, posture, and gait to help maintain and improve your balance.

  • Centre of Gravity Training will reduce your body sway and help you move more quickly. Some of the exercises are done while seated on a stability ball while others are done standing on the floor, a step, a foam pad, or an uneven surface.

  • Multi-sensory training will help each of the sensory systems to work more efficiently: the eyes, inner ears, and muscle receptors. Some of these exercise are performed standing, while other are performed sitting on a stability ball or a chair.

  • Postural Training will help to improve the strategies you use subconsciously to correct your posture while you are moving such as ankle and hip correction and your ability to step out quickly to prevent a fall. These exercises are done standing and require a trainer to support you or move you through space using resistance bands placed around your waist.

  • Gait Training will help improve your walking gait pattern so that it is more efficient, flexible, and adaptable to environmental changes. The exercises are designed to increase the length of your stride length and help you get around obstacles better.

No exercise program is complete without including strength, endurance, and flexibility training. Of all of the systems that decline with age, the musculoskeletal system is one which benefits the most from exercise and can be improved at any age.

Muscles are made stronger by resistance training. You don't have to lift heavy weights, operate complicated machinery, or join a gym. You can strengthen your muscles with simple exercises using everyday props, stability balls, and elastic bands or tubing in the comfort of your own home. Strong muscles will cause your bones to become stronger as well and reduce wear and tear on your joints. A strong musculo-skeletal system will serve you well in reacting and responding to a situation that may otherwise cause you to fall.

Your muscles don't just need to be strong, they must also be kept supple and flexible. Any falls reduction program must also include flexibility training to stretch muscles that have been worked. This will allow you to reach and move with ease without pulling a muscle or causing a painful spasm.

A strong heart is also important by giving you the energy you need to react and move quickly in order to avoid falling when something startles you or you trip and lose your balance. So, aerobic activity should be included in any falls reduction program.

I highly recommend that you begin a falls reduction program that you can do at home, with a friend, or at a gym or recreational facility. If you decide to work with a trainer, make sure he or she is qualified to prescribe a falls prevention program. Many recreation facilities and gyms offer programs. Whatever you decide to do, remember that through exercise you can help reduce the risk of falling and the number of falls you experience. Having a strong body, good posture, and balance will go a long way to help keep you on your feet and not on your rear-end!

To your health,



Belfry, S. et al. (2004). The project to prevent falls in veterans: a multifactoral risk factor screening and intervention study. Scientific Proceeding from the 6th World Congress on Aging and Physical Activity. London, ON: Canadian Centre for Activity and Aging, 157-164.

Brown, R. (2004). How to start and sustain a falls prevention program for seniors led by seniors. Scientific Proceeding from the 6th World Congress on Aging and Physical Activity. London, ON: Canadian Centre for Activity and Aging, 147-149.

Freiberger, E. (2004). Prevention of falls - an ongoing longitudinal research project. Scientific Proceeding from the 6th World Congress on Aging and Physical Activity. London, ON: Canadian Centre for Activity and Aging, 150-153.

Islam, M.M., et al. (2004) Improvement in body sway after 12-wk of customized balance training versus tai chi exercise in older adults. Scientific Proceeding from the 6th World Congress on Aging and Physical Activity. London, ON: Canadian Centre for Activity and Aging, 57-64.

Islam, M.M., et al. (2004) Improvement in fitness after 12-wk of well-rounded exercises in older adults. Scientific Proceeding from the 6th World Congress on Aging and Physical Activity. London, ON: Canadian Centre for Activity and Aging, 78-81.

Rogers, M.E. & Page, P. (2005). Standing StrongTM: a strength and balance program for older adults. Can-Fit-Pro Annual Conference, August 18-21. Toronto, ON (unpublished paper).

Rose, D. (2003). Fall Proof!: A Comprehensive Balance and Mobility Training Program. Champaign, IL: Human Kinetics.

Westlake, K.P. & Gulham, E.G. (2004) Activity level, proprioception, postural sway, and fear of falling in older adults. Scientific Proceeding from the 6th World Congress on Aging and Physical Activity. London, ON: Canadian Centre for Activity and Aging, 43-57.

Previous column:

Controlling Diabetes Through Exercise

See all columns

Next column:

Strength Training Fact and Fiction

Sidebar #1:

Other Hazard for Falling
Here are some other things you can do to decrease your risk of falling:

  • Clear away clutter (throw rugs, unstable furniture, low-lying objects)
  • Put in nightlights
  • Add handrails to staircases that need them
  • Fix uneven surfaces outside your house
  • Clean up spills inside and wet leaves outside
  • Don't get up too quickly
  • Ask your doctor if any of your medications could affect your balance

The Government of Canada has produced a great brochure on Falls Prevention. It has a lot of useful information to help make your home environment safer. There is also a subsidy program available for homeowners who qualify to adapt your home with features to make it safer.

Sidebar #2:

Fear of Falling: The Vicious Cycle
The fear of having a fall can actually make it more likely that you will have one! How can this be? Many people who fear falls restrict their activities. But when you are less active, your muscular strength decreases, and so does your cardio-vascular capacity. Even your balance gets "out of practice". This makes it more likely you'll take a fall.

Sidebar #3:

What about Tai Chi?
Tai Chi has many health benefits such as improving flexibility, co-ordination, reducing stress, and helping with balance. But in a study presented last year at the 6th World Conference of the International Society for Aging and Physical Activity, researchers determined that balance-specific exercises are much more effective than Tai Chi in training the sensory systems that control balance.