Im­prov­ing your bal­ance will lessen risk of falls

Daily Freeman (Kingston, NY) - - YOUR DAILY BREAK - An­thony Ko­maroff Ask Dr. K

I’m in my 70s. A friend of mine re­cently fell and broke her hip. I’d like to avoid a sim­i­lar fate. What steps can I take to avoid fall­ing?

Falls send mil­lions of peo­ple in the United States to emer­gency de­part­ments each year with bro­ken hips and head in­juries. Im­bal­ance is a com­mon cause of falls. Liz Moritz, a phys­i­cal ther­a­pist at Har­vard-af­fil­i­ated Brigham and Women’s Hospi­tal, rec­om­mends sev­eral strate­gies to peo­ple look­ing to im­prove their bal­ance.

• PHYS­I­CAL THER­APY. Phys­i­cal ther­apy for bal­ance fo­cuses on three things: the abil­ity of the joints and brain to com­mu­ni­cate, the bal­ance sys­tem in the ear (the vestibu­lar sys­tem) and vi­sion. Ex­er­cises such as stand­ing on one foot, first with the eyes open and then with the eyes closed, can help co­or­di­nate all three. Joint flex­i­bil­ity ex­er­cises, walk­ing and lower-ex­trem­ity ex­er­cises can also help.

• MUS­CLE STRENGTH­EN­ING. Core strength is very im­por­tant for bal­ance. If the ab­dom­i­nal mus­cles in your core are weak, they can­not sup­port your legs when you’re walk­ing. And if the mus­cles in your but­tocks and hips aren’t strong, they won’t be able to pro­pel you for­ward. Mus­cle strength­en­ing ex­er­cises can help.

• TAI CHI AND YOGA. Tai chi and yoga make you pay at­ten­tion to the con­trol and qual­ity of move­ment, which im­proves your bal­ance. In tai chi, you prac­tice slow, flow­ing mo­tions and shift your weight from one limb to an­other. Yoga in­cor­po­rates a series of fo­cused pos­tures and breath­ing. Both ex­er­cises in­crease flex­i­bil­ity, range of mo­tion, leg and core strength and re­flexes.

• VI­SION COR­REC­TION. If your vi­sion is im­paired, your risk of fall­ing in­creases dra­mat­i­cally. If you’re hav­ing trou­ble with your vi­sion, the fix may be as sim­ple as a new eye­glasses pre­scrip­tion. Once you hit age 40, you should have reg­u­lar, com­pre­hen­sive, di­lated eye ex­ams.

• ASSISTIVE WALK­ING DE­VICES. A cane or a walker can com­ple­ment your bal­ance and give you more sta­bil­ity and con­fi­dence walk­ing. Walk­ers are avail­able with wheels in­tended for dif­fer­ent ter­rain, lock­able brakes, seats, bas­kets and other fea­tures such as head­lights. Canes are avail­able with var­i­ous hand­grips and bases.

Bal­ance is one of those things that we take for granted. In most of us, it be­comes worse as we en­ter the last half of our lives. But we of­ten don’t no­tice it —un­til sud­denly we do.

I re­mem­ber the mo­ment when I no­ticed it. A light bulb in a high ceil­ing fix­ture needed re­plac­ing. So I did what I’d done be­fore, though not for quite a while. I got out the tall lad­der and started to climb. Half­way up, it sud­denly struck me: I wasn’t very steady. This was not a good idea. In­deed, it was a bad idea.

I called a young handyman who had done odd jobs for us and told him I had a small job for him. When he asked what it was, I replied: “Change a light bulb.” He replied: “Well, this is a first for me, but if the money is good, I’ll be right over”!

Dr. Ko­maroff is a physi­cian and pro­fes­sor at Har­vard Med­i­cal School.)

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