Learn to Not Fall

Falls send more peo­ple, es­pe­cially younger folks, to the doc­tor than any other in­jury. The best pro­tec­tion?


AL­CIDES MORENO and his brother Edgar Moreno were win­dow wash­ers in New York City. On De­cem­ber 7, 2007, the broth­ers took an el­e­va­tor to the roof of a 47-story apart­ment build­ing. They stepped onto the 16-foot-long, 3-foot-wide alu­minum scaf­fold­ing de­signed to slowly lower them down the black glass of the build­ing. But the an­chors hold­ing the plat­form gave way,

plung­ing it and them 472 feet to the al­ley be­low. The fall lasted mere sec­onds.

Edgar tum­bled off the scaf­fold­ing, hit the top of a wooden fence, and was killed in­stantly. But res­cuers found Al­cides alive, crouch­ing amid a tan­gle of crushed alu­minum in the al­ley next to the build­ing, breath­ing and con­scious.

Falls are one of life’s great over­looked per­ils. We fear ter­ror at­tacks, shark bites, Ebola out­breaks, and other re­mote dan­gers, yet each year an es­ti­mated 646,000 peo­ple die world­wide af­ter fall­ing. Falls are the sec­ond-lead­ing cause of death by in­jury, af­ter car ac­ci­dents. In the United States, falls caused more than 33,000 fa­tal­i­ties in 2015.

Falls are even more sig­nif­i­cant as a cause of in­jury. More pa­tients go to emer­gency rooms in the United

States af­ter fall­ing than for any other form of in­jury, in­clud­ing car ac­ci­dents, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion. And while el­derly peo­ple with frag­ile bones cer­tainly need to be care­ful, they may not be the group at the big­gest risk of in­jur­ing them­selves in a fall. In a study pub­lished last year in PLOS One, nearly 18 per­cent of men ages 18 to 44 had re­ported a fall­re­lated in­jury in the prior three months, more than dou­ble the per­cent­age of men 65 and older.

Falls can hap­pen any­where at any time to any­one. Spec­tac­u­lar falls from great heights out­doors, such as the plunge of the Moreno broth­ers, are ac­tu­ally ex­tremely rare. The most dan­ger­ous spots for falls are not rooftops or cliffs but the low-level in­te­rior set­tings of ev­ery­day life: shower stalls, su­per­mar­ket aisles, and stair­ways.

Any fall, even a tum­ble out of bed, can change life pro­foundly, tak­ing some­one from ro­bust health to grave dis­abil­ity in less than one sec­ond.

It’s no won­der that sci­en­tists are now en­cour­ag­ing peo­ple of all ages to learn how to fall to min­i­mize in­jury, to view fall­ing not so much as an un­ex­pected haz­ard to be avoided as an in­evitabil­ity to be pre­pared for.

Train­ing may even have been a fac­tor de­ter­min­ing the out­come of the Moreno broth­ers’ fall to earth. One the­ory was that Al­cides lived be­cause when the scaf­fold­ing gave way, he lay flat and clung to the plat­form, as pro­fes­sional win­dow wash­ers are taught to do. As the scaf­fold­ing fell into the nar­row al­ley, air re­sis­tance may have built up against the plat­form, slow­ing it down. De­cel­er­a­tion is the key to sur­viv­ing falls and re­duc­ing in­juries. As the joke goes, “It’s not the fall that gets you; it’s the sud­den stop at the bot­tom.” Al­cides ul­ti­mately un­der­went 16 surg­eries and was in a coma for weeks. But af­ter a long reg­i­men of phys­i­cal and oc­cu­pa­tional ther­apy to strengthen his legs and re­store his bal­ance, he can walk again. “I keep ask­ing my­self why I lived,” Al­cides told the BBC. “I have a new baby—he must be the rea­son, to raise this kid and tell him my his­tory.”

Given the tremen­dous cost of falls to in­di­vid­u­als and so­ci­ety and the in­creas­ing knowl­edge of how and why falls oc­cur, it pays to learn how to pre­vent them—and what you can do to lessen harm in the split sec­ond af­ter you start to fall. Some of the fol­low­ing tips are just com­mon sense—and too eas­ily brushed aside un­til the over­sight has caused an ac­ci­dent. A few sug­ges­tions might re­quire a bit of train­ing, or at least some prac­tice. They’re all worth think­ing about, no mat­ter how steady you may feel on your feet.


Se­cure loose rugs or get rid of them. Make sure the tops and bot­toms of stair­cases are lit. Clean up spills im­me­di­ately. In­stall safety bars and put down trac­tion strips in show­ers, and treat slick sur­faces such as smooth mar­ble floors with anti-slip

coat­ings. If there’s ice out­side your home, clear it and put down salt.


Watch where you are go­ing. Don’t walk while read­ing or us­ing your phone. Al­ways hold handrails—most peo­ple us­ing stair­ways do not. Don’t have your hands in your pock­ets, as this re­duces your abil­ity to re­gain your bal­ance when you stum­ble. Re­mem­ber that your bal­ance can also be thrown off by a heavy suit­case or back­pack.


Wear good shoes with treads. On ice, do not wear high heels. Wear a hel­met when bi­cy­cling, ski­ing, and skate­board­ing. Use a cane or a walker if re­quired. Hike with a walk­ing stick. And get a hear­ing aid if you need one. “In­di­vid­u­als with hear­ing loss had more dif­fi­culty with bal­ance and gait and showed sig­nif­i­cant im­prove­ment when they had a hear­ing aid,” says Linda Thi­bodeau, a pro­fes­sor at the Univer­sity of Texas at Dal­las’s Ad­vanced Hear­ing Re­search Cen­ter, sum­ma­riz­ing a re­cent pi­lot study.


Drugs, al­co­hol, and even sleep de­pri­va­tion can af­fect bal­ance and co­or­di­na­tion, mak­ing them a fac­tor in falls. If you feel light-headed or faint, sit down im­me­di­ately. Don’t worry that some­one might think you are weak or that you are be­ing rude; you can get back up once you’ve es­tab­lished you are not go­ing to lose con­scious­ness. Eat a bal­anced diet to sup­port bone den­sity and mus­cle strength, es­pe­cially if you are older, so that you are less likely to be in­jured if you do fall. A study of more than 12,000 el­derly French peo­ple in 2015 found con­nec­tions be­tween poor nu­tri­tion, fall­ing, and frac­tures. Strength train­ing helps too. Lower body strength is important for re­cov­er­ing from slips; up­per body strength, for sur­viv­ing falls.


Sci­en­tists study­ing falls are de­vel­op­ing “safe land­ing re­sponses” to help limit dam­age. If you are fall­ing, first pro­tect your head. Fight trainers and para­chute jump coaches en­cour­age peo­ple not to fall straight for­ward or back­ward. The key is to roll and try to let the fleshy side parts of your body ab­sorb the im­pact.

“Don’t reach back for the floor with your hands,” says Chuck Coyl, fight di­rec­tor at the Lyric Opera of Chicago, de­scrib­ing how he tells ac­tors to fall on­stage. “Dis­trib­ute the weight on the calf, thigh, into the glutes, rolling on the out­side of your leg as op­posed to fall­ing straight back.”

If you do fall, don’t do it like this. In­stead, pro­tect your head and twist to land on your “fleshy” parts.

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