Don’t fall into the fear cycle
ALANCE REACTIONS TEND to diminish with age, in the same way as eyesight, says physiotherapist Steve Clarke, who has worked at Chelsea and Tottenham football academies and now specialises in treating people at home.
Loss of confidence is one of the main factors affecting balance, he explains. “If someone has been in bed for two or three weeks, they might be weak when they get out and their confidence might have dropped, even if they had good health before. By employing exercises, they can regain their strength and confidence.”
“If someone feels they are at risk of falling, their muscles will become tense, so they won’t move normally. This becomes a very negative cycle: the more frightened they are of falling, the less they do and will actually increase the chances of a fall when they do move. They will cope much better if they have been active through their lives and it is never too late to start. I see a number of people with Parkinson’s for balance retraining.”
Joint replacement can cause problems, too. “Nerves around joints such as hips and knees send messages to tell the brain where they are. If a joint is replaced, those nerves are removed, so the messages are lost. However, there’s a lot that can be done to compensate.”
Lewis Rawson sees physiotherapy patients at the Spire Bushey hospital. “They might have an arthritic knee or shoulder that requires strengthening of the joint muscle. If it’s to do with ageing, for example loss of balance or high risk of falls, I would go for balance retraining as well as muscle strengthening,” he says. “There are falls classes where, among other things, people are taught how to get up if they have a fall. The thinking is to reduce fear of falling; you can cut the risks significantly with improved strength. Even sarcopenia (wasting of muscles) can be reversed through resistance exercises.”
Resistance exercises can be done with weights and resistance bands. “Use a chair to do repeats where you stand up and sit down or use a bottom stair to step up and down. If you’re confident, you can lie on the floor to do a bridging exercise where you lift your bottom up and down to strengthen the muscles around the hips.” For those with serious mobility problems, he suggests water-based exercise. “Even someone with quite severe injuries can be lifted into a pool to exercise using the buoyancy of the water,” he says.
“All these exercises, in water or out, keep people mobile and help them become more mobile,” says Mr Rawson. “Things like gardening can help, activities that increase the heart rate so you get a bit short of breath. This has particular benefits for those with osteoporosis, as exercise reduces the rate of bone density loss. Exercising for 15 to 30 minutes, three to five times a week, can cut your risk of dementia.”