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Unless you have a history of falling, fall prevention may not be something that you think about in conjunction with your Pilates or movement practice. However, given that falls are the leading cause of both fatal and non fatal injuries among older adults, fall prevention is important to consider especially as we get older. 

 

According to the Center for Disease Control: 

 

  • 25 percent of Americans who are 65 or older fall every year

  • Every 11 seconds, an older adult will be treated in the ER for a fall

  • Every 19 seconds an older adult will die from fall related injuries

  • More than 3 million fall related injuries are treated in the emergency room every year, which results in over 850,000 hospitalizations and over 29,000 deaths

  • The estimated cost of fall related injuries is expected to reach $67.7 billion in 2020

 

While falling is a serious and scary issue, the good news is that there are simple ways to reduce or even prevent the risk of falling. 

 

Common risk factors for falling

 

The most common risk factors for falling can be categorized as physical, behavioral, and environmental. Physical risk factors include changes to your body, such as a decrease in balance, strength, or coordination, which could contribute to falling. Behavioral risk factors are any actions that you may or may not take to address your risk of falling. Environmental risk factors include any trip hazards in your environment, such as uneven terrain in your backyard or an object that is low to the ground and difficult to see in your home. When it comes to reducing your risk of falling, it is beneficial to pay attention to any shifts in your health and fitness.

 

Some things to notice, which may contribute to your risk of falling include: 

 

  • A decline in strength, balance, and coordination while performing activities of daily life, such as climbing the stairs or carrying in the groceries.

  • A change in vision, which can negatively affect balance and make it more difficult to see trip hazards.

  • Any side effects from both prescription and over-the counter-medications, which may result in dizziness, sleepiness, or dehydration and contribute to the risk of falling.

  • The space in which you live. If you are concerned about falling, a simple way to reduce your risk is to identify and address any potential trip hazards from your home. 

  • A change in a chronic condition. Many older adults will experience a chronic condition, such as diabetes, heart disease, or arthritis. These conditions often correlate with increased pain, depression, and loss of function and may require medications, which can contribute to an increased fall risk. 

The Solution is in the Sensory Systems

These sensory systems include:

 

The Vision System: You use your eyes to locate the objects around you and track any changes in your environment. Your eyes also inform you of when you or something around you is in motion.

 

The Vestibular System: Located in the inner ear are small structures called sensory organs that detect movement and orientation to gravity (e.g. if you are standing or lying down). These sensory organs help you sense if you are standing still, moving, or rotating. 

 

The Proprioception System: Located in your skin, muscles, and joints are specialized nerve endings called proprioceptors that help you sense how your body parts are aligned and moving through space. In the case of balance, it is particularly important that you have good proprioception or body awareness around your neck and ankles, because of the role that these areas play in determining the direction of the head and stacking the joints to keep you upright when we move. 

 

As you age, it is not uncommon for these sensory systems to become less responsive, which in turn compromises balance. However, it is possible to increase the receptivity of these systems and reduce fall risk by engaging in an exercise or movement program that emphasizes body awareness, posture, and strength (3). Pilates is a form of movement that focuses on the mind-body connection and can be especially beneficial for building strength while addressing body awareness, control, coordination, and balance.

 

Additionally, there is evidence suggesting that Pilates can be used to reduce fall risk. One study found that thirty-five adults between the ages of 61 and 87 reported a reduced fear of falling and experienced improvements in balance and postural stability after completing an eight week Pilates program (4). It is likely that Pilates is effective in improving balance, because of the emphasis placed on posture and body awareness. Additionally, Pilates exercises involve moving through different orientations to gravity, such as seated, lying down, and four point kneeling, which can help stimulate the visual, vestibular, and proprioception system. 

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When I am working with clients or training instructors on how to restore balance and coordination, it is vital to understand and address the sensory systems -- where sensory gaps may exist, applying the proper exercises, and measuring how these systems are improving.  -- Trent McEntire

Trent McEntire

Trent McEntire, Director and Founder

As someone who became a professional dancer after rehabilitating his own severe movement restrictions established at birth due to Cerebral Palsy, Trent understands how the quality of life is affected by how well you can (or can't) move your body.  For 20 years, he has been sharing his discoveries and method with those seeking to overcome their own movement limitations. His work has led to an international school and equipment designed to further the development of Pilates Therapy and Neuro-Movement. Trent has presented his work at international conferences and host sites in Italy, Japan, Spain, Mexico, UK, Brazil, Canada, and throughout the US.

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