3 Surprising Reasons Seniors Fall (Plus Simple Fixes)

Many seniors think of falls as a “natural part of aging”.  The incidence of falling definitely increases as we age, 1 in 3 adults over the age of 65  fall in any given year.  However, there are many modifiable factors that influence how safe we are on our feet; one of the most overlooked factors is our feet themselves!

Our feet are our connection to the ground.  Their flexibility, strength and communication strategy with the rest of our body are key to ensuring we are steady.  Declines in these systems can negatively impact our stability quickly.  The good news is many of these systems can also be positively impacted with a little exercise guidance from a physiotherapist.

Ankle Flexibility – The Problem

Ankle stiffness can make it difficult to bend the ankle upward; this movement is called dorsiflexion.  When this is limited, we are more likely to catch our toe when we are stepping up a curb, trying to recover from a mis-step or walking on uneven ground.  Area rugs and bathmats can also become hazardous when ankle flexibility declines.

Increased ankle stiffness can occur after injury, due to underlying joint changes like osteoarthritis or even to changes in movement patterns that start to limit muscle and joint flexibility.

Ankle Flexibility – The Fix

A calf stretch can help improve ankle flexibility.  I like the calf stretch where you stand facing a wall and step one leg backward (heel down, knee straight) to feel the muscles pulling in the back of the lower leg.  Ensure the toes of the back foot are pointed straight forward.  Holding this position for 20-30 seconds and repeating 2-3 times daily can be help optimize ankle flexibility.

For more stubborn ankles, a trip to a physiotherapist for some hands-on manual therapy and more targeted exercises for the ankle joint can be helpful.

Ankle & Foot Strength – The Problem

The ankle muscles need to control the large movements of the foot and to respond quickly when balance is challenged.  Decreased strength in the front of the ankle can make it harder to lift the foot upward, making it more likely to catch your toe.  Decreased strength in the calf can make it harder to generate forceful push off during walking and harder to slow down the drop of the heel when walking.  The small muscles in your foot also grip the ground to help with pivoting and navigating uneven ground.

Ankle & Foot Strength – The Fix

The right ankle and foot strengthening exercises will be different for each person.  However, simple calf raises (standing on two feet and rising up onto your toes) and toe tapping (lifting the front of your foot up and down while keeping your heel down – think of tapping along to your favorite song!) can go a long way for most people.  To strengthen the muscles of the foot, you can curl the toes towards the bottom of your foot as though trying to drag a towel under the foot towards the heel.

For each of these exercises, holding each repetition for 3 to 5 seconds will increase the work. Trying to do 15-20 repetitions of each movement daily is a good place to start!  Of course, meeting with a physiotherapist could help you have a more individually tailored approach and make any needed modifications for other painful joints or limitations.

Ankle & Foot Proprioception – The Problem

Our joints have an amazing ability to communicate with our brains to tell us where our body is in space; this is called proprioception.  As we get older, instead of relying on information from our feet, our body starts waiting for information from the hip joints.  Unfortunately, by the time our hips know we are off balance, we are REALLY off balance and it becomes much harder to prevent a fall.

Ankle & Foot Proprioception – The Fix

The good news is that, with training, ankles can communicate faster and more effectively.  Practicing standing on one foot for 15- 25 seconds without holding anything (safely next to a countertop!) is a good start.  More challenging work can be learned with the guidance of a physiotherapist.

Working on stability and safety is important for everyone, especially seniors.  Taking time to learn some effective strategies, “from the feet up”, can go a long way to reducing your risk of falling!  If you’re looking for guidance, connect with your local physiotherapist for a program tailored to you!