Fall Prevention Program: Part III
HOME SAFETY CHECK:
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If you have fallen previously, you may be feeling nervous, anxious, or even helpless about moving around in your home, or in new environments.
We at Peak Performance PT want to make sure that you are able to do the activities you desire.
Here is something you can do TODAY to “fall- proof” your home! (See prior posts on medical checks, and assessing your risk for falling.)
Remember, this is only one starting point. You still have your physicians check, and exercise which will be the next and final Fall Prevention Program.
Let’s go through your home room by room…..
FLOORS: Be sure to look in each room.
- Ask someone to move the furniture so that you have a clear path from room to room.
- You can either remove throw rugs, use double sided tape to hold them down or make sure they have a non-slip backing so they don’t slide around or bunch up.
- Always keep objects like magazines, shoes, or towels off of the floor. If it is difficult to do so, there are a wide variety of “reachers” available at local stores (i.e. Debbie’s Supply in East Rochester), or on-line, that will allow you to reach high or low places to pick up light weight objects without getting into a position that puts you off balance.
- Coil up or tape cords and wires next to the wall so that you do not walk over or trip on them.
STEPS AND STAIRS:
- Always keep stairs free from ANY objects.
- Fix loose or uneven steps.
- Have an electrician, or family member put in a light at the top AND bottom of the stairs! Both top AND bottom should have light switches. If they can get light switches that glow, that is even better.
- If you have a light that is burned out, ask a friend or family member to change it.
- You should make sure your carpet is firmly attached to EVERY step, or remove the carpet and apply non-slip rubber treads instead.
- Place a bright colored strip of tape at the top and bottom of the last stair, especially in stairwells to the basement, or garage, where it may be difficult to see.
- Fix or attach handrails to both sides of the stairwell. They should run the entire length of the stairs, and be able to hold your body weight if you were to slip and grab a hold of them for support.
KITCHEN:
- Rearrange your cupboards to have the things you use most on the middle shelves. Waist to shoulder level shelves will be the easiest to reach.
- If you must use a step stool, get one with a bar to hold onto. It is MUCH steadier than a chair!
BATHROOMS:
- Put a non-slip rubber mat, or self stick strips on the tub or shower floor.
- Have a carpenter or handyman (or woman), attach grab bars inside the tub/shower stall, and next to the toilet if necessary.
- Consider a night light in the bathroom, and/or a non-skid shower chair.
- Avoid pulling yourself up by the sink. They are often not secured to the wall well enough to support your weight.
- Consider a hand held shower head if you need to sit in your shower.
BEDROOMS:
- Place a lamp close enough to reach while you are in bed.
- Keep a flashlight nearby your bed also.
- Clear a path from the bed to the bathroom. It should be lit by at least a night-light, preferably one that goes on automatically when it gets dark.
- Keep emergency contact numbers in large print near each phone.
LIVING ROOMS:
- Avoid sitting in low furniture or chairs with no arms, as these are difficult to get out of. Remember, you should always be able to touch your feet on the floor when seated. If not, try a pillow behind you. Use chairs that are firmer, and have arm rests.
GENERAL:
- Wipe up ALL spills immediately.
- Change the batteries in your smoke detectors when changing your clocks for daylight savings time. If it is too high, ask for assistance.
Fall Prevention Tips Part 2
Last week I introduced you to the causes and outcomes of “Falls”.
As an infant, we are like “Gumby” and we seem to bounce back with no apparent issues. But as we age and usually pass the 6th decade of our life, our bodies just don’t have that elasticity.
The next two articles will describe your possible medical and home intervention. As in the first article, if you even know who Gumby is …you may read this with renewed interest!
Check with your doctor on the following conditions:
Vision: your eyes are closely tied to your balance. Your eyes give your brain feedback on your body’s position. If your vision has been getting blurry, the information to your nervous system will be inaccurate, or incomplete. Have your eyes retested. Wear your glasses when you need them.
-be careful with bi or tri focal lenses on stairs or uneven surfaces. You will have to look down to see through the proper portion of your glasses. Your lenses may make objects appear closer than they really are, so moving slowly is a good strategy.
Hearing: If you are missing out on the sounds around you that may protect you, you may not even know it. Usually, you can tell that you are starting to have difficulty in a room full of people, or on the phone. You will start straining to hear clearly, maybe set your TV volume very high, or start avoiding the phone, or crowded gatherings. Rely on someone close, and if they say you should have your hearing checked, believe them. Hearing loss will also affect your balance. There are so many new advances in hearing loss and correction now, you will be surprised! Ask your doctor.
Orthostatic Blood Pressure: This is when you change positions or levels (laying down to sitting up, sit to stand) and your body doesn’t react appropriately so you get dizzy, or temporarily light headed. Taking multiple medications daily can also cause this, but I am referring here specifically to an inability of your nervous system to control pressure changes in your arteries and veins. It may help to squeeze your hand and leg muscles a few times before getting up, and then get up slowly. If you are still getting light headed, consult your doctor.
Drug interaction: More than four medications daily is the standard issue. Check with your doctor yearly on the medications you are taking and any interactions that may be causing you difficulty.
Urinary tract infection: alert your doctor immediately if you suspect a UTI. Symptoms can include fever, pain in the lower abdomen just above the pubic bone, or below the navel, burning when urinating, blood in the urine, sleep disturbances or fatigue as a result of increased bathroom trips at night, or sudden overnight changes in your ability to think or remember. The changes mentioned here can increase risk of falling. These are treatable by your doctor.
Remind your Doctor:
- about any fall you have had
- if you have weakness in one or both legs, or other leg problems
- if you use an assistive device such as a cane or walker
- about any other medical problem you have ie: heart, blood pressure, diabetes, stroke, or neurological.
- about any sickness that has left you laying down for more than a week
After your doctor’s assessment, they may recommend:
- Modifying your medication dosages
- A medical check on your symptoms
- Vision or hearing referral
- Physical Therapy for balance and strengthening
HERE IS THE GOOD NEWS!
Once your medical issues have been addressed, Peak Performance PT can help address those issues like strength and balance! Working your strength and balance has been shown to prevent falls!!! We can assist you with how to fall proof your house, and work with you on different strategies if you do end up on the ground.
We want you to be able to do those things that you love like hiking, walking, dancing, biking,or playing with your grandchildren.
We want you to be able to do the things necessary things to keep your house in order like raking, laundry, negotiating stairs, gardening, or washing your kitchen floor.
Feel free to contact us about a relative, spouse, or yourself if you feel that your balance and/or strength are limiting you from living the life you want!
I would love to help you to help yourself.
Karen Napierala PT, AT, MS
Call 218-0240
Peak Performance PT
SPRING FORWARD…Fall…NEVER!!!
When I was younger, I would not hesitate to climb a tree, walk across a log, or even climb a mountain!
Now, although I do it, when I think about getting down, I am much more tentative.
I don’t know about you, but over the past few years I have even noticed my parents using their hands on their thighs or the chair hand rests as a necessity to get up!
They also seem to look down more frequently as they walk, especially outside on uneven ground.
Have you noticed any of the following in YOURSELF or A LOVED ONE?
- Difficulty negotiating your way to the bathroom at night, and/or in the dark?
- Using both hands to push yourself up out of a chair?
- Reaching to grab something to pull yourself up out of a chair, or off of the toilet?
- Keeping your eyes focused on the ground more and more as you walk, especially in new places?
- Depending on the hand-rail to navigate up and down stairs?
- Tentative to go DOWN a step, or curb without support?
- Painful knees, hips, or ankles with a “hitch in your get-along”?
- Losing your balance more frequently?
- Feeling dizzy when you stand up?
- Not being able to see as well as you used to?
Note: If you actually know what a “hitch in you get-along” is then I am speaking to you directly!!
Well, you are not alone…
Every 8 seconds in the US someone turns 60 years old!
While I believe that age is a state of mind, and 50 is the new 20….(humor me), the fact is that as we pass the 60 year mark, we often fight the effect of decreased physical activity and the natural aging process.
These are the years that you begin to experience the effects of decreased muscle mass, risk of osteoporosis, decreased vision or use of bi/trifocals, an increase in the number of medications taken, changes in bladder control and just plain gravity.
You may notice difficulty standing on one leg to get pants on. You may get that stiff feeling in your ankle, knee, hip, shoulder, or spine. (You may recall even the last time you tried to turn around to back out of your driveway that it used to be easier!)
Studies show that these are just some of the factors that predispose us to falls.
A “Fall” is defined as an unintentional loss of balance which the person comes to rest on the ground, floor, OR a lower level.
As a matter of fact, 33 % of people over 65 years old WILL fall and that rises to 50% of us after we reach 85 years old!
In 2005, 433,000 people were hospitalized with injuries after a fall and a staggering 15,800 deaths occurred as a consequence of the fall itself or a complication from it.
Falls account for over 81% of fractures over the age of 66! The estimated cost of individual expenses as a result of these falls cost $19 billion in 2000 with the projected expectation of $55 billion in 2020!
I would say that this issue is a huge burden to our health care system as well as to each of us affected with the repercussions of a fall individually wouldn’t you!?
So what does this mean for you?
Is there anything that you can do to prevent, or slow these aging processes?
First, you need to find out if you are in the risk category.
Take this quick little quiz:
Y N 1. Can you get out of a chair without use of your hands, or chair rests?
Y N 2. Do you take more that 4 medications per day?
Y N 3. Can you stand on your right leg alone for 10 seconds?
Y N 4. Can you stand on your left leg alone for 10 seconds?
Y N 5. Do you get up to go to the bathroom in the middle of the night in the dark? ( including a night light?)
Y N 6. Are you comfortable standing on your tip toes and reaching over your head for something?
Y N 7. Can you comfortably bend over to pick up something off the floor without something to hold on to?
Y N 8. Have you fallen, OR lost your balance in the last 3 months?
Y N 9. Have you had a Urinary tract infection in the last 3 months?
Y N 10. Do you get dizzy when you turn your head quickly?
If you answered YES to more than 2 of these you are at risk for a fall!!
The more questions you answer YES to, the higher the risk.
Anything above 5 and you are at very high risk of a fall!
Over the next two weeks we will be offering a series of hints to help you stay safer, and avoid falling.
They include:
1. Fall Proof your Home: These are things you can do right away to insure that your home is as safe as possible for you.
2. Fall Proof your Life: Start looking at your present health and make sure the proper medical personnel are working with you.
3. How to “Get up and Go” independently: For those at lower risk (1-4) of the above predisposing factors, Peak Performance will provide you with a program to improve your balance and strength.
For those of you at high risk, a supervised exercise/balance program and gait screening may be necessary.
Feel free to contact your physician to clear you of any medical issues, and then contact Karen at Peak Performance Physical Therapy for an initial evaluation and custom tailored fall prevention program.
Water…The Source of Life
How long could you last without FOOD? Experts say up to 8 weeks!
How about WATER? Depending on the heat, those same experts say 3 days!!
What does that tell you about the importance of each of those to your body?
Why is water sooo important? Why especially in these hot, humid, and potentially active days of summer does your body crave it…no, depend on it?
Water does some really crucial tasks in our body. Most importantly, it REGULATES YOUR BODY TEMPERATURE. Raising your body temperature only 3.4 degrees to 102 can be serious, while core temperatures above 105 (only 7 degree increase) can be life threatening.
Water also helps LUBRICATE YOUR JOINTS. Have you ever ridden a bike with a really rusty chain? Not a very smooth ride, is it? Eventually the friction produced without lubrication on the chain will wear down the bike’s parts…..The same is true with your joints!
TRANSPORTING NUTRIENTS to your muscles and organs is another task that water assists in. Remember in the spring when we had all that rain and the rivers were flowing freely and fast? Now think of those smaller streams that are pretty low with our lack of rain. The water travels so much slower. Our bodies are the same. When they have a lack of fluid in them, the blood flow and muscle function is less efficient, and you just feel sluggish.
Finally, and very importantly, water is a key to your body’s WASTE MANAGEMENT. I don’t even have to give you a visual of your garbage overflowing the last few days before pick-up. I don’t even have to remind you of the smell on a hot day of a pile of garbage decaying and rotting. After our body processes our food, especially cooked and processed food, we want the Garbage to be removed!! Water is the key to keeping the flow out of our bodies!
When we don’t replenish our Water supply we start to look like our grass! This is called DEHYDRATION.
We can get dehydrated especially in the summer from:
- Excessive sweating
- Failure to replenish fluids after exercise or activity
– Drinking only when thirsty
- Inadequate fluid intake
- Drinking only Caffeinated drinks
What does Dehydration feel like?
First symptoms:
- Decreased saliva production (can you spit?)
- Decreased frequency and amount of urine you excrete
- Deep color and strong odor in urine
Further signs:
- Dry mouth
- Rapid heart rate
- Lethargy (lack of energy) or irritability
- No urine output
- Feel hot
- Vomit or diarrhea
WHAT SHOULD YOU DO IF YOU BECOME DEHYDRATED? The best thing you can do is prevent this by drinking non-caffeinated beverages with minimal sugar (that’s a subject for a future blog!).
What I can tell you is that everyone sweats at different rates, and it depends on the temperature and humidity and activity level. I can also tell you that it is recommended to drink .5 oz of fluid x Body weight / day (or 75-100 oz / day for a 150 lb person). That formula sounds very scientific, and it is.
But, there is an easier way, and here it is: I call it “Hydration for Dummies” because it is so simple:
- Monitor your urine color and output. It should be a fair amount with a very faint yellow color. If it is dark, concentrated, or less than usual amount, that is a sign to DRINK MORE WATER!
- Weigh yourself before and after practice, or activity, especially if you are in the heat, or sweating! If you have lost a few pounds, it is probably only water (sorry, no fat loss that quickly). You should replace those fluids! Right away! Experts say that more than 2% loss of body weight (fluid loss if due to activity) is crucial to replace by drinking fluids.
Now go play, run, swim, jump, be active and enjoy. Oh, yea and…….DRINK YOUR WATER!!
The Biggest Loser Part 2
Opera singer Olivia Ward has something new to yodel about. The slimmed-down 35-year-old was named winner of season 11 of “The Biggest Loser,” edging out her sister to claim victory after shedding 129 pounds in eight months.
For some reason most Americans are drawn to “The Biggest Loser”, myself included.
Maybe we love to see the underdog overcome years of heartache against all odds.
Maybe it is the American dream to succeed, and we love success stories.
Maybe we are secretly hoping that we can pick up some tips as to how to get, or keep our fitness level up.
Most of us don’t have Jillian yelling in our ear to do 5 more reps, or push ourselves, so what can we do on our own?
1. Check with your doctor: Have a full physical before starting any exercise regimen.
2. Work with a trainer or a class with a certified instructor or Physical Therapist: Get in a safe but fun class for your level of fitness. There IS strength in numbers.
3. Find someone to go with: Get to know someone in class who can be your accountability partner. Women especially, but men also work well with a buddy system of support- (and maybe women like someone to talk to). Try to find someone who is at least as motivated as you, at least most of the time.
4. Incorporate some sort of weight training, or body weight resistance training into your workout, at least two times per week: More muscle means increased metabolism. (This way you can still have that snack or desert, and you will ward off osteoporosis).
5. Consult a nutritionist: Contact a professional or look online for some sensible new eating habits as the old ones weren’t getting you the results you wanted.
6. Go SLOWLY for the first 4-6 weeks: Expect a 1.5 % body weight loss per week MAXIMUM.
7. Understand that you are in it for the long haul! It will take months, even years to undo what probably took you years, possibly decades to produce! This will NOT be a diet plan, but a new way of living! Embrace it, and Enjoy it! Try seeing Rochester by hiking, canoeing, kayaking, biking, or just walking. It is so beautiful around here and there are a lot of outdoor groups to join, or maybe you can experience it with your workout partner or even by yourself!
There may be aches and pains along the way. If they persist, ask your doctor about them, or come and see us at Peak Performance Physical Therapy.
You may have just gone too fast, too soon or you may have some underlying biomechanical issue that is stopping you from reaching your fitness goals.
We would love to help you with any issues or just encourage you on your fitness journey so that you can truly be the “Biggest Winner!”
Who really is the biggest loser?
Last season, I watched 16 very obese contestants workout on The Biggest Loser until they fell over from exhaustion, or wretched. This season, the same scenario. Do they do it for the $250,000?
Maybe…
But I think not. These people are at the end of their emotional rope.
Tired of not only what they see in the mirror, but being left out of activities, unable to fit in seats, unable to join friends on simple activities, unable to play with their kids or grandkids because of their size and physical condition.
They would do anything to get back to where they can function, and they do, including subjecting themselves to basic training like conditioning with “in your face” treatment.
Here is why it works for them while on the show.
First, they are finally part of a group. A group who works together, accepts each other, and shares their struggles and their victories. Add in a little competition and their confidence grows.
Second, they have a chef who prepares all of their meals. Then add in some fiercely bubbly trainers who motivate you…OK, FORCE you to exercise for hours a day beyond your wildest dreams of your personal tolerance.
Those of you that are already active are salivating at this.
Those of you that aren’t think it sounds like “hell” on earth.
Here is the dilemma I see. It is called reality TV, but is it reality for the majority of Americans?
These people go from inactivity to full activity in MINUTES! In the inactive, it takes 6-8 weeks to prepare connective tissues and muscles to support the increased load on the joints from jogging, or even fast walking!!
It takes 4-6 weeks also to prepare the cardiovascular system for activity when you have been resting in your favorite chair for years!!
Behind the scenes of the Biggest Loser, there are health histories, mechanical and medical screenings, continuous checkups, change of medications, behavioral and social support.
We also don’t hear about the stress fractures, muscle tears, pains, and strains that literally bombard the set.
When we see these amazing transformations on television, can WE expect to become fit like this, or will our joints and muscles be the “biggest losers” in a regimen like that?
If this is seemingly impossible for the average person to lose so much weight safely in such a short time at home, what CAN we do?
To Be Continued Next Month
7 Things You Need To Know About Knee Rehab
Welcome to Karen’s Korner - “News You Can Use!”
Karen Napierala, MS, AT, PT
7 Things You Need To Know About Knee Rehab
Karen Napierala, MS, AT, PT
Hello everyone! Each newsletter I will be bringing you some tidbits of information to help you or your friends with their health needs.
While recently reading an article about knee replacements I decided to run some ideas by Robert. I bet you didn’t know that not only is Robert our awesome Office Manager here at Peak Performance but he is also a patient!!!
About two years ago, before coming to work at Peak, Robert was involved in an accident. He suffered a serious knee injury which lead him to surgery, and thus to our doors. Robert was telling me about his journey into the unknown territory of Knee Rehabilitation. There were things he wished he had known before he started the whole process and these seemed like universal concerns of our other patients.
Like many of you, Robert had experienced the pain of his injury, the fear and uncertainty surrounding his surgery and his future. Robert had gone through the tireless work of recovery and rehab all to succeed in returning to his goals, to work and a productive life. He felt that if he had known some of these facts beforehand that it would have made the journey easier so Robert encouraged me to pass along these tips to you…
“SEVEN SERIOUS…yet not so SECRET TIPS for Knee Rehab”
1. Get a specialist! You wouldn’t ask an auto repair man to fix your roof would you?! I
would like my roof done quickly and efficiently by a roofer who fixes roofs day in and
day out. You know… experienced, specialized!!
2. Fill up your tank! Be ready. If able, make certain that your body has the strength and
flexibility to handle the unexpected, or the upcoming. Even if it is your knee that is
undergoing surgery, your arms and core need to work overtime using crutches, a walker,
or just getting on and off the couch one legged! Not sure what to do…call us.
3. Set your Goals! What is it that you are limited from doing because of your injury and
condition? Do you want to play with your grandchildren on the floor, walk across a
grassy field, play sports, or just stand on one leg to get your pants on? Once you know
your goals, you and your therapist can work towards them.
4. Get involved! Pick a Physical Therapy clinic that you enjoy spending time in, since you
will be there two times a week to start for a little while. You will be able to be around
others like you recovering from surgeries or injuries also. You will be able to talk to your
PT, and just as importantly, speak with other people about their recovery process to gain
insight and reassurance in your progress.
5. Pain…..No Gain! If your doctor prescribes pain medications, take them! You are
having surgery not a picnic, some soreness should be expected. However, pain and
swelling reduce your ability to strengthen your quadriceps (you know the big muscles on
the front of your thighs that help you do just about everything!). Pain can also greatly
reduce your ability to make gains in the crucial ranges of motion you need to complete in
the first week after surgery. Less pain will get you more gain…really.
6. Take notes! Either you or a buddy will need to write some things down. It may seem
simple at the time but trust us there is a lot of information on the first visit or two and it
can be easy to forget. We encourage you to draw pictures or diagrams of your exercises.
You can also take pictures with your camera or cell phone to help you recall things later!
7. Own your program! Your doctor and your PT will give you all of the information,
instruction and support that you need to succeed but there is only one person who can
make it happen and that is Y-O-U! We can encourage, motivate and help you while you
are here at Peak Performance PT but outside of the building it is your knee, your
program. Own it. Do it. It’s not always easy but if you follow their instructions you
will be on your way to a successful recovery!
Hope these tips were helpful. We will talk again next month!
Until then…please take care of yourself.
Karen
Click the link below to save or print this article for yourself or a friend!
“SEVEN SERIOUS yet not so SECRET TIPS about Knee Rehab”
Questions or comments? E-mail us at robert@peakptrochester.com or call 585-218-0240
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