Presentation: The Missing Link of Fall Prevention
Updated with transcript: 10/27/24
The Missing Link of Fall Prevention is a presentation I originally made for Doctorate level Physical Therapy programs that delves into the thesis and science behind Science of Falling and falling techniques. Because of my firm belief that all people should learn proper falling techniques, I have made a recording of this presentation to share with everyone academic and non-academic.
In this presentation I discuss why I started Science of Falling, falling statistics, the research that supports falling techniques, basic beginner techniques, and finally analyzation of falls.
I hope you enjoy this presentation! If you are interested in having a similar presentation given to your class or clients feel free to message me via any of my social media pages or on scienceoffalling.com through the “contact” page.
Enjoy!
Video Transcript
00:00:00 [Music] Hey what's going on everyone this is Dr. Brent Pritt with Science of Falling and today I'm going to be presenting the missing link of fall prevention, essentially the thesis of Science of Falling. I originally created this presentation with the intention of presenting at colleges, at gyms, anywhere that you might find some use from learning falling techniques and kind of incorporating this into their daily practice, with their patients or clients. So let's get into it
00:00:40 So who am I? Well like I said, my name is Dr. Brent Pritt, i'm a licensed physical therapist also a strength and conditioning specialist through the NSCA. I graduated from the University of New England in Portland, Maine in 2020. I’m originally from California, but I moved to Maine for three years to obtain that degree. And I went back to California briefly to work at an outpatient clinic. I am now back in Maine working at another outpatient clinic here, so I’ve practice in both California and Maine in general outpatient clinics.
00:01:08 I did some work in a hospital setting during my clinicals, but I'm mostly an outpatient PT. Along with that I'm an avid exerciser including weightlifting which is kind of my first love, obstacle course racing, and parkour. And that's kind of my moving background. A lot of that background is what caused me to find my love for balance and falling, as well as create the platform Science of Falling. So what is Science of Falling? Well this was actually a project I created in 2020 near the beginning of the pandemic.
00:01:42 While studying for my physical therapy boards I had this free time. I wasn't going out much and I decided to finally take a stab at making something that I thought was valuable to other PTs and other health care professionals at large to teach proper falling techniques. It was really just born from the realization that in healthcare we don't actually teach falling techniques, or how to fall properly, to patients that would really utilize these techniques efficiently. It would be helpful for them to learn
00:02:13 and prevent injury. Oftentimes we only teach balancing, maybe how to get up off the ground, and we're missing that middle piece. So the mission was to create a platform to teach these following techniques and balance strategies in order to prevent injury and to improve functional ability in the the lives of our patients and clients. So let's define what a fall is because it can be a little ambiguous. A lot of times people just think it's going to the ground, but I think it's a little more fine-tuned than that for a good
00:02:43 definition. So the Merriam-Webster definition would be to descend freely by the force of gravity which is a generalized fall right? We're just descending to a lower level. Any event which results in a person coming to rest inadvertently or not on purpose rather on the ground or floor or other lower level so this one doesn't necessarily, uh, imply that the person has to go to the ground they may just fall down and catch themselves on a seat or something like that. Now this one's my favorite from McGraw Hill, a precipitous drop from a height or
00:03:12 from a higher position which may be accompanied by injuries. I think that a lot of people think that falling has to accompany an injury, but I don't think that's true at all. Matter of fact, I think if people learn to fall correctly it can actually be a useful human movement to get out of a dangerous situation or be more athletic. So the gap in physical therapy, we already kind of talked about this but we're going to go over it again. So we often teach people how to balance. You know, especially me in my outpatient
00:03:44 settings. I teach people how to balance all the time and it's really, you know, whether they're coming back or a fall injury or they're coming back from an outpatient procedure such as a knee replacement we want to get these people stable on their feet so that they don't fall. Initially, and I think a lot of people know how to do this, a lot of people enjoy doing this with their patients or their clients and teaching them how to bounce and it's a great part of the the continuum of fall proofing a patient.
00:04:11 A lot of us also more in the PT realm focus on teaching patients how to get up. Now this is actually not done as often as I think it should be, but it's not unheard of to have PTs teach a patient how to get up off the ground. Maybe have them do that multiple times. You know, with athletic populations we might be working on something like the Turkish Get Up and just really getting people comfortable being on the ground, because I find that after we are out of our young teens, maybe we don't go on the ground
00:04:42 very often anymore. We usually stay in seats, we walk around a lot, we don't have to lay on the ground to do stuff unless we're doing something maybe like yoga, which not everybody does. Now here's the piece that I created Science of Falling for is the falling techniques. That there's this continuum of balance to falling to the ground and getting up so if we don't teach this middle piece, we're doing a huge disservice to our our patients and clients. Because we're taking out this area that either can make or break, whether a patient or
00:05:13 client gets up safely from the ground after a fall. Or if they're stuck on the ground because they end up breaking a hip or breaking your wrist or getting a concussion. So we're missing this huge middle piece and I think that we need to bring this more to the forefront of healthcare, physical therapy, and chiropractic. Whatever it might be, and make it an actual part of our our toolbox and modalities for these patients. All right so let's talk a little bit about falling in the older adults. When we think of falling we often think of,
00:05:46 you know, 60 plus and all the bad things that might happen at that point. So we're gonna start off on there. So the prevalence of falls in older adults, one out of four older adults fall each year. That's, I mean, 25 percent chance that someone that you love, that maybe 60 plus is gonna fall down. You know one in five of these falls causes a serious injury. Eight hundred thousand patients a year are hospitalized secondary to a fall. That doesn't necessarily mean they're going in for anything, um, absolutely crazy, but that
00:06:16 means they're going to the hospital for some reason. Whether to check up on themselves, or to have, um, some surgery done or something like that. Now falls are also a common cause of hip fractures and TBI - Traumatic brain injuries. These are things that can drastically reduce a person's quality of life. Can actually you know increase their all-cause mortality, and really take them out of the game of life pretty efficiently if we're not wary of them. So hip fractures and brain trauma injuries are definitely a big factor to
00:06:49 worry about when falling. And not only that, but just talk about the monetary side of this. In 2015 more than 50 billion will be spent on treating those who had suffered a fall. That's insane, 50 billion dollars for something that is quite preventable if people have the proper training and techniques. And as we'll discuss later on, it doesn't take much training at all to teach someone to fall with a pretty adequate falling technique. So, uh, that 50 billion dollars is quite ridiculous for the ease of preventing that money being spent on
00:07:21 that. If we also look over to the left here, you know fall death rates in the US are increasing 30% from 2007 to 2016 for older adults. You know it's a little bit of an older stat, but that's pretty insane you know every year it's going up that much. And if we look at this other one. You know, if it goes at this rate, still seven fall deaths every hour by 2030 again for something so preventable where we can use techniques to train people to fall properly and prevent injury there's no need for seven people to potentially
00:07:53 die every hour by 2030. It makes no sense. So this is a cool graph from the CDC, this basically shows the falls reported by state and this was in 2018 so I apologize not fully up to date here but it's close enough to where we are now and this is interesting because it goes by state to state so you can actually look up your state you can go to the website and it will pull up the stats of that state as well. So if we just look at these colors you know the the light pink or the lightest pink rather almost white there 20 to 26
00:08:24 percent of falls are reported there. And so I'm in Maine right now, so if we if we look at the middle pink right here that's going to be 26 to 28 basically of people falling every year. Now I'm also originally from California so if we go to California that's actually the highest level of falls reported. It's also a big state, so uh, I expect there to be more falls reported just by sheer numbers but you know 28 to 33 and now it's also important to know that these are compared to the average of fall rate of 27.5
00:09:00 for those 65 and over. So that's just comparing to the older population here but that's still quite high that almost a third of the population in California, a little over a fourth of the population in Maine, are having these falls and now that's not even talking about if an injury was involved or if death was involved. But it's still talking about the fall rate and so obviously we have an issue with people falling there's a balance aspect we need to address but we need to address the falling aspect
00:09:33 because this many people are falling we got to teach them how to fall. So let's go to the next slide because this is actually playing off this one a little bit more. So fall deaths by state, so and this is again 2018, so if we again look at these numbers with the key over here talking about Maine had a lower fall rate than California in the last slide, but this is also one of the highest death rates per fall 88 to 105 for 100 000 falls which is crazy. Now Maine is also one of the older states in the country.
00:10:05 It also has snow and ice. So how much of that affects this number? I don't really know, but it's still interesting that there is that high of a rate of deaths again for something that is quite preventable. Now again, interesting enough, California which had the highest reporting of falls has the lowest death rate of falls. Now that might be because there isn't the snow and ice element there. You're not slipping without any control. California tends to be one of the healthier states in terms of activity
00:10:35 levels in older adults, so that might play into it as well, with you know, more strength and everything. But still you know, 28 to 53 deaths per 100 000 for something that's preventable is still quite outrageous. You know I would like to see this maybe 10 or 20. So it's definitely something to look at, and again if you look at the bottom of the slide this is referencing 64 deaths per 100 000 adults as the average. Why should older adults fall, you know, we're just adding on to what I just talked about. Well you know we can reduce
00:11:05 the injury risk and increase confidence after learning falling techniques, and there have been some studies which I have not referenced in here, but um, that show patients with higher fears of falling tend to fall more. So if we reduce that fear, we can reduce their likelihood of falling in the first place at all, but also emboldening them with confidence that they if they do fall down, they can protect themselves with a proper technique. Not only that, we talked about earlier how most people don't go to the ground.
00:11:33 So just teaching falling techniques, inherently because of the physicality of it, they're going to be getting on the ground, they're going to be moving around on the ground, and they will get comfortable on the ground. Which is something I believe should be considered as a natural human movement and a natural position for us to be in. Now this is pretty cool, the other way we train other aspects from being on the ground you know if we're on the ground we have these older adults putting weight bearing through their upper body,
00:12:03 so their muscles, and their bones, are also getting stronger. So it has so many benefits beyond just preventing injury. So is fall training useful for only the older adult? Absolutely not. You know it's good for everybody. So adults, both young and old, children, and athletes. Everybody's going to benefit from learning these proper following techniques. So why should children learn falling techniques, you know, they're kids they're pretty low to the ground. You expect they wont be injured that
00:12:31 often from falls. You'd actually be kind of wrong on that though. 66 of fatal falls among children occur from a height. Now because of their lower stature, what may not seem like a big height to us is actually a much bigger height to them. So teaching these kids to have some sort of semblance of basic falling technique, and an idea how that looks, could protect them from this height. You know eight percent were the result of falls on the same level. So pretty low, but again they have short stature so that's expected
00:12:58 among children under 15 years old. Non-fatal falls are the 13th leading cause of disability adjusted life years lost, so basically when a child falls they get injured maybe they're paralyzed or something where they they essentially don’t have that relatively quote unquote normal life. And now they're disabled and they don't have the same movement capacity that they did before that fall. So learning the fall techniques can prevent this. Also falling ranks as 12th leading cause of death among five to nine year olds, and
00:13:28 also 15 to 19 year olds. You know this shouldn't even be on the list of the ranks for deaths among children. You know, falling should be something that a young healthy kid is able to come out of easily. Obviously if you're falling from a 20-foot height that's a little bit different. But from basic falls from you know six feet or below it doesn't make much sense that that's even a factor in death among kids. And in 2004, there's nothing more recent that I found, but in 2004 46,000 children died from falls worldwide.
00:14:02 Senseless, senseless, that, you know, if we in healthcare, or you know even personal training, or schools, taught kids how to fall we can prevent so many of those deaths without even really trying. Or making these kids feel like they're trying to prevent the fall. This is really cool, so falling is a normal part of child's development, especially in the early years. You know these kids fall dozens, if not you know more times, per hour just trying to learn to walk. As they get better they don't fall as
00:14:32 much, but we can utilize that area of frequent falling to kind of train proper falling techniques, as these kids learn to walk and they learn to you know use their muscles correctly we can just add in a little bit of that fall training and get these kids on the right track way early on. And just make it a part of their life without even thinking about it. Also because they are lower to the ground, just like that last stat of eight percent of injuries from children on a low ground, you know they don't get hurt
00:15:01 as much. So teaching them how to fall from a level ground, and they have the shorter stature until they're you know six foot adult, is going to be much safer. We can ingrain the pattern a little bit earlier, so, and despite popular belief motor skills might not actually be easier obtained at younger ages so we should actually teach children to learn these techniques at a younger age so that they have more time to ingrain these motor patterns into their their motor skills and make it so when they do
00:15:35 fall, with this child in the photo, they have proper technique and they automatically do it without thinking just like riding a bike. So this is this is my speculation because there's not much research actually on falling right now relative to, you know, say balance research, but I think if kids learn to fall earlier they will actually ingrain these skills and make them more succinct and part of their motor skill tree. Like we talked about for a longer time and actually reduce overall likelihood of injury
00:16:07 well into their adulthood. Because this is going to be a motor pattern that they know and they understand and it's just automatic for them. So what about athletes? You know, we think about athletes as being the cream of the crop physicality and, you know, a fall could never hurt them right? well that's actually not quite true. There's, there's very sparse statistics on this, but we'll talk a little bit about that here coming up. So generalized research is sparse, but more attention is given to the type of injury, so you know,
00:16:40 the number of ACL injuries in basketball, rather than how the actual ACL injuries occurred. 27.9% of sports and recreational injury episodes resulted from falls during the year of 2011 to 2014. Again this is probably the most recent that I could find. Just because the research on this is fairly sparse. Falls lead to nearly half all the TBI’s related hospitalizations in the US. Sport-related TBIs are about 4.5 of sports injuries. So a lower percentage of sports injuries as a whole, but
00:17:12 just falling in general such a big factor of traumatic brain injury that we need to address that whether it's an athlete or anybody else. Sports and recreational activities contribute to about 21% of all TBIs among American children and the adolescents, so you know, if these kids are playing football and they get hit pretty hard, they go hit the ground, their head recoils that's that's a TBI related to a falling type incident, which may have been at least minimized through proper falling techniques. Acute upper extremity fractures and sports
00:17:46 are also associated with falls to a high degree. Although the percentage is obviously going to vary by sport because of the different demands on the body. So finger fractures and snowboarding, running, and skiing are mainly caused by falls. As this gentleman in the picture shows, you know, he's taken a pretty aggressive fall and if he uses proper falling techniques he can get out of it safely, if he doesn't, he kind of just lets his body ragdoll. There's more, um, chance of him suffering a pretty either fatal or serious injury.
00:18:14 Distal radial fractures tend to be associated with sports which falling is common, so again, what we would call FOOSH injuries in the healthcare world, falling on an outstretched hand, can be prevented with proper falling techniques. Fractures are 25% of all horse riding injuries, and the majorities are due to a fall, so getting kicked off the horse. Um, not a very common sport for people, but it's still interesting to see that the falls are so prevalent in a sport like horseback riding which may not be obvious to a lot of people.
00:18:43 So not only that, but fall training can actually be improved, or be useful for improved performance. Uh, you know, a lot of people focus on fall training for prevention of injury, but how about we just look at it as an actual performance enhancer. So in some sports fall training is already included. So martial arts is a big one, parkour is huge, volleyball which most people don't think as of learning fall training, actually has some things like laying out and you know going for a pancake is a type of fall training. Some
00:19:14 sports lead to passive learning of fall techniques, and it's trial and error. And it's kind of a self-limiting thing so if someone can't fall properly they're going to get hurt easier and they're going to fall out of the sport faster. So football, baseball, skateboarding, skiing, snowboarding, these are all things where we don't train falling, but inherently if you don't fall well you're not going to progress in the sport because you're getting injured and you're not going to do it anymore or be unable to do it. Now,
00:19:43 so you know, how can it actually be used to improve performance? Well we can reduce time on the ground, we can allow riskier plays to be executed. Like a baseball player diving over the catcher going for home base, and we can open up movement options to move around opposing players. Again, just like this, this player diving over the catcher. If a person does not know how to fall, they couldn’t do that. And that might be a very risky play, and lead to one of those FOOSH injuries, but if they know how to fall, they can do a dive role pretty
00:20:11 simply over that catcher, make the play, make the point. You know, end up on all the highlight reels, and uh, essentially just be an awesome player that has that movement option. So is fall training effective in reducing injury? The research is saying yes, and although it's it's relatively sparse, all this the research that is out there right now is definitely, uh, for fall training. So if we look to the right, this is me actually in my early 20s practicing, um, some fall training at a parkour gym. I
00:20:46 went to California to the Flying Frog Academy, and you know, as you can see me there, I'm doing, actually doing what's called a shoulder roll. So just practicing is fairly easy, it's actually relatively fun, but let's look at the research for fall training. So hip impact can be reduced by around 16 percent with sideways falling after only 30 minutes of training. Now, um, sideways falls are actually fairly high contributor to hip fractures in elderly. So you know, if we train these elderly for 30 minutes we reduce the impact by 16%. That's quite
00:21:20 dramatic, and that can actually save someone's, um, hip. Save them from a hip replacement, and eventually or hopefully, save them from, um, disability in the long run. For someone who's more skilled in the in the art of falling, such as a martial artist, you know these techniques can reduce hip impact by at least 25%. So check those numbers out, if we're talking about 16% after 30 minutes, versus 25% for a skilled fall, that 30 minutes is almost getting up to an expert level. So it's quite extraordinary how quickly
00:21:52 we can learn these techniques to be effective with them. So control backwards and forward falls can reduce injuries forces to the ACL after landing on the ground, compared to a soft landing technique, where we bend the knees and we kind of squat into it. So if you're a basketball player and you're going up for a jump shot and then someone pushes you, and you come down in an awkward position, I would rather have that player kind of fall down, roll out with a proper falling technique, and then get back
00:22:24 on the feet quickly, and try to stabilize on their feet than have more of a chance of tearing that ACL, because you know, yes they might get up get up a little bit quicker if they land correctly, but if they injure the ACL, they're going to be out for the rest of the season most likely. So if we can teach these players to know when a awkward fall is going to occur, how to fall down properly, get back up quickly, we can reduce the number of ACL tears and other types of injuries quite dramatically, just from having that as a
00:22:51 movement option. Now this next one's from a meta-analysis with a bunch of different, um, studies in it, but you know the general consensus was that intentional stepping reactions, squatting, elbow flexion during a forward fall, forward rotation martial arts rolls, and bodily relaxation, all can reduce injurious forces during fall. Now, I did not put in here, but I want to mention, that the martial arts technique of slapping the arm out, was actually found not to have any effect, and in my opinion, because you're
00:23:22 actually adding force to the fall, I would assume that on concrete in the real world, that's not a matter of environmental martial arts studios, that you might actually injure your elbow arm or hand because you're adding force to your fall, with no real reason for it. So what kind of fall techniques should be taught? So a lot of the research, just like we talked about, is based on martial arts techniques. But like I kind of alluded to, most martial arts techniques are actually performed in a padded environment of some sort.
00:23:58 The real world's not like that, the real world's all concrete, hardwood floors, you know, you sometimes, you have grass, carpet, or sand around you. But you know, ninety percent of time, especially if you live in a big city, you're going to be falling on concrete, and that concrete is not forgiving by any means. So I want to kind of bring, with Science of Falling, into real world falling techniques. Just like I said martial arts techniques aren't designed for the real world, they're not designed for the concrete
00:24:22 jungle we live in. Patients should be taught techniques that transfer to the unique challenges of the concrete world into there falling techniques, and they meld those two, and are ready for the hardest types of falls. So that when they land on something soft, they're even more safe. There is a gentleman called Amos Rendao, he created, uh, something called parkour ukemi, where he essentially took basic martial art arts principles of falling, and morphed it into the parkour world where he utilized those basic techniques on the
00:24:52 concrete world and adapted them to make them safer and more efficient for everybody. So what are kind of the, the highlights of parkour ukemi? Uh, it's designed for the modern world, you know, techniques allow reduction of injury in almost any situation and there are, there is a falling continuum that this gentleman made. The techniques include, but are not limited to, safety roll or shoulder roll, which is seen in this this photo on the slide. Side rolls, back rolls, half rolls, forward and backward break fall variations, which are very
00:25:26 common in martial arts settings, drop landings, such as the soft landing from a jump, and then quadruped variations such as things like the ukemi gallop, or um crawling on all fours, galloping stuff like that. So some key underlying principles of safe falling techniques. Protect the head, we don't want you know, the head is our lifeline, so if we hurt the head and we get a major TBI our life changes forever. So we want to protect that as much as possible, uh, preferably not let it hit anything during a fall. We want to absorb
00:25:58 force over the longest period possible. This can affect the the force absorbed per second, so it's kind of like throwing, if you have a cube and you throw it on the ground it's going to hit pretty hard. If you throw a ball on the ground it's going to roll and absorb that force until it slowly stops. So less force is absorbed by the actual object or the person during this we want to use meaty parts of the body as contact points, because that's going to add some extra padding to us. I'm going to use the palms,
00:26:24 we're going to use the butt or rather the glutes, and use the back musculature. So instead of doing a gymnastics forward roll where we're rolling over the spine, we want to actually use a diagonal cross section from shoulder to hip but we go over a lot of that back musculature saving the bony areas and saving the joints. We want to keep the body relaxed as possible, you know, we don't want to be gumby necessarily, but we want to be able to absorb shock as we catch the ground, maybe and roll over and just simply go with it,
00:26:53 instead of being ridged and stiff. And trying to hit our arm on the ground and have a FOOSH injury, um occurring, you know, we want to be aware and cognizant. If a fall is about to happen. it's better to just go with it rather than fighting it and that's going to mean squatting to the ground, getting as close as possible, so that we reduce the distance we have to travel to hit the ground. That's going to effectively reduce the impact forces, and finally you know, same idea we want to go with the fall. If a fall is occurring we just go with
00:27:22 where it's taking us, and then we use our arms our hands and everything to slightly direct it, just in case there is an object or a person in our way. Now this isn't always going to work out perfectly, but it's better than falling into an object that can possibly hurt us or impale us, or do something bad. So if we can slowly direct and maybe graze an object, or completely miss an object, we're actually much better off. So the four beginner falling techniques everyone should learn, and I put up some videos and I'll show these here in
00:27:52 a second. Um, stepping reactions are not technically a falling technique, but they're kind of the the front line to preventing a fall, you know, these are these are essentially where you start losing your balance and then you step out to catch yourself. So you'll lose your base of support, for it essentially, you have to stop yourself by stepping out in any direction and preventing the fall. Now these can also be used as a transitional technique into a fall where you step out and maybe do a slight lunge when you get closer to
00:28:21 ground, and then you go into a falling technique. Again reducing those forces. So let me show you that one real quick. All right so I queued up this video for you, and this is actually a video I made about a year ago teaching the stepping reaction continuum that I use with my patients. Um, this will take people from not understanding what step reaction is to essentially creating a pseudo-fall and teaching them how to be reactive and able to make a stepping reaction without issues. So this is just a basic side step
00:28:50 that I had my dad do. He leans out of his base of support and once he finds that tipping point he falls. so as I'm teaching this I'm protecting him to make sure that he doesn't fall completely. But this is a very useful technique to learn how to start that stepping reaction process, and fall efficiently. All right the next one is the butt fall. This is going to be the first falling technique that I teach most people. This is about as simple as a proper falling technique you can get. It's utilized in backward falling scenarios where you are
00:29:23 falling backwards and you're either going to land on your back, your butt, or your head, and in this scenario what we do is we actually get the this person to crouch down as much as they possibly can, aim to land on their glutes as their first contact point, and then roll backwards kind of like a roly-poly. These people will often have a couple of bruises on them from the fall, especially if it's kind of a violent fall, it'll prevent any fractures or serious injury to a person. So I queued up this video
00:29:53 and this is me again. A video from about a year ago me teaching falling techniques in the old clinic I used to work at. Um, and this is me demonstrating a basic backward fall, or backward butt fall, excuse me so that was about it. That was very simple, just crouching down falling on the butt rolling out, like a rollie pollie. Coming back up to either your butt or your feet depending how much momentum you have. It's very simple, and it's the first technique I'm going to teach any person over 65. Much easier to understand, and it kind of
00:30:29 gets a person used to being on the ground, or on a mat. All right, so these are the more advanced beginner techniques that I would teach somebody. The first one is going to be a half back shoulder roll. Now I like this one, um, because as one of my my good buddies Christian Fairfax says, he's a parkour coach, but he says this kind of teaches the basics for a lot of the more advanced techniques. So this one although basic is also a base for everything else. And so in this one essentially it's it's an advanced version of that backwards
00:31:00 butt fall, where instead of going to both glutes you go to one glute. So say we're going to my right glute, and then you roll along diagonally along your spine, along those meaty points of the back musculature, rolling to your left shoulder so from right hip to left shoulder. You use your hands to stop yourself so you don't roll completely over so you're going to your back and you come back up onto your hips, or your butt. This protects the bony areas a little bit more since we are using those meaty points and it's also better for higher
00:31:29 momentum falls because you can stop yourself with your hands from rolling over backwards and injuring your neck. This is definitely the best choice for people who have more of an athletic background who have the basic prerequisites of physicality. So let's check this one out again, this is going to be me teaching this, uh, in one of my tutorial videos on scienceoffalling.com. So go to the hip, and roll the up shoulder, as I use my hands to stop myself from rolling back over at the same time it's a little bit more,
00:32:03 um, complicated technique because you actually use your legs as rudders to to steer yourself if you're going to hit something. So you have a lot more control in this position than the the basic butt fall. All right the the most, uh, difficult basic falling technique to learn is going to be the half forward shoulder roll. So the half-back shoulder roll kind of teaches a person that diagonal meaty pathway to use to prevent injury in a fall. The half-forward shoulder roll has you actually going over forward your
00:32:35 head, just like a somersault, but in that diagonal fashion. So this is going to be definitely better for any fall within your kind of frontal plane, um, or in the plane in front of you rather. And this is just the exact opposite of that last fall, it's always going to be safer to use this technique than simply catching on your hands and coming to your chest, or just falling with a block arm, and pushing. Essentially it requires much less upper body strength than the typical forward fall, which is again catching yourself in a push-up position.
00:33:09 So let's check this one out all right so now this one is essentially absorbing force over a longer period of time rather than just stopping yourself forward. So this is me demonstrating this again. So going over the back to that right shoulder to the left hip using my hand at the bottom right there to stop myself, and using my feet to stop myself as well. So fairly fairly complicated versus the the original butt fall or simply just falling out with the arms out stretch, but you're not going to get injured
00:33:43 nearly as often with this, if ever, because it is such an efficient absorption technique for the force from falling. All right. So this is, uh, kind of a fun part of this presentation we want to analyze a fall. So I, I'm a big proponent of analyzing falls, so that you can determine how to get out of different following scenarios. Now this is more of a, I would say academic exercise, but it's also kind of fun just for the lay person to see. Oh I wonder how that person fell, what could they've done better, and this is also a little bit more fun
00:34:15 than just looking at slides. So we're gonna look at five different falling videos that I've taken out and I've put on my um social media for Science of Falling. We're going to basically talk about them briefly, what happens in them, in the falling scenario, how this person may have prevented it, or maybe why they fell that way in the first place, and maybe it was an efficient fall overall. All right, so here's the first one this is a gymnast on the uneven bars. I am not a gymnastics, uh, specialist or even knowledgeable at all
00:34:44 about gymnastics, so I've seen this variation of this fall often. And I, I'm from the gym, that I've talked to sometimes it's the best way to get out of the situation that I'm going to show you without getting completely injured, especially with the pad environment. Let's watch it. There you go so she's doing a skill, but misses the grab on the bar lays herself out flat, and hits the ground with her stomach. In that padded environment, that's great, because what she's actually trying to do it seems like is reduce the potential injury from
00:35:17 trying to land on her feet, because landing on her feet is gonna have a lot more force through her body, and those, uh, the knee and ankle joints possibly leading to some type of ligamentous injury, But by laying her body out she's actually absorbing the force throughout her entire body on this matted environment. So quite an interesting type of fall something you'll see often if you watch a lot of gymnastics videos of people missing their skills, so it was, it was interesting. All right the next one this
00:35:46 older gentleman right here, watch his feet. He's getting a little crossed up there. Now this gentleman, clearly from the beginning of the video, it's going to replay here in a second that's quite a wide base of support as he walks. Very kind of rigid type of gait, and it's kind of choppy at the same time. So he clearly doesn't have much control walking, then he adds a moving element, which is his dog, to it and you can see he crosses up and she steps on his own foot leading to him falling down, and I'm pretty sure he
00:36:21 probably was pretty banged up after this, because that was quite a hard fall. His elbow got hit pretty hard on that left side of his. So it's, it's interesting to watch this because those stepping reactions I was talking about, there actually is a technique of using something called a karaoke a grapevine, or also what I've also heard called the Stroll, to essentially learn to cross those those legs over, and be more efficient in cross-stepping, just like he's doing right there. And teaching him how to be okay with those awkward steps and save
00:36:52 himself. Or at least get into a position and get him to the ground safely through a squatting technique, but at the same time a patient like this, that you see, if you were able to watch this video and then see the patient you would definitely want to work on their balance as well. Because clearly the balance was a little bit off before you begin walking. All right, so this is more athletic, this is Tracy Porter of the the Jets I believe, versus Marshawn Lynch. So Marshawn Lynch is actually gonna take Tracy Porter
00:37:26 down but just watch what he does. So Tracy Porter comes up on him, watch him, he rolls it out, he gets back in the game pretty quickly. So see how quickly he stands up and starts running? So he's back in the play. So if we're talking about falling techniques leading to more athleticism being able to fall efficiently and get up right away, is going to help you stay in the game longer, and actually potentially make a critical play, um, rather than just kind of fall on the ground. So if you actually watch the
00:37:59 beginning of the video, a couple times, the other people trying to tackle him, I mean watch these people just fall on the ground, and act like a ton bricks. That guy falls down doesn't get up very quick, Tracy Porter gets up fairly quickly, but if we watch the rest play, there's actually another guy down here. That guys just out of the play instantly. So if these people know how to dive, tackle, and roll out to get back in the play, they might have a second chance to stop a run from happening. All right, so this one's the funniest of my
00:38:30 nephew. I was at my brother's house and I told my nephew show me a fall, and so this is what he did. Runs up, he goes, actually goes to his hip so that he naturally knows how to fall properly, even though he's short stature and he doesn't have to do that. If you watch him he goes to his left hip falls to shoulder shoulder and rolls out and essentially saves himself a little bit of shock. But you know he was just messing around. So for him to do it that, and if, well watch any of my falling tutorials,
00:39:02 um, I teach a similar technique to that. That it's quite impressive he is doing it without even ever learning how to. So this, these abilities of are innately within us we just have to kind of let them flourish, and grow, and be trained properly. All right, last one here. This one is more of a real world situation. This is a person of average age, I'm assuming 30s. Probably, from what I could see. She is at some stairs and wearing heels. This is not a fun video, but it definitely drives a point home, and the point that drives home is that
00:39:39 a fall is going to happen to anyone, anytime even if you feel like you are healthy and able. So there was a couple mistakes in this. As she was carrying a lot of packages, uh, that probably could have been done in two trips, but you know how many of us are actually going to take the time to do that? A lot of us take 17 bags and try to get into the house as quickly as possible going to grocery stores. We just, we want to be efficient, but the thing is, she also was doing was she wasn't taking her time on these stairs. She didn't efficiently, you
00:40:06 know, spot her next step. Her heels also got a little wobbly right there, and that leads to her fall. Now how could this fall have been made better? Even if it's happening, prevention is the best medicine, but you know if we're trying to make this fall better what could she have done. Well, she definitely could have ditched those boxes instead of holding on the whole time. If we teach proper falling techniques, we teach that safety is going to be the priority, not what you're holding. So she should have dumped those
00:40:34 and then she could have probably squatted down a little bit, and get closer to the the ground, as she was going down and reach her hands out, and end up in more of a uh, probably like a barrel roll to her side, so she rolls down the stairs, instead of just hitting every single stair very hard. So real world situation, not always cut and dry, and how the falling technique would help this, but just important to know that this is going to happen to anybody. And there you go, so that is the the missing link presentation. You know I
00:41:06 originally created this for colleges especially PT programs, and had the intention of creating a lab component after to teach these basic falling techniques that I spoke about before. I hope to still do that in the future, but I definitely wanted to get this out to everybody so that everybody has the the option to kind of investigate this further. This is just a essentially a kickstarter for what I want to make Science of Falling, and what I want people to take away from falling as a modality. I really want this
00:41:38 to become commonplace in healthcare, in personal training, in gyms everywhere. And make it, you know, an acceptable form of training just like balance training is. So I appreciate you, make sure to check out scienceoffalling.com, Instagram @science_of_falling, and my Facebook page scienceoffalling as well. If you want this presentation for any reason, feel free to message me on any of these. My email is also on scienceoffalling.com through the contact page and thank you for watching. Here are some references for those that
00:42:12 want to grab some of these that were mentioned throughout or they were shown throughout the slides thank you happy falling! [Music]
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Happy falling!
