Why Learning to Fall is Essential
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Why You Should Care About Falling
It’s no secret that as a person ages or becomes ill, they are often at higher risk of sustaining a fall and acquiring an injury. According to the CDC, 1 in 4 elderly adults over the age of 65 will sustain a fall this year. (1) Not only that, the medical costs from these falls across the US can total up to $50 billion annually. (2) That was not a typo. Yes, $50,000,000,000.
To me that just seems insane and unnecessary. And don’t think that if a person is young and healthy they are free from the risk of falling. If a person currently lives in an area that has winter snow and ice, you better believe they are at a higher risk than the average American for an unexpected fall. Not to mention the multitude of other natural hazards that can throw off a person’s balance and lead to a fall. The reality is that everyone on earth is aging, and will be in the high-risk group of 65+ before you know it.
The types of injuries from falling are vast and varied. The type of injury sustained, and the extent of that injury are dictated by how someone falls. These injuries can include the classic FOOSH (fall on outstretched hand), fractures to the hip or lower extremities, head trauma, and even spinal cord trauma. These injuries are preventable, or at least can be minimized in severity through proper falling techniques.
Fall Training is Underutilized
Fall training is relatively new and untapped in the field of physical therapy. There are very few PT clinics in the world utilizing this form of movement education. The clinics that do are relatively limited in their approach to teaching fall techniques.
Most treatment time will be focused on improving strength and balance to reduce the chance of falling. While improving these areas is important, what happens if a patient falls anyway despite our best efforts to strengthen musculature and improve balance?
No matter how good someone’s balance is, a patch of ice can send them to the ground and ultimately to the emergency room.
So I ask, are healthcare providers leaving valuable injury prevention tools on the table? Is there benefit in teaching a patient how to fall? I’d say emphatically, YES.
Where Can We Look For Safe Falling Techniques?
The average person may have some exposure to fall training in the form of community programs, such as local martial arts classes. This type of fall training is called ukemi in some circles which means, “to receive”. I know that term is foreign to most but stay with me here.
Ukemi in its traditional form is practiced by receiving techniques (having a technique or move done to you), such as a judo throw, and learning how to safely take that technique without becoming injured. Some of the safe falling techniques you may have heard of include break falls and rolls.
For example, a judo instructor throws a student to the ground. For the student to prevent serious injury, they will perform a break fall and slap the ground to dissipate forces. If the ukemi technique is performed correctly, the student should walk away without a scratch. If not performed correctly, a bruise or worse could occur.
In a more modern approach, the idea of ukemi has been adopted by parkour practitioners in order to train appropriate and safe falling techniques in a variety of real-world contexts. None of these contexts involve being attacked by a partner like in martial arts. Instead, falling techniques in parkour are utilized in a way that protects one from getting injured while walking, running, tripping, and landing from heights. It is from this parkour ukemi methodology and practice I propose that both the general public and health professionals learn how to fall.
Final Thoughts
Learning how to fall is essential for personal physical safety and to strategically reduce the staggering medical costs for fall related injuries. Again, that cost being roughly $50 billion annually. (2)
I liken proper falling techniques to learning how to use the emergency brake in a car. Most of us will never have to use the emergency brake in a hazardous situation, but if we had to, we all know what to do and it can save our life. The same goes for falling. Learning how to fall can be the difference between a sprained wrist or a severe traumatic brain injury. Hopefully we will never have to use these skills, but personally, I’ll take the sprained wrist any day. I’m sure our most would feel the same.
Well there you have it in a nutshell --my thesis for this website that is the Science of Falling. In future articles, we will take a closer look into the science of falling, types of injuries, pathology, and a whole host of other interesting and related topics to increase not only your knowledge as a healthcare practitioner or layperson, but also your safety and confidence with movement (planned and unplanned) within the world we inhabit.
References
1. Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics Society. 2018;66(4):693-698. https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.15304. doi: 10.1111/jgs.15304.
2. Gwen Bergen, Mark R. Stevens, Elizabeth R. Burns. Falls and fall injuries among adults aged ≥65 years — united states, 2014. Morbidity and Mortality Weekly Report. 2016;65(37):993-998. https://www.jstor.org/stable/24858985. doi: 10.15585/mmwr.mm6537a2.
Thanks for reading the first article on Science of Falling. I would love to hear your thoughts about teaching patients how to fall. Have you attempted teaching these techniques? Do you believe some patients would benefit more than others? What benefits and challenges do you foresee when teaching patients to fall? Leave a comment below!
Happy falling!
Special thanks to Pam Hale and Siobhan McConnell for editing this article
