Fear of Falling

Winter has only just begun and already I’ve heard about several incidents of injuries from falls, at least one of them serious.  Of course, anyone can fall at any time of the year, but it seems like winter is a particularly dangerous time when ice and snow accumulate all around us. Some falls result from what we call “black ice”.  This is that devilish condition when a thin layer of ice on asphalt is invisible to the eye.  When encountered it can cause supports like feet, bicycle tires or even autos to slide perilously.  Another insidious form of hidden ice occurs frequently in my area where daytime sunshine causes standing snow to melt and then refreeze when the sun goes down and temperatures fall.  This condition can be particularly precarious when another layer of snow falls on top obscuring the ice layer below so you don’t know where it is until you step on it.

Although older adults seem more prone to falls, and many studies show that the consequences of falling for older adults can be particularly dire, no one is immune from falls.  There are many articles featuring suggestions for preventing falls.  All you have to do is Google “Fall Prevention” and you will find examples.  But I would like to focus on the causes that I see most frequently and that I think can be at least partially addressed with training.  First and foremost is failure to pay attention.  Our modern lifestyle seems to encourage hurrying.  We worry about slowing down when there are people behind us.  Or making that car wait for more than a few seconds while we cross a street.  Something distracts us and we forget to pay attention to our surroundings.  Have you ever been looking down at your feet (or your cell phone) and suddenly been hit in the head with a tree branch?  Admittedly I’m guilty of that one.  So the first piece of advice I would give is slow down.  Look around you in all directions.  Be aware of your surroundings.  Make sure your next step is on firm ground.  Sometimes I will take my foot and just slide it back and forth in front of me to make sure my next step is not on ice.  That car that’s waiting for you to pass is most likely not going to run you over.  And no matter where you’re going, the extra few minutes will not make any difference in the long run.  Unless they save you from injury.  Then, in fact, the extra few minutes might make a huge difference!

The second most frequent cause of falls I’ve observed or heard about is not taking proper precautions.  For example, not wearing appropriate shoes.  You think “I’m only going out for a few minutes.  I can make it in my high heels.”  Perhaps that’s a little extreme, but you get the picture.  You get away with it once and think it won’t be a problem the next time.  And maybe it’s not.  Until it is.  Wouldn’t it be better to just take that extra few moments to be safe.  I could go into a big rant here about the footwear industry and how it encourages us (especially women) to wear inappropriate shoes, but I’ll save that for another time.  Suffice it to say that most of you know what works in these situations.  It often comes down to the choices you make.  It’s also important to remember that just because you’ve been careful to clear your own walkways, this may not be the case everywhere you need to go.

There are many reasons why people fall.  Some of them are related to physical conditions or side-effects of medication.  If you have these types of concerns hopefully you will get professional advice on how to deal with them.   But so many falls result from preventable circumstances that it’s worth another reminder.  This provides yet another reason to tout the benefits of movement practices.  Mind-body practices like yoga, Pilates and others can help you to learn to pay more attention to the way you move.  These practices help encourage strength, flexibility and balance.  We think of balance as being able to stand on one foot.  But practicing balance exercises can also be a way to strengthen the muscles that will help you catch yourself and avoid falling.  Or help you get up if you do fall.  Holding onto something because you fear falling might be helpful, but wouldn’t it be better if the muscles that support you were stronger.

Mobility has been described as more than just being able to move, but also maintaining strength through a full range of motion.  Stability is the quality that enables one to retain or regain position when impacted by an external force.  So, for example, if you’re standing and something pushes you, you’re ability to recover your position would be a way to measure stability.  So you can see how mobility and stability go hand in hand.  Then there is flexibility which might be described as the quality of being able to bend without breaking.  Clearly all of these traits are also necessary components for good balance.  If you feel stronger and more stable you will also gain confidence.  Fear can make us tense.  Tension makes us brittle and rigid.  Rigidity is the opposite of flexibility. Tension zaps energy and strength.  So learning to relax can be as important as all the other elements of balance.  Breathing practices, also an important component of mind-body practices such as yoga and Pilates, can help relieve tension and encourage relaxation.  They also help you slow down and recognize that few circumstances merit the hurrying we often feel is so necessary.

Finally, being in good physical condition might not prevent a fall, but it will certainly help you recover from one.  And cultivating more conscious awareness of your mind and your movements can help you in all aspects of your life.   If you haven’t tried it yet, it’s never too late.  If you can move and breathe, there is a practice for you.  Take the time to find one.  You won’t be sorry.  And it just might save you from yourself.

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Improving Independence

This past week we celebrated Independence Day, a milestone in American history.  On that day we recall our fledgling nation’s successful effort to separate itself from British rule and establish our own local government.  Since that time the concept of independence has become a significant pillar of American culture.  As a society we place a high value on individual independence.  We love the idea of the self-made person who succeeds by using his/her own wits and ingenuity.  A lofty ideal for sure, but a myth nonetheless.

Of course, we can often improve ourselves and sometimes even our circumstances through hard work and determination.  That’s true.  But everyone who does succeed at anything owes that success to external factors as much as internal drive.  Start with the accident of birth.  If you were born here in the U.S. or have had the good fortune to obtain citizenship or permanent resident status, you can thank that one fact alone for many of the opportunities you’ve been able to take advantage of in your life.   You can’t credit your birth to any ability of your own. It just happened that way and you are the unwitting beneficiary.  Maybe you were born into a privileged family, maybe not.  Or you might have had access to great schools and teachers.  Or not.  The amenities in your area – roads and transportation options, clean water, accessible food sources, etc. – may have served to add or detract from your quality of life, but either way they certainly contributed.  Sometimes the ability to change surroundings is available and sometimes not.  So in many ways, we are not as independent as we think.

Even those who are “off the grid” will probably find that they are still dependent on some external sources.  For example, if you grow your own food, you still may need certain weather conditions.  The availability of clean water is always a factor even if you use indoor gardening options.  As human beings we are neither infallible nor immortal.  We need food and water no matter what.  And we are subject to all kinds of illnesses and other physical problems.  At this point you might be wondering if I’ve been reading too many dystopian novels.  In fact, my intention is not to paint a bleak picture of human frailty, but simply to remind us all that we need each other.  We are all interconnected. Like or not.  And when that fact is accepted, the potential exists for all of us to get along with each other much better that we do.

A recent article in Yoga Journal reminds us that we are “supported in countless ways through each moment of your life”.  The article is about gratitude, but it is also about independence and interdependence.  The 17th-century author and pamphleteer, Roger L’Estrange, is quoted as saying that we often “mistake the gratuitous blessings of heaven for the fruits of our own industry.”  Thus not only do we need each other, but we are dependent on everything on the planet and even the universe to support us.  Without all of it, we could not exist.

Having said all of that, one of the most common refrains I hear among older people is that they (or should I say “we”) want to maintain their independence for as long as possible.  Becoming completely dependent upon others for daily needs is something many of us dread.  We want to keep driving our cars, walking on the trails, choosing our own food, living in our own homes, seeing other people when we want to or being alone when we prefer.  We don’t want to be a “burden” on our families, or on society.  And yet most of us will at some point lose at least some of our ability to take care of ourselves.

Still medical research suggests that this doesn’t always just happen simply due to aging.  Sometimes it is a result of inactivity.  As I’ve often said, the less you move, the harder it is to get moving again.  Another of my mantras is that we all need to move while we can move because one never knows when their ability to move will be altered.  Illness or accident can immobilize any of us at any time.  When people tell me they are afraid of flying, for example, I often respond that they could get hit by a car tomorrow.  Or trip getting out of bed.  Anything can happen.  These are just more ways in which that illusion of control over our own lives can go awry.  Sometimes a post-traumatic stress reaction can set in.  Once you experience pain from any source, it is easy to become fearful that the same pain will return.

So it all comes back to letting the lure of potential benefits overcome the siren song of fear.  In “Exercise:  A Guide From the National Institute on Aging” the authors state that “just about every older adult can safely do some form of physical activity” and, in fact, “studies suggest that not exercising is risky behavior.”  If motivation is a drawback, dangle that carrot of independence right in front of your nose every time you try to erect barriers.  Too hot or too cold outside?  Set a timer and walk around your house for 20 minutes.  Better yet, walk up and down some stairs.  You don’t have to go fast.  Just move continuously at whatever pace is available to you.  Or take a class!  Most classes are indoors and some are even air conditioned.  Afraid to go by yourself?  Call a friend or relative to go with you.  Remember that a class can be a source of support and strength.  These are two of the many qualities that help us to maintain independence while still recognizing our interconnectedness.  Leave your fear of looking funny at the door.  There was a wonderful article in this week’s “On Being” blog called “Perfection Will Do You In“, by columnist Parker Palmer.   In it, there is a poem by a 94-year-old Benedictine monk named Kilian McDonnell which is a must read.  Here is my favorite part:

the Venus de Milo
has no arms,
the Liberty Bell is
cracked.

Bottom line:  nobody is perfect and we all need each other.  And remember – the independence you may save or extend could be your own.