Beware the Injury You Cannot See

Just a few days ago we celebrated the first day of fall here in the Finger Lakes region of NY…  with summer-like temperatures.  While we can’t prevent fall from coming (eventually), we can take action to help prevent falls.  You know, the serious kind.  Fall prevention is a very broad topic.  I want to focus your thoughts today on one very important aspect of fall prevention:  the injury you cannot see.

Are falls preventable?  Yes!

Falls can have a profound impact on you, your family and society.  Every 13 seconds an adult over age 65 is rushed to the emergency room due to a fall.  If by discussing fall prevention here leads to one less fall, we have done a great thing.

fall prevention pic

Photo courtesy of National Council on Aging


A fall is defined as landing on the ground or some other lower surface when you didn’t intend to be there.  This may include slips, trips, etc.  Have you had a fall in the past year? Past 6 months, past 3 months?  Were you hurt?  Do you feel unsteady when standing or walking?  Do you worry about falling?  Do you limit your activity because you fear falling?  Fear of Falling is a lasting concern that may cause someone to stop doing activities that they remain able to do.

Fact:  The fear of falling is in itself a risk factor for falls.

Here’s why:  Legs weaken with inactivity. When we sit, we lose muscle strength that we need to use to stand and walk and move. Inactivity leads to falls due to the change in strength, balance and coordination.  Also, it may make someone feel alone.  Over time, if they avoid activities with others, this can lead to depression or anxiety.

}  Fear of falling is the injury you cannot see.

}  You may not even see it yourself, but your loved ones might.  I usually hear from someone’s daughter that their mother needs help.  And I will add that the one who fears falling is almost always receptive to information and help.

}  Falling, and the subsequent fear of falling, shakes your confidence.

}  There is an evidenced-based questionnaire called the ABC Scale that I often use to help assess someone’s confidence and fall risk when it comes to their mobility.  Please let me know if you would like a copy of it by emailing me at


Here is a list of factors that are also known to help predict fall risk.  A score of 4 or more implies someone is at risk for falls.

◦      Age 65 or older

◦      Three or more documented medical diagnoses

◦      Prior history of falls within 3 months.

◦      Incontinence

◦      Visual impairment

◦      Impaired functional mobility (eg fear of falling)

◦      Environmental hazards

◦      Poly-pharmacy (4 or more prescription meds)

◦      Pain affecting level of function

◦      Cognitive impairment

How did you score?

(Source:  MAHC-10 – Fall risk assessment tool)



What can I do about it?


}  Fall prevention sometimes requires a multi-dimensional approach.  That is, consulting with your physician and other allied health professionals can put you on a path to a healthier lifestyle.

}  Take control of your fitness level.  By becoming stronger, we are better able to handle the varied environments and surprises that come our way.

}  According to WJ Evans, chief of physiology lab at Tufts University said, “Most falls are due to profound muscle weakness from not doing anything.”  Great news!!  We can change this!

}  Think positively… believe you can make a change

}  Exercise

}  Eat right

}  See your physician regularly


}  Your mindset is critical.  If you believe you can improve your health and fitness, you can!

}  If you believe you can’t, you most definitely won’t.



ALWAYS talk with your doctor or healthcare practitioner before starting an exercise program.

Begin with physical therapy or fall prevention classes. Be sure the classes you sign up for are designed for your age group or ability level and have an experienced instructor. Let the instructor know you are new to the class when you first arrive.  Observe a class if you’re not sure.

When you find something that works for you, stick with it.

Some types of exercise known to be effective to reduce falls include:

}  Fall prevention classes

}  Core training

}  Pilates – Buff Bones® (visit for more information)

}  Tai Chi

}  Walking program

}  Aquatic exercise (good for fall prevention – limited effectiveness to help with bone strengthening)


In summary:

}  Fall risk increases as we age.  Falls have a profound effect on our lives.

}  Falls are largely preventable.

}  There are many causes of falls and thus many solutions.

}  Our fitness level has a major bearing on fall risk.

}  We can decrease our fall risk by getting stronger… at any age!

}  Beware the fear of falling… the injury you cannot see.

}  Contact your physician and fall prevention expert like a physical therapist or experienced trainer to discuss options that are safe for you.




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