Plan Now to Avoid Falling Later

My Strategies to Stay Strong, Stay Standing

Tibia raises for strength and flexibility

Events seem to come in clusters and waves. Over the past several months, a couple of my friends’ elderly moms have taken tumbles. Although not disastrous, they were varying degrees of bad: cuts, bruises, rattled nerves, newfound fears. One went to the hospital for several days before going into a transition facility…which is ultimately never a good thing for senior people.

In the thirteen years we cared for my mom, we had five episodes that landed her first in the hospital, then in transitional care, and each time she emerged less than when she went in. It’s as if some of her energy, vitality, and will was deposited at the door, and she didn’t get it back when she left. Poof. Gone. Admittedly her state of health was in a natural slow decline, but these incidents took big chunks out of her reservoir and it was a noticeable difference. In my mind, an avoidable difference.

Plan not to fall
I’ve given a great deal of thought to my experience with my mom since her passing, and it is one of my driving forces for creating Ageosophy. We hear a lot about financial planning for our future retirement (there is a huge industry built around it) but what about planning our future health? Oh, yes, there is another mammoth industry to insure bad outcomes, but what if we prepare to avoid those bad outcomes as much as possible?

As someone verging on 63, I’m convinced—with every fiber of my being— that falling is one of those incidents within our control that can be mitigated or avoided. Experience tells me falling can be the beginning of the end for some people, and statistics bear that out. According to CDC statistics, “More than one in four older adults report a fall each year. In 2021, 38,742 older adults aged 65 and older died from preventable falls, and nearly 2.9 million were treated in emergency departments.” Other estimates put it as high as one-third of people over 65 will have a fall annually. And this data reflects incidents that were reported…imagine all the spills and tumbles that don’t make it into the system. YIKES!

I’m on hyperdrive to prepare and prevent. As with many things in life, there is no magic bullet or special potion as the remedy, but rather a holistic strategy that encompasses diet, exercise, lifestyle, and home. And, it’s an ongoing process…far from one and done. This will be at the forefront of my mind from here on out, and I’m already being more mindful about several key areas daily.

Diet

Overall health
My priority is to maintain a moveable weight and general good health with a diet strategy of whole foods, high protein. Pretty simple. Experience cooking for my mom proved to me that a myriad of health and weight issues can be alleviated by a diet free from highly processed foods. After I put her on a whole food, lower carb eating plan, she lost 70 pounds and was able to wean off of all medications…at the age of 88. Whole foods are also a better source of nutrients, vitamins and minerals that maintain a balanced gut, strong bones and teeth, and healthy immunity.

Protein is a priority
As we age, we metabolize protein less effectively than our younger selves, so it’s important to increase our intake. Protein is critical to maintaining muscle mass and offset sarcopenia, which is the loss of muscle and strength that leads to frailty and an increased risk of premature death. 

For me, though, the recommended amount of protein is a little daunting, requiring 1-1.2 grams of protein per kilogram body weight (one kilogram is about 2.2 pounds. (This is a great calculator.) I’m constantly having to work on it… so all my meals have protein front and center, and any snacks are essentially protein. For instance, my current favorite nibbles are parmesan crisps made solely from parmesan, which is the highest protein cheese with 35.1 grams per 100 grams. Sprouted seeds and nuts are another go-to protein source. I’m also considering adding in a small protein shake several times a week, and developing a couple of new favorite go-to protein meals for a change of pace.

Regardless of the source, increasing protein intake as we age is of paramount importance.

Exercise

Overall strength
Mitigating the expected natural loss of muscle is a two-pronged approach: 1) eating substantial protein, and 2) building muscle through strength training and weight bearing exercises. And it is never too late to start! Incredibly, study after study shows that even frail elderly people aged 75+ can increase muscle mass and strength by simply strength training twice a week, with improvements in as little as eight weeks. One super impressive study demonstrated that 86–96-year-olds who did high-intensity weight training were nearly three times stronger by the end of the trial.

All strength training counts, whether it is your own body weight exercises such as push-ups, squats, and wall sits; or free weights and machines; or resistance training. Any movement that challenges the muscles will build a strong muscular-skeletal system.

Develop grip strength
What do your hands have to do with your feet? Plenty, actually. Statistically, grip strength has a direct correlation with the quality of life as we age. Practically speaking, good upper-body strength could prevent you from taking a real tumble. Think of times you’ve slipped but been lucky enough to catch yourself. This becomes exponentially harder as we age and lose not only upper-body strength, but grip strength as well. It’s easy to start at home. Squeezing a tennis ball and wringing a towel are things you can do immediately to strengthen your hands.

Practice balance and flexibility
Practicing balance to maintain balance may seem obvious, but I’ll go out on a limb and say that it’s not something most people do. It doesn’t have to be complicated; I do simple things like stand on one leg while I’m cooking. Or when I put shoes on, I’ll see if I can put my socks and shoes while balancing on one leg. If I’m feeling really ambitious, I use my husband’s balance disks, which are designed for runners to strengthen the feet, ankles, and lower legs

I’ve also started incorporating a few of the staples from Ben Patrick’s (Knees Over Toes Guy) protocols that are especially good for older people, such as walking backward or the humble tibia raise that his 70 year-old mom demonstrates in a popular video. Although strengthening the tibialis anterior muscle is essential for knee strength, it is key to the foot's dorsiflexion, which tightens and significantly affects our gait—think older person shuffle.

Lifestyle

Ground communication to the brain
I confess that I’m becoming obsessed with feet and their role in our aging process (this won’t be the last you hear of it and I’ve written a previous post) although I don’t see many other people talking about this. I began going barefoot more often about two years ago, and I’ve gradually become more and more aware of how vitally important the health of our feet is to our overall wellbeing. They are truly our foundation.

I started going barefoot first thing in the morning because I noticed my feet were really tender when I got out of bed. The solution wasn’t cushier slippers, but rather more flexing and movement to encourage the naturally lubricating synovial fluid to flow through the joints. Low and behold, it worked. Over time, my feet were less sore in the morning and it’s a habit that has stuck.

That armchair experiment shifted my mindset to increasing mobility and strength in my feet, which is foundational for overall balance. Now, I am mostly barefoot in the house (and I have a pair of barefoot slippers I love), and I purposefully flex and exercise my feet throughout the day.

I also started wearing zero drop, barefoot style footwear as everyday, casual, run-around shoes…which led to another epiphany. Without a stiff sole between the foot and the ground, my feet flex and communicate to my brain precisely the condition of the surface I’m walking on…enabling my brain to adjust my body’s reactions accordingly. Otherwise, the brain thinks that I'm walking on as flat and unbending a surface as stiff, cushy shoes convey. Additionally, I believe that this increased communication to the brain aids in enhancing neuroplasticity, which will help keep the brain young. 

I am convinced the general state of stiff, weak feet and inflexible shoes are a major factor in falling. The seed was planted in my mind with my mom who—despite thorough neurological testing with normal results—constantly felt off-balance. As I watched her shuffle in thick-soled shoes with no give or bend, I remember thinking, “These shoes are not good…” and over time, I’ve grown more and more convinced that very popular chunky, ultra shock-absorbing athletic style shoes are doing more harm than good. I’m officially rebelling against them!

Sit on the floor often
The ability to sit on the floor and get up of your own accord has been shown to be a predictor of mortality. Some of the countries with the lowest correlation of falling resulting in death are countries where they sit on the floor and squat often as part of their daily lifestyle.

So throughout the day, I do deep squats to pick things up or reach into the bottom cabinets, and I sometimes sit on the floor to put my shoes on. I’ll sit on the bottom step of our staircase periodically to check messages or tap out a quick note, just as a change of pace from sitting in a chair and stretch my back and hips. I’ve even adapted my exercise routine to incorporate the movement of sitting down and getting up several times at the end of each session.

Home and environment
In articles I read about preventing falls, inevitably the focus turns to fall proofing the heck out of the house.

But my frame of mind is much the same as when our son was an infant starting to toddle. You may find this crazy, but we did not baby-proof our home. Except for the gate at the base of the steps (because he insisted on crawling up), nothing changed. There were exposed table corners, regular electrical outlets, freely opening cupboard doors, valuable breakables at little hands height, etc, etc… I can hear the gasps. Our plan bore fruit and he learned to be careful and mindful from a young age, and we had absolutely none of the issues most new parents fear.

My strategy is to keep my mind active by purposefully being aware of my surroundings. Of course, I exercise common sense—there aren’t extension cords running through the house or boxes lying around to fall over. But otherwise, I am not going to adopt the mindset that the environment is my downfall. Stairs are my friends and I will be strong enough to climb them!

The one caveat I make is for an already elderly and feeble person, such as my mom was. We did get to the point at which we removed all the throw rugs, didn’t let her shuffle with her little dog on a leash that could trip her up, put beautiful grab bars (not the ugly, industrial Home Depot specials) in the bathroom, and generally cleared a path from point A to point B. By the way, I’d keep the grab bars as able-bodied people can benefit from them as well.

Situational awareness
Once we leave the home environment, having situational awareness while we are out and about during the day can be lifesaving. An increasing number of people just out walking are seriously injured due to either texting, talking, or simply not paying attention. It’s something easy and within our control to be more aware of our surroundings.

Just the beginning
I’m honestly just scratching the surface of the myriad of practices that you can incorporate into your life to decrease your chances of falling and mitigate the risk of severe outcomes. This will be an ongoing effort and as I hone my favorites, I’ll be sure to share them with you. I’m confident with a holistic strategy, it is possible to take control of this issue to live well, age great.

---