I’ve been a physical therapist (PT) for 24 years. Good for me right? No, good for you! This means I get to share things I’ve learned and you get to keep your $25-$75 (…or sometimes more) co-pay. In this article I’d like to discuss falls, mobility and maybe, just maybe, how to live a bit longer. First of all, what is mobility? By definition mobility means “the ability to move or be moved freely and easily,” but I’d like to drill down and be a little more specific. Today I’m talking about joint mobility. Everyone knows that as we age our joints don’t move as well as they once did. This can begin the slow decline of “I’m not moving as fast as I used to”, followed by “I’m not moving as much” and then comes “It takes me longer to get around…” Eventually you’re moving less, you’re losing strength and you’re losing the ability to move around as you want. So begins the downward spiral…can you see the tiny little whirlpool above the bathtub drain and hear the sharp little sucking sound?
Wow, that’s depressing! There is hope. Please read on.
All this “not moving as well” and “decreased joint mobility” that we accept as we get older puts us at a higher risk of painful joints, loss of strength, more falls, inevitable fractures and a shorter life span. Not good… not good at all. I’m privileged to work with a wide variety of clients of all ages. I used to be surprised by the lack of joint mobility I would find in people in their 30’s and 40’s, but not anymore. Sad to say that nowadays I expect to find a lack of mobility in my younger clients ankles, hips and backs. It becomes even more restricted in older adults.
Let’s talk about the hips for a second. They are the second most mobile joint in our body only beaten out by the shoulder. Our hips are made to move in every direction, even to rotate on their axis. Quick question…can you sit Criss-Cross-Applesauce? It requires hip flexion and “external rotation”, (a big $10 word that we PT’s like to use when we’re trying to sound important) which means rolling the thigh outward. If you can’t, you should start. Try it while you’re watching TV. Lean back on the sofa and pull those tootsies up into your lap, let your knees drop down and feel the stretch. Better yet, sit on the floor in front of the couch and try it. Get those hips opened up; your back and knees will thank you.
“OK, so what’s this about a shorter life span? Are you saying that because my hips and ankles aren’t loosened up I won’t live as long?” No, I’m not saying it. In a study published in 2012, Dr.’s Leonardo Barbosa Baretto de Brito Claudio and Dr. Claudio Gil Soares de Araujo, et al, say it. For their study, participants aged 51-80 took what they named the “Sitting-Rising Test.” Study members would stand in the middle of an open area, get down to the floor and then get back up. Pretty simple, yes? Possible 5 points on the way down and 5 points on the way back up. Every time a hand, elbow, knee or any part of the body was used for stability or to push, a point is deducted. For example if you put two hands on the floor to get down, that’s a 2 point deduction. If you use a knee and a hand to get back up to a standing position, that’s another 2 point deduction. In this example you’d score a 6/10. The long and the short of the findings are that for every point drop in your score, your risk of dying increased by 21% over the next 6 years compared to someone scoring higher. In this example, your score of 6 puts you at a 42% higher risk of mortality in the next six years than someone scoring an 8.
Having said all of that I don’t believe the study is all encompassing, there are a great deal of variables and maybe even a few flaws (as can be found in all scientific studies). The study was large (over 2,000 people), looked at “all cause” mortality, (meaning if you flamed out on the highway due to an 18 wheeler smashing you, it still counted), but they collected a lot of data. With a study group that large you will begin to see trends. I’m not here to debate their findings, but I will say even if they’re only half right it presents a strong argument for working on your flexibility and strength.
Working on your flexibility and strength doesn’t have to be a major undertaking. Even the simple act of getting down on the floor and getting back up will do it. Ask anyone over the age of 60 “When was the last time you got on the floor?”. I ask this of all my patients over the age of 50. My favorite response of all time was “Do you mean voluntarily?”. Yes, voluntarily, when was the last time you got down on the floor? The usual reply is “I can’t remember.” or “I get down to play with my grandchildren but I have to scoot over to the couch so that I can get back up.”
That’s a problem folks.
Falls are a huge problem in the US (and the world). I don’t have the data to back up this next point, but let me ask you. Who is more likely to fall? Someone that actively gets up and down off the floor 10-20X a day, or the person that never gets on the floor and hangs onto furniture as they walk throughout the house? To be fair, there are many potential causes of falls in older adults, poor eyesight, poor hearing, medications, illness, diseases (think Parkinson’s, Diabetes or Stroke), throw rugs, comforters draped off the end of the bed…the damn cat. I’ll bet you $1 that someone who is used to getting up and down regularly is less likely to fall and more likely to get back up after said fall (barring serious injury, yes, I’m looking at you hip fracture) than someone who hasn’t been on the floor in months, voluntarily.
If you, dear reader, are feeling like you’re not moving around as you’d like or have a real fear of falling and want to begin, please check with your doctor or PT first. If the thought of getting on the floor and back up is scary, then I’m talking to you. Get with a PT that can assess you and teach you how to do it safely. If you’ve had a knee or hip replacement, it doesn’t exclude you, but you need to be careful. You’ll need instruction, seek it out.
If your thought is “What a pain in the a$*, I don’t need to do that!” then you NEED to begin. Clean your baseboards, hit a yoga class(es!), sit and watch TV in front of the couch “criss-cross applesauce”, simply get up and down 10X in the morning and 10X in the evening. Heck, do a Turkish Get Up! (I have no affiliation with www.exrx.net, simply like their explanatory video) The Turkish Get Up is my favorite “all body” mobility, stability and strength exercise. Perform two of them on one side and two on the other. Just do it without a kettlebell or weight until it gets easier. Much better than Burpees. (I love hate you Burpees).
There you have it. It is vitally important that you stay mobile and strong as you age. Falls suck. Lying on the floor for a long time after you fall, sucks. Hip fractures suck. Surgery sucks. Being scared of falling sucks. Spending a few minutes a day working on your mobility/strength, being more confident when you walk, reducing your risk of falling, putting yourself in a position to get back up after you fall, and maybe even living longer, most decidedly Does. Not. Suck.
EXCELLENT read Chris!