BY JACKIE OSBORNE, PT, DPT
John loves being outside. He has beautiful gardens full of flowers – species that he has carefully selected so his vegetables are perfect and ready to share with his neighbors and friends, season after season. John’s garden is still a breathtaking sight, but it’s less abundant these days.
Last summer, John tripped over the hose in the yard and hurt his right knee and elbow – really his entire right side. After about two weeks of taking it easy, John felt better. His soreness had resolved. Bruises healed. The day was bright and perfect for planting, so out he went. He started with the onions, but the next thing he knew he was lying in the grass looking up at the blue sky.
John had fallen again – this time after stumbling when he reached for his shovel. As a physical therapist, this is the time when I would have loved to meet John. He was an active, social guy with a brilliant hobby who, at the age of 77, experienced a couple accidental falls. An avid gardener is bound to trip over the garden hose at some point, right?
But the falls didn’t stop there.
Unfortunately, I didn’t meet John until he was admitted to the skilled nursing facility a few weeks after Christmas. He fell in his bathroom one evening, but this time, he could not get up. John had fractured his right hip and jaw. He lived alone, so no one even knew he was there – stuck on the bathroom floor – until a neighbor came over nearly two days later to find out why he wasn’t in the garden.
By that time, John was dehydrated and developed kidney failure. He had surgery on his hip and his jaw, and required lots of fluids and antibiotics. He was hospitalized for 22 days before coming to a skilled nursing facility, where a medical team, including physical, occupational, and speech therapists, worked with him over five weeks until he was finally ready to go home.
John is now receiving physical and occupational therapy five days a week in his home. His grandson, who thankfully attends college nearby, moved in to help him. John is on the mend and will meet his goal of getting back into his garden, but not without help.
I just wish I had met John sooner.
As a physical therapist, I think I could have helped John avoid his injuries. I may not have been able to keep him from tripping over that garden hose, but I likely could have helped him avoid the subsequent falls and the aftermath that followed.
Physical Therapy & Fall Prevention
While physical therapy is often a critical component of recovery from a fall, many people don’t realize that PT can prevent falls in the first place, especially falls that cause injury.
Falls are often thought of as just a natural consequence of getting older. And while it may be common for older people to fall, a person’s age is not the reason a fall occurs. It is actually what the aging body can do – or can’t do – which contributes to an event like a fall.
That’s why health care providers often recommend that older adults avoid declines in mobility by engaging in regular physical activity and exercise. In fact, physical activity guidelines indicate that older adults should engage in 150 minutes of moderate intensity exercise or 75 minutes of rigorous intensity exercise at least three times per times per week. Flexibility and balance exercise should also be incorporated. And don’t forget exercises to improve cognitive health.
But that exercise advice can be overwhelming, and sometimes it’s a challenge to even know where to begin.
The fact is, a physical therapist is often the best place to start – especially to help older adults develop a maintainable exercise routine to prevent falls.
Risk factors for falls are present for months or even years before a fall actually occurs. As an expert in human movement, a physical therapist will conduct a comprehensive and individualized movement assessment to determine which body systems are not operating optimally for an older adult to successfully move without falling. These include vision, sensation, leg strength, coordination, power, flexibility, and postural reactions that need a tune-up.
From there, a physical therapist can design a physical activity program that is tailored specifically to a person’s needs – working around issues like knee or back pain, or other concerns like heart conditions, breathing problems, low bone density, diabetes, or difficulty moving after a stroke or other injury. A physical therapist also has the expertise to help identify the appropriate health care providers like ophthalmologists, podiatrists, internists, or occupational therapists who can contribute to the team-based approach to decreasing fall risk.
Getting back to activity after experiencing an illness or injuries from a fall like John’s can be overwhelming, and for many, it’s the beginning of a downward spiral toward poorer health and ability. It’s important to see a physical therapist before an injury happens.
Your physician or your health plan can help you identify a physical therapist if you don’t already know one. In addition, the Florida Physical Therapy Association also has an excellent resource called “PT for Pain” at www.PTforPain.org, where you can learn more about PT and find a physical therapist near you.
Jackie Osborne is a physical therapist with Brooks Rehabilitation in Jacksonville, Florida.
Visit https://www.ptforpain.org/find-a-pt to find a PT near you.