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Cutting Your Fall Risk

by Terry Hartnett

Walking is something that, for most of us, just comes naturally. From the day we take those first timid steps as a baby, we tend to take our ability to walk for granted. As we grow older, we begin to realize the important role walking plays in our daily lives and how essential it is to maintaining a healthy and active lifestyle. Falling can too easily change all that. For many individuals over 60 — particularly those who have arthritis — preventing falls should become part of a daily effort to maintain an active and independent way of life.

No matter what type of arthritis you have, there are concrete steps you can take to reduce your risk of falling. One of the most important is to begin an appropriate program of exercise to improve your flexibility, mobility, muscle strength, and balance, all of which can make you steadier on your feet. Exercise alone, however, cannot prevent all falls. If you have arthritis you should also carefully assess your own risks for falling, which may include the medicines you take or hazards in your home. This article will help you understand why people with arthritis are at higher risk for falls and how you can use exercise and other measures to lower that risk.

Age, arthritis, and the risk of falling

Both age and arthritis are risk factors for falling. There are several reasons why your risk of falling increases as you get older. Slower reaction time, weaker muscles, worse eyesight, changed posture, and decreased sense of balance are just some of the age-related changes that can make you less steady on your feet. In addition, many older people — especially those who have fallen before — have a fear of falling. People who are anxious about falling tend to have less muscle strength (because their anxiety causes them to stay off their feet) and are more hesitant in their movements, both of which can actually increase the risk of falling.

Arthritis can further complicate the picture. In the first place, arthritis can actually make your sense of balance worse. Part of what helps us keep our balance is a mechanism in our bodies called proprioception. Proprioception is the process by which your muscles tell your brain where all your body’s parts are at any time, allowing your brain to tell your muscles when to make adjustments. Proprioception helps you keep your balance when you walk, for example, by alerting your brain to the pressure being placed on the muscles. The brain then tells the body when and how to shift its weight and make other compensations to keep you balanced. But when arthritis wears down the cartilage and other tissues in the joints, it can also damage some of the sensory nerves proprioception depends on. The signals from your muscles don’t make it to your brain, and your body may not compensate properly. Arthritis in the feet and knees, for example, can make it more difficult for you to sense how your body is positioned. In the absence of good proprioception, the body has to rely for balance on vision and the vestibular system — the body’s internal balancing system located in the inner ear — making you less stable.

In addition, arthritis can affect balance by causing pain in the weight-bearing joints. The pain can cause you to change your gait, thus increasing the risk of falls.

Finally, arthritis can cause people to lose muscle strength, which increases fall risk. Research has found that people with osteoarthritis in the knees have reduced strength in the muscles in the front of the thighs (the quadriceps), which is a risk factor for falling. Arthritis in the feet or ankles can also increase the risk of falls. Keeping your quadriceps strong and your ankles strong and flexible is an effective way to reduce the risk.

Exercise

There are many common exercises that can reduce the risk of falling. As you start thinking about an exercise program, keep in mind that no two people are exactly alike. Your arthritis may limit or weaken you in ways that do not affect others with the condition, and your exercise program should be tailored to your particular needs. Start by asking your doctor about what exercises are best for you. Or ask for a referral to a physical therapist or occupational therapist. A physical therapist can show you specific exercises that you can use as part of a daily routine at home. An occupational therapist will focus on exercises that help you improve your ability to do activities of daily living such as bathing, cooking, cleaning, and dressing. One important point to remember when exercising: The adage “no pain, no gain” is a myth. You never want to exercise through pain with arthritis. The goal is to build strength and flexibility. Pain can get in the way of that goal.

Two types of exercise that have been shown to help people with arthritis manage their condition and improve their daily functioning are tai chi and water exercise.

Last Reviewed on October 27, 2010

Terry Hartnett is a freelance editor and writer based in Pittsburgh, Pennsylvania.

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