Winter is upon us and the accompanying forces of nature are set to affect our bodies in various ways. From the perspective of falls risks, Winter brings changes that many of us need to make allowances for. The most obvious ones include the need to take a bit more time to check for hazards such as slippery paving, manoeuvring around large puddles, re-thinking a journey to avoid a possible downpour and staying out of blustery winds.
However, even the most organised of us may find ourselves caught out dealing with unanticipated situations in Winter. Take, for example, a scenario such as trying to grab a hat as it flies off in the wind. With sudden movement, our bodies make adjustments for a change in conditions by altering our foot position and posture to influence our walking speed and centre of mass. As a last resort, to try and stop a fall, we use our reflexive saving strategies of stepping and or reaching.
We can reduce the chance of a fall with some simple strategies such as: choosing to hold a grab rail when climbing up or down steps, using a walking aid (if appropriate), taking a different and safer route, wearing suitable clothing including supportive shoes with grip; and carrying an umbrella.
Some people notice a change in mood with season changes. The reasons behind this are likely multifactorial. However, having less daylight to perform exercise, socialise and conduct your usual routines can affect both mood and falls risk. Indeed, the impact of reduced daylight hours in Winter has further reaching impact for falls risks. With lighting conditions being reduced at this time of year (shorter days and more cloud cover) the risk for falls increases. Visual input is crucial for balance through increased sensory awareness. With diminished visual input our balance is challenged more.
People with arthritis often report that joints feel stiffer and ache more in the winter months. Those changes may affect the way you walk, step down off curbs, turn to look at points of interest, and step out of the way of a quick moving object. Of course this means that your movement is not as fluid. If there is associated pain, you may not be able to rely on your saving strategies if you do lose balance.
If you already identify yourself as someone ‘at risk’ of falling or have already fallen, hopefully you know why this is. It could be due to poor balance, joint pain, muscle weakness, something in the environment you keep tripping on, toileting at night time in the dark or a medical cause. I would encourage you to discuss the cause of your falls with your GP and it is worth seeing a Physiotherapist to examine your walking pattern and screen your falls risk factors.
Remember, if your falls are due to mechanical causes, exercise is a fundamental part of keeping yourself off the floor. Your exercises should be tailored to your body’s needs and ideally you should be ‘challenging your balance’ for a minimum of two hours a week. Challenging your balance equates to making your body sway or ‘wobble’ in a non-predictable way. This in itself can be fear provoking for many people so you should rely on set exercises from your Physiotherapist.
Many exercises can be done in the pool (hydrotherapy) and the Arthritis Foundation has a variety of classes that are likely to suit your needs. Alternatively access your local community pool. Doing classes like yoga, tai chi and dance also works your balance and have been found to offer improvements in reducing falls risks. Tai Chi for Arthritis (Dr Lam) run by the Arthritis Foundation has a body of research evidence to support this claim.
As you age complications from falls increase in severity and can often affecting your quality of life and independence. If you have osteoporosis, the effect of a fall can have a significant impact – particularly if it results in a fracture. Hence, preventative strategies are of high importance.
Unfortunately, falls are not always reasonably preventable. However, knowing that you have done your best to minimise your risks not only provides personal satisfaction but you also get to learn more about your own body while you do it.
Remember your GP can refer you to a ‘Falls Clinic’ through the Department of Rehabilitation and Aged Care in your area or link you in with other suitable programs. Other useful resources include the Stay On Your Feet website www.stayonyourfeet.com.au
Of course, AOWA has a number of helpful resources. Please contact the telephone advisory line on 1800 011 041 or contact us via email on firstname.lastname@example.org or visit our website www.arthritiswa.org.au
by Shona Beesley, Senior Physiotherapist Sir Charles Gairdner Hospital