Balance, fall prevention, dizziness and more

Dr. Mark De Anda specializes in treating the lower back and sciatica. (Courtesy photo)

By Dr. Mark De Anda

Over the past several weeks, we’ve been discussing balance, falling and trying to understand the parts of our body that make up our balance system.  This week, we are going to finish up this discussion on balance by talking about the most common reasons senior citizens fall.

Our eyes play a huge role when it comes to balance.  As we mature into adulthood, we rely more on our sight to keep our balance.  However, our eyesight may become poor as we age as well.  So the one system that we depend on for balance begins to weaken!  This can really set us up for falls or at least put us at risk.

So what can we do?  Physical therapists, who specialize in balance, work to increase the strength in eye movement.  We do specific exercises to increase eye mobility, so our patients are not limited and can fully move their eyes, head and trunk freely and independently.   If we begin to lose our sight or the mobility of our sight, we are giving less sensory information to our brain about our environment.  This is kind of like walking in dark.  How confidant are you?  Your chance of losing your balance and falling are much greater.

Our muscle strength and coordination also plays a big role in keeping our balance and avoiding falls.  How many of us have more muscle strength and movement now compared to when we were 20 years old?  None of us, of course.  As we age, we lose strength, and we become less active causing decreased coordination and reaction time.  It’s a natural part of life.  All of us lose muscle mass and strength making movement less fluid or free.

As movement is restricted, joints are stiffer and less flexible.   A good example of this is ankle or foot tightness.  Many of my patients lose strength in their legs and develop ankle tightness which causes them to trip.  Trauma and surgeries can also affect strength and coordination. Lifting our legs over a step is not so simple anymore. The coordination of moving one foot in front of the other is also affected and makes it difficult to walk which also can lead to falls.  Strokes may affect our posture as well.

Do you remember when grandma would tell you to stand up straight?  Well, grandma was right! As we age, we lose our posture mainly due to inactivity, sedentary living or sitting down six to eight hours a day.   As our head, shoulders and trunk lean forward it offsets our center of gravity.  This make is much easier for us to trip over things and fall forward.

Unfortunately, reaction time decreases with age and the ability to respond is lessened as well. At some point after a couple of “accidents” you must ask yourself, was it really an accident? Remember, a fall can cause injury or fractures that can lead to lengthy hospital stays!  Ultimately, falls can shorten your life span and lead to early death.

Medication may also affect your balance.  Medications are necessary for many of us that suffer from chronic conditions like high blood pressure, high cholesterol, breathing problems, etc… Unfortunately, many medications affect our balance and cause dizziness.  This is why we must understand and be very familiar with our medications.

Other chronic diseases such Parkinson’s or Multiple Sclerosis directly affect our nervous system.  Parkinson’s disease affects our brains and our ability to process sensory information or movement while Multiple Sclerosis affects our nerves in our arm and legs and really limits our nervous system’s ability to send signals for movement.  If you have any of these two conditions, I highly recommend you to seek a consultation with a physical therapist to understand how we may help your movement and avoid falling.

Finally, we must consider Vertigo. Our inner ear is made up of three loops filled with fluid and crystals.  Each loop tells our brain what motion or position we are in such as walking forward, backward, bending over, sitting or lying down.  When the fluid is lost or somehow restricted, the missed messages are sent to our brain and the room begins to spin!  Vertigo may also be caused by trauma to the brain from head injuries.

My name is Dr. Mark De Anda, and I’m a doctor of physical therapy located in central San Antonio. If you call (210) 314-6725 and schedule and appointment, I can confirm exactly what causes of your loss of balance and give you a written plan of exactly what a successful treatment looks like.