Vestibular Exercises: Exercises For Dizziness, Vertigo and Motion Sensitivity

EASING VESTIBULAR SYMPTOMS

As we age, it is not uncommon to experience symptoms of dizziness (lightheadedness and unsteadiness), vertigo (a sensation of spinning or whirling), motion sensitivity (motion sickness) and balance problems. These are all vestibular symptoms and can significantly impact daily activities and quality of life.

Fortunately, there are proven strategies that can reduce symptoms of vestibular issues.

In this article, we will look at the vestibular system so you can better understand what may be happening when you're experiencing these symptoms. We will also look at what can improve symptoms, including exercises and more.

NOTE BEFORE: It's important to remember that not all dizziness is caused by vestibular issues. Dizziness can have various causes, including neurological, cardiovascular, or metabolic conditions, medication side effects, dehydration, anxiety, and more. Therefore, please ensure you see your doctor or health care professional if you experience dizziness, especially if it's persistent or severe, to determine the underlying cause and receive appropriate treatment.

WHAT WE WILL BE COVERING IN THIS ARTICLE:

• WHAT IS THE VESTIBULAR SYSTEM AND WHAT DOES IT DO?

• VERTIGO IN SENIORS: DIZZINESS VS VERTIGO

• POSTURAL HYPOTENSION: ANOTHER TYPE OF DIZZINESS

• VESTIBULAR EXERCISES FOR SENIORS (EXERCISES FOR DIZZINESS, VERTIGO & MOTION SENSITIVITY)

• BEGINNER VESTIBULAR EXERCISES (VIDEO)

• INTERMEDIATE VESTIBULAR EXERCISES (VIDEO)

• OTHER TIPS FOR PREVENTING DIZZINESS ARE VERTIGO

WHAT IS THE VESTIBULAR SYSTEM AND WHAT DOES IT DO?

The vestibular system is a sensory system of our body, which is predominantly situated in the inner ear, safe and protected inside the temporal bone. It sits adjacent to our cochlea, our organ of hearing. 

Diagram: The Vestibular System

It contains three canals, known as the semicircular canals, and two organs, the utricle and saccule, which are known as the otolith organs. 

The semicircular canals are positioned at right angles to each other, allowing them to detect rotational head movements. They are filled with fluid (known as endolymph). When the head moves, this fluid flows into an area called the ampulla.

Diagram: A closer look at the Vestibular System

In the ampulla, the movement of the endolymph causes the movement of hair cells, which sends signals or information about the head movement to the brain.

The otolith organs (utricle and saccule) also detect movement. They are responsible for detecting linear acceleration of the head (which are changes in speed or direction in a straight line) and changes in head position with respect to gravity, such as when the head moves forward or backward or when the head is tilted up or down.

More specifically, the utricle is sensitive to horizontal head movement, e.g., moving forward or backward in a car. The saccule is sensitive to vertical head movement - moving up and down.

The otolith organs contain hair cells that are covered with tiny crystals of calcium carbonate called otoconia (or otoliths). When the head moves, the otoconia shift, and the hair cells' movement generates nerve impulses transmitted to the brain.

Together, the semicircular canals and the two otolith organs provide the brain with information about the position, movement, and orientation of the head and body, allowing us to maintain balance, coordinate our movements and provide us with a sense of where our body is in relation to the space around us (spatial orientation).

However, there may be times the vestibular system may not function as it should, leading to symptoms including:

• Dizziness or vertigo

• Imbalance, lightheaded or unsteadiness

• Motion sensitivity or motion sickness

• Nausea or vomiting

• Sensitivity to light or sound

• Tinnitus or ringing in the ears

• The feeling of fullness in the ears

• Imbalance or unsteadiness

• Headaches or migraines.

VERTIGO IN SENIORS: DIZZINESS VS VERTIGO

A symptom of vestibular issues, which can occur among older adults, is vertigo.

Vertigo is a specific type of dizziness characterized by a spinning or whirling sensation. 

Dizziness, on the other hand, is a more general term that can refer to a range of symptoms, including lightheadedness, unsteadiness, and feeling faint.

The most common cause of vertigo is Benign Paroxysmal Positional Vertigo (BPPV).

BPPV is a condition where the otoconia (the calcium carbonate crystals discussed above), typically embedded in a gel membrane, become displaced from the utricle and move into one or more of the fluid-filled semicircular canals where they shouldn't be.

View fullsize

How Vertigo Occurs.

This can cause the canals to become overly sensitive to head movements, leading to feelings of dizziness or spinning when the head is moved in certain positions.

BPPV is typically a self-limiting condition that resolves on its own within a few weeks to months, although it can recur in some individuals.

Treatment options for BPPV may include a series of specific head and body movements, known as canalith repositioning procedures (EG. Epley Maneuver) or vestibular rehabilitation exercises, to help move the displaced otoconia out of the semicircular canals and restore normal vestibular function. Medications and surgery are generally not recommended for BPPV.

POSTURAL HYPOTENSION: ANOTHER TYPE OF DIZZINESS

Another type of dizziness that is not uncommon when one gets older is postural hypotension.

Postural hypotension is dizziness or lightheadedness when going from lying or sitting to a standing position. Postural hypotension is caused by a drop in blood pressure.

With postural hypotension, vestibular exercises are not typically used as a treatment.

Postural hypotension is usually managed by addressing underlying medical conditions contributing to the problem, adjusting medications, and making lifestyle modifications such as drinking plenty of fluids, avoiding alcohol, and standing up slowly and standing to a walking aid if required.

However, vestibular exercises can help improve balance and reduce the risk of falls that may occur as a result of postural hypotension.

If you experience dizziness when going from a lying or seated to a standing position, let your doctor know.

Vestibular Exercises for Seniors (EXERCISES FOR DIZZINESS, VERTIGO & MOTION SENSITIVITY)

Vestibular exercises can improve balance, reduce dizziness and vertigo, and increase confidence in daily activities. These exercises can also help prevent falls and promote physical and mental health.

Studies have shown that vestibular exercises can improve the vestibular system's function and reduce symptoms of dizziness and vertigo. These exercises can also help improve postural stability and reduce the risk of falls. [1, 2, 3, 4]

A successful vestibular rehabilitation program should contain exercises of the eyes, the neck and the rest of the body.

Types of vestibular exercises that are commonly used in vestibular rehabilitation include:

• Eye and Head Exercises: These exercises may involve moving the head in different directions while focusing on a stationary object or tracking a moving object with the head and eyes.

• Gaze Stabilisation Exercises: These exercises involve fixing your gaze on a stationary object while your head is moving. This helps train your brain to interpret signals from your vestibular system better.

• Balance Exercises: These exercises help improve your overall balance and reduce your risk of falls. Examples include standing on one leg, walking heel-to-toe, and standing on an unstable surface.

• Habituation Exercises: These exercises involve exposing yourself to movements or situations that typically trigger your symptoms in a safe and controlled environment. Over time, your brain may learn to tolerate these movements or situations without causing symptoms.

• Canalith Repositioning Manoeuvres: These manoeuvres involve moving your head and body in specific ways to help reposition tiny crystals in your inner ear that may have become dislodged, leading to vertigo.

• Brandt-Daroff Exercises: These exercises involve repeatedly sitting up and lying down in a specific way to help desensitise your brain to movements that may trigger vertigo.

It's important to note that the prescribed exercises will depend on symptoms and diagnosis and should be guided by a healthcare professional trained in vestibular rehabilitation. 

And it is essential to take precautions when performing vestibular exercises to reduce the risk of injury, including measures in place to prevent falls. 

Always start with gentle exercises and gradually increase the intensity as you become more comfortable. If you experience any pain or discomfort, stop the exercise immediately.

Incorporate vestibular exercises into your daily routine to get the most benefit. Start with a few minutes of exercise daily and gradually increase the duration and intensity.

BEGINNER VESTIBULAR EXERCISES (VIDEO)

Join me for these slower-paced vestibular exercises that are perfect for seniors.

These vestibular rehabilitation exercises can be used to relieve symptoms associated with vestibular dysfunction, that being dizziness, vertigo and motion sensitivity.

Always make sure you see your doctor or Vestibular Physiotherapist before undertaking these exercises.

Beginner Vestibular Exercises

INTERMEDIATE VESTIBULAR EXERCISES (VIDEO)

Intermediate Vestibular Exercises

Other Tips for Preventing Dizziness and Vertigo in Seniors

In addition to vestibular exercises, there are other steps you can take to prevent dizziness and vertigo. These include:

• Reducing stress can help prevent dizziness and vertigo by reducing tension in the body and promoting relaxation.

• Practising relaxation techniques: Stress and anxiety can worsen dizziness and vertigo. Practising relaxation techniques such as deep breathing, meditation, or yoga can help reduce stress and improve symptoms.

• Staying hydrated is required for good health and can help prevent dehydration, which can cause dizziness.

• Eating a healthy diet rich in nutrients and low in processed foods and vegetable oils can help maintain overall health and prevent conditions that may lead to dizziness or vertigo.

• Getting enough sleep is vital for overall health and can help prevent fatigue, which can contribute to dizziness and vertigo.

• Improving general fitness may not directly decrease vestibular issues, but it can improve overall health and reduce the risk of certain health conditions that may contribute to vestibular problems. Additionally, regular exercise can improve balance and coordination, which may help compensate for vestibular dysfunction and reduce the risk of falls. 

• Avoiding alcohol, tobacco, and other stimulants can help prevent dizziness and vertigo by reducing the risk of conditions that may lead to these symptoms.

• Using caution with medications: Some medications can cause dizziness as a side effect. Talk to your doctor about any medications you're taking and whether they could contribute to your symptoms.

• Managing underlying conditions: Certain conditions, such as migraines and inner ear disorders, can cause dizziness and vertigo. Managing these underlying conditions through medication or other treatments can help prevent symptoms.

References

For References used in this article, click here.

Keeping Up Your Exercise

Welcome to 2023! The first article of the year from me.

I hope you had a good Christmas if you were celebrating, and a good New Year. I definitely did!

I’m a week late on this article, I did sit down to write something to help get your year off to a good start last week. However, nothing I wrote I felt was worthy of sharing.

So I turned my laptop off and now, a week later, here I am again trying to think of something good to write that will help KEEP you moving this year.

I put the “KEEP” in capitals because this is the most challenging part when it comes to exercise and other healthy habits. I want you to be exercising throughout the year and for many years to come.

Exercise and movement is medicine. Medicine that should be undertaken consistently each week (preferably daily in some way) to get the benefits and keep the benefits.

Getting started with exercise or another new habit is usually relatively easy. However, when motivation wanes or something comfortable tempts us, it can be challenging to override this in the moment and stick to what we had originally planned.

Our minds will find ways to justify why we don’t have to exercise. We miss a session, and then one missed session turns into two missed sessions, then maybe three or four. And then more. Until it gets to “I haven’t exercised for a while”.

Unfortunately, if we don’t keep up our exercise, we eventually start losing what we’ve gained.

There will always be times when motivation dips or something unexpected gets in the way. So we want to ensure we have some ways to deal with these times that we don’t feel like exercising.

Here are some steps you can take:

1. COMMIT to exercise.

   Unless there is good reason not to, commit to some exercise or movement at least three times each week.

2. Remember “WHY”.

   Everyone has different reasons as to exactly why they’re exercising. You will have your specific reasons also. Think of these reasons, and think about how you will feel after making progress with your exercise versus if you don’t exercise. Remember, when you exercise today, your future self will thank you.

3. SHOW UP.

   If you’re demotivated to exercise, start by just taking steps to show up to the exercise.

   For example — put on an exercise video and sit in front of it. Once you’ve done this, there’s a high chance you’ll start following along.

   Or, if you know you should go for a walk, just put your exercise clothes on and tie up your walking shoes. Now start taking steps out the door. When you’ve done this, you’re likely going to keep walking.

   After some time into it, you’ll most probably find it’s not so bad. And when done, you’ll feel better after.

   You don’t have to go all out. Start small, make it easy, have fun with it. Even if it’s not the best session, that’s ok! Don’t beat yourself up. Aim to do better next time.

4. REPEAT.

   Get back to it the next day or the day after, and do your best to improve on your last session (it’s ok if you don’t improve, and even if it’s a slight improvement, that’s great!).

So there are four steps you can follow when you feel your motivation slipping.

I do the same when I don’t feel like exercising. I still make sure I get to the gym. I start with exercises I enjoy and gradually build on this during the session. Most of the time, after some time of the exercise, I get into it. If it’s not a good session, I know I will get back to it tomorrow or the next day. So it’s ok!

I also did the same for my writing last week. Every cell in my body did not want to write, but I know this resistance is normal, So I committed, sat down in front of my laptop and wrote. What I wrote last week was no good, but here I am back to it.

You may have tips to stay consistent with your exercise or other habits. If so, I’d love to hear them. You can let me know by placing a comment below..

I look forward to hearing about your progress with your health and exercising throughout the year.

If you don’t know how, or where to start, create a plan with the exercise videos here.

You can create a playlist of your favourite exercise videos by following this link here.

And if you’re stuck or have questions, join the More Life Health Facebook Support Group (click to join), which is an amazing, supportive group.

I will be writing an email each week to help you on your health and fitness journey. So I will see you again next week! Make sure you’re signed up to the mailing list, you can do so here morelifehealth.com/join …. And more exercise videos to come.

Looking forward to a happy, healthy and exercise-filled year with you!

2023 is going to be a great year!

Stay moving!

- Mike

Exercises To Do Before Knee Replacement Surgery

Includes VIDEO ON PRE-Knee Replacement SURGERY ExerciseS

So you’re booked in for an upcoming knee replacement surgery.

You most probably have been given a list of exercises to do before this surgery (and other pre-operative instructions) by your surgeon. This will ensure your legs are strong as possible before your surgery, which will help with the recovery.

As a Physiotherapist who has helped many people in your exact situation, I want to help you by going through the exercises in a video so you can follow along to them.

Before we get into this, however, let’s go through a few other things you can do to allow for better recovery following surgery.

Preparing For Knee Replacement Surgery

MENTAL PREPARATION

Undergoing any kind of surgery can be daunting, but it's important to remember that knee replacement surgery is very common and typically has a successful outcome. Still, it's normal to feel some anxiety about the procedure. Here are a few tips to help you mentally prepare for your surgery:

• Talk to your surgeon: If you have any questions or concerns about the surgery, be sure to voice them to your surgeon ahead of time. This will help put your mind at ease and ensure that you understand everything that will happen during the procedure.

• Educate yourself: Learning as much as you can about knee replacement surgery will also help reduce your anxiety. Talk to your surgeon, read books or articles, and watch videos about the surgery so that you know what to expect.

• Find a support system: Whether it's friends, family, or a support group for people who are undergoing knee surgery, having a supportive network will help you feel more comfortable going into the procedure.
  You will find many people who have undergone this surgery in the MORE LIFE HEALTH SUPPORT GROUP - which you can join HERE

PHYSICAL PREPARATION

In addition to preparing mentally for your surgery, it's also important to take some steps to prepare physically. This will help ensure a smooth recovery and decrease your risk of complications. Here are some things you can do:

• Lose weight: Carrying extra weight puts more strain on your knees. Not only will losing weight help with the pain prior to surgery, it will also allow for a smoother recovery. Speak to your doctor about weight loss techniques.

• Quit smoking: If you smoke, it's important to quit at least six weeks before your surgery. Smoking can delay healing and increase the risk of complications. Speak to your doctor about weight loss techniques.

• Get healthier - Start introducing healthier habits into your life - eating a healthier diet, getting optimal sleep and reducing stress are some great ways to improve your health.

• Exercise: Strong muscles help support your joints, so it's important to exercise regularly prior to your surgery. This will help you stay strong and improve your overall health. We will cover exercise in the next section.

• Get your home ready: Before your surgery, you'll need to make some changes to your home to accommodate your recovery. This may include: making sure you have someone to help, setting up a comfortable place to sleep, removing any rugs or other trip hazards, and stocking up on easy-to-prepare meals.

Knee replacement surgery is a major procedure, but if you take the time to prepare both mentally and physically, you can help ensure a successful outcome. Talk to your surgeon about any questions or concerns you have, and be sure to follow their instructions for a safe and smooth recovery.

I also cover more on what you can do (plus exercises), in the video below.

EXERCISES TO DO BEFORE KNEE REPLACEMENT SURGERY

Exercises to do before Knee replacement surgery

When Exercise Isn't Medicine

EXERCISING SAFELY

I know you know that exercise is medicine... And it is!

Exercise is essential to be healthy and to move well, and it can assist in many health conditions.

However, there are times exercise can do more harm than good, and it's my goal to make sure you're exercising and exercising safely to get the results you want and are doing this for many, many years to come.

When I get questions like "Hey Mike, what exercises are best for (insert painful area here)?"

I'll ask back a few questions to understand what's going on a little more, and it's clear the person has been overworking the area in some way, and more exercises won’t be helpful.

What's needed is a period of rest or lighter exercise to stop aggravating the area and to allow the body to heal.

I also commonly see people going all out with their exercise. They're under the impression that because exercise is healthy, more must be better, and they’re working themselves too hard.

The same goes for people who work a stressful or physical job and then, for example, each day do a heavy gym workout or go on a prolonged run on top of this......

And little thought usually gets put into recovery, sleep and getting adequate healthy calories to maintain healthily bodily function.

Yes, they may start looking better and be happy with their slimmer waist and new muscles, but it may be only a matter of time before something gives.

And we don't want this. We want the results without the issues…..

To do this, firstly, we must understand that when we undertake many types of exercise; we are stressing the body so it then adapts to become stronger, fitter, more flexible, moving better and so on due to the demands placed on it.

But as we are stressing the body, it’s important we do it correctly.

Here are some tips on how to exercise to get results without issues:

⁃ Start small, remain patient, and build on this. By doing this, you're building a strong foundation that will allow you to keep going.

⁃ If you feel you could be overdoing it, and if you're the type of person that finds it hard to slow down and do less…. Do your absolute best to pace yourself!

Remember, if something happens, you could be out of exercise for longer than if you paced yourself, which will be much harder.

⁃ If you've got pain and are most probably aggravating the area with activity/exercise, more exercise will not be the answer. Ease off the exercise. Stop aggravating the area. Allow the area to rest. And get it checked by your doctor or Physiotherapist.

You're on the right track when you notice your painful areas are feeling better after taking some time off. Don't push into pain.

⁃ If you're under high levels of mental stress and doing a lot of higher-intensity exercise, you may be burning the candles at both ends. Mental stress and physical stress equals compounded stress. They’re both taking a toll on your body.

Get your stress under control, have rest days, stretch, get massages, meditate or do more things that help you to relax.

⁃ Get your diet, sleep and recovery right. Have some time off.

⁃ Don't rush your exercises. Use good exercise technique. This is important; you'll also get better results when you do this.

By doing these steps, you will be exercising correctly and will see the benefits while minimising the risk of issues or injury.

Remember these tips and make sure you’re doing them.

If you're stuck, you can always ask your question in the More Life Health Facebook Group.

That’s it from me for now.

I will be seeing you soon with a new video. And more!

Remember, all exercise videos can be found categorised here.

Stay tuned for more!

Stay well!

And keep moving………. the right way!

⁃ Mike

5 Simple Health Tips!

This morning I was thinking about what I could write to help motivate to get everyone moving more and to be healthier this week.

At the time, nothing much came to me.

But after opening my laptop and sitting down to write, I want to talk about what steps you, or anyone, can take right now to improve your health. And to improve how you are feeling right now.

I’ll keep it to my top 5 so this email isn’t too long. I have ordered these tips by what I feel you should start with first, that being……

1. Prioritise Sleep.

Try to get to bed at a decent time, and take action to make your sleep environment more conducive to getting the best sleep you can.. Sleep is restorative.

Why not do this right now?, Think of what you can do today to improve your sleep tonight. (If you’re stuck, click HERE).
What helps me most is not looking at any screens about an hour before bed.

2. Reduce Stress.

Stress has a significant effect on our health. Don’t ignore it!

Think about anything causing unnecessary stress in your life and start doing what you can to reduce or eliminate it.

Also, do your best to avoid hearing and watching too much of the bad stuff happening in the world. Try to focus on the good stuff. You’ll feel better for it.

And ….. start being nicer to yourself. You’re great!

3. Cut Out Unhealthy Foods.

Nutrition is a vast topic. It can be confusing and also a somewhat divisive topic. Doctors and nutritionists have different takes and ideas of what is best.

If I could give just one tip, however, that you could take to get you eating better for your health, which I’m sure the majority of good nutritionists would agree on - I would say stop consuming highly processed junk food AND refined seed oils. Eat more real natural food.

4. Get Moving More.

If you know you must get moving more, just start by building up the amount of time you’re up on your feet and moving.

Start with walking, and do more of it.

But with any movement, always start small and build on it.

It’s common for people to go from not doing much exercise to getting a sudden burst of motivation and going all out. I see it over and over again. This won’t get you very far. It usually leads to burnout or a painful niggle or injury.

Allow your body to adapt to higher amounts of exercise gradually. This is the right way to do it.

You will build a stronger, healthier foundation when you spend less time sitting and gradually build up to more moving.

I started increasing my walking recently and I’m really liking getting out and about. Here is a picture from a recent walk of mine (that I shared in the More Life Health Facebook group that I thought you may like to see).

Are there any nice walking tracks you can go on yourself?

And start doing specific exercise videos. You will find the exercise videos categorised HERE.

5. Get Outside More and Be Happier.

For tip #5, I’ve gone with getting outside more. Breathe the fresh air. Get sunlight (without overdoing it). Vitamin D and bright light are important for health.

Also, why not do some things you like this week, guilt-free without stress.

And you can let me know what makes you happy in the More Life Health Facebook group. I love seeing what you’re doing in different places around the world, and I also love hearing about your hobbies (especially when it’s a hobby I haven’t heard of before).

- Mike

THE ULTIMATE GUIDE TO FALLS PREVENTION FOR SENIORS - PART 3

BE PREPARED - WHAT TO DO IF YOU FALL

In Parts 1 and 2, we covered all required to decrease your falls risk to a large extent.

This next part is essential for everyone and could be the most important section of this article, so please take your time going through the content. All of it!

I say it’s most important because there is always a chance anyone could fall, which means YOU or someone you know!

The outcomes of a fall when older are usually much more severe, with an increased risk of serious injury. Additionally, getting up off the floor usually isn’t so simple if the physical capabilities required are not there, potentially leading to further issues.

Furthermore, those who may be around to assist you and do so incorrectly may also put themselves at risk of injury or falling, ending up in the same predicament.

So it’s essential to know how to be prepared for a fall if one was to happen, know what to do if you fall, how to get up off the floor safely, and how to help someone who has fallen.

In this part, we are going to cover all of this.

CONTENTS OF PART 3:

• WHAT TO DO IF YOU FALL

• HOW TO REDUCE HARM AND SUMMON HELP IF YOU FALL

• BE PREPARED: CREATING A FALLS EMERGENCY PLAN

• WHAT TO DO IF YOU FALL: HOW TO GET UP SAFELY AFTER A FALL

• VIDEO - HOW TO GET UP SAFELY IF YOU HAVE FALLEN

• HOW TO ASSIST SOMEONE WHO HAS FALLEN

• WHY YOU SHOULD TELL YOUR DOCTOR AFTER A FALL

WHAT TO DO IF YOU FALL

Below is a flow chart on what to do if you fall and find yourself on the ground.

I have made it so you can print this to have a copy you can refer to.

Click on the diagram below, download and print it, and familiarise yourself with it.

SHARE THIS SECTION with anyone who could benefit from it. It may save a life!

Steps to Take Following a Fall - Click to download and print

As you can see from the diagram, many scenarios can occur following a fall.

The best possible outcome of falling is not having any injuries and getting up safely. In this scenario, you should still tell your doctor just to make sure there is no injury you may have missed.

It's also important in all cases to understand why you had your fall, which your doctor will help uncover.

Take note of the red section on the right in the diagram above. This is a situation following a fall in which you are on the ground, injured or not, unable to get up, with no way to summon help.

This is where many problems following a fall arise, and it's a situation WE MUST AVOID BY HAVING APPROPRIATE MEASURES IN PLACE.

HOW TO REDUCE HARM AND SUMMON HELP IF YOU FALL

This step aims to ensure that if a fall occurs, you can get help as quickly as possible to minimise any secondary consequences.

We will go through some questions to ensure you're covered for most situations if you fall.

CAN YOU GET UP OFF THE FLOOR?

If you were to fall in your home (assuming no injuries), do you feel you could safely get back up off the floor?

You want to ensure you have the physical capabilities to get up off the floor if you were to have a fall. The best way to do this is through exercise and a healthy diet to improve your strength, balance and fitness.

We will cover how to get up off the floor safely below.

For various reasons, some of you reading this may have difficulty getting up off the floor, or if you were injured, you want to stay where you are until help arrives - to avoid further injury.

In these situations, it is VERY IMPORTANT to be prepared and able to summon help effectively.

IDENTIFYING SITUATIONS THAT COULD BE PUTTING YOU AT RISK

Are there walks or activities you undertake where it might be challenging to get up from the ground if you fall? 

(An example could be: walking on your own through an open field, a sports oval or a walking track. In these places, there is nothing to hold onto).

If your answer was yes - 

If you lack confidence in your physical capabilities to get up and you were to have a fall, in such a situation, the best thing you can do is find an alternate route to take to avoid this.

If you cannot recover in situations like this, you may be in a hazardous situation.

If this is a route that cannot be avoided, many actions can be taken to minimise the dangers, e.g.:

• Do everything in this guide (all three parts).

• Take your walking aid with you if you have one.

• Tell a friend or family member where you are going.

• Take your mobile phone with you and keep it handy.

In summary, if one of your activities or walking routes could put you in danger of falling, be prepared or, better still, change your activity (if possible) with a safer option. 

HOW TO SUMMON HELP IF YOU FALL

If you were to fall and injure yourself, would you be able to get help in all situations?

Think of all areas of your house and the tasks you undertake, and determine how you would get help if you fell.

Here are ways to summon help in different situations:

a) In The House (Particularly the Bathroom): 

• Someone you live with (spouse, family member or roommate, neighbours, carers).

• Telephone (cordless or mobile are best) - always kept charged and with you.

• Pendant alarm.

c) Outside 

• Be sure there are people around; get to know your neighbours.

• Mobile phone kept with you (pocket, bag or walking aid).

SUMMARY - WAYS TO SUMMON HELP:

• People: Attract the attention of those around you (family, neighbours, friends etc.)

• Landline Phone: Throughout your house in close reach, or always keep a cordless phone with you.

• Mobile Phone: kept charged and with you, especially when outside.

• A Pendant Alarm.

Note: Make sure phones are always within reach; cordless or mobile phones are best in the house or outside.

To safeguard yourself further, have a check-in system with a neighbour, friend or family member where you can check up with each other daily at a specific time.

BEING PREPARED: Creating A Falls Emergency Plan

At this stage, we've ensured there is a way to summon help if you fall.

This section will determine who to call if you fall and ways to quickly contact them.

WHO TO CALL

1. KNOW YOUR FRIENDS, FAMILY MEMBERS OR NEIGHBOUR'S NUMBERS

The first step is to determine and know who you would call if you were to fall.

Right now, think of three people you would call if you were to have a fall.

You can put your answers in the action plan.

KEEP YOUR NUMBERS IN EASY ACCESS

1) If you have a landline phone, store the numbers of who you will call on the phone and know how to access the numbers quickly. 

2) Keep a printout of your emergency contacts on or near each house phone.

3) Store emergency contact numbers on your mobile phone and know how to access and call them. If you don't know how to use your phone, take the time to do so.

2. KNOW YOUR EMERGENCY NUMBERS

I'm sure you know your local emergency numbers, but here are several, just to be certain!

• Australia = 000

• New Zealand = 111

• The United States & Canada = 911

• The United Kingdom = 999

• From Any Mobile Phone - 112 (Anywhere in the World)

3. CONSIDER OTHER TECHNOLOGICAL DEVICES

As previously mentioned, using your mobile phone or a pendant alarm are ways to call for help if fallen. Another way to quickly and easily summon help and stay safe is to use Smart Watches.

Apple Watch

Smartwatches, like the popular Apple Watch, track different components of your health and fitness. The features include step tracking, heart rate & oxygen saturation monitoring, sleep monitoring and much more. 

Furthermore, the Apple Watch has inbuilt fall detection.

The Apple Watch fall detection is a life-saving feature that can help you if you fall. Using sensors, it can detect when you've fallen and automatically call for help to your nominated contact numbers if it detects that you're unresponsive. 

Once enabled, the Apple Watch will continuously monitor your movement data to detect if you have fallen. If a fall is detected, the apple watch will vibrate and display an alert. You can choose to dismiss the alert or call emergency services.

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Apple Watch - Fall Detection Screen

If you are unable to dismiss the alert or call emergency services, the apple watch will automatically call your emergency contacts and send them your location. The apple watch will also display your medical id so emergency responders can quickly get information about your medical conditions.

You can set up your medical ID in the health app of your iPhone. For further details on how to set up your medical ID on your Apple device, click here.

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Apple Medical ID

Fall detection is on the watch automatically for people over 65 years old. If you're under 65 years old and want to turn on fall detection, you can do so in the settings app on your Apple Watch.

If you have an apple watch, click here for details on setting up the Apple Watch fall detection.

Another great feature of the apple watch is the voice control, where you can speak to your watch and call someone, e.g., "Hey Siri, call my daughter!" This feature could come in handy if you fall and want to call a family member or friend quickly. Click here for a link on how to use voice command.

If you're interested in purchasing an Apple Watch, click here to view them or head to your local Apple store. But note that the "Series 3" Apple watch does NOT have fall detection capabilities.

There are other smartwatches on the market with fall detection software.

WHAT TO DO IF YOU FALL - HOW TO GET UP SAFELY AFTER A FALL

If you are on the ground after having a fall, how you react can cause more injuries than the fall itself. You want to make sure you know how to handle this situation!

The first step: DO NOT PANIC!

Your first instinct may be to get up as quickly as possible, especially if your fall is in public.

Avoid this instinct. STOP!... Take a deep breath…. Slow down! Relax.

It may also be the instinct of people around you to help you up immediately. Do not allow this.

Take another deep breath and assess your situation by asking these questions…

1. AM I HURT?

IF YES…

If you feel you could be hurt, other than minor cuts, scratches or bruises, DO NOT GET UP. 

If there are people close by, call them for help or use your telephone, mobile phone or pendant alarm to summon help, as discussed in the previous sections. 

Getting up from the ground when you are hurt (even with assistance) can cause further injury.

Ensure those who have come to your assistance have called for trained professionals (e.g. ambulance) and do not try to get you up.

The professionals are trained to deal with situations just like this.

WAIT FOR THE TRAINED PROFESSIONALS TO ARRIVE. 

Wait for the ambulance - or in a nursing home, community setting, or similar - for the doctor, nurse or physiotherapist to assess you. Once you have summoned help, keep warm and comfortable the best you can.

[Continue on to step 2b]

IF NO…

If you do NOT have any injuries, ask yourself :

2) CAN I GET UP?

IF YES…  Continue to 2A

IF NO… Continue to 2B

2A) I CAN GET UP: HOW TO SAFELY GET UP FROM THE FLOOR AFTER A FALL!

STEP 1:

1. Lying on your back. Relax, take another deep breath in and out.

2. Roll onto your side and tuck your elbow under.

3. Push into straight arms.

1. Lying on your back

2. Roll onto your side & tuck elbow under

3. Push into straight arms

STEP 2:

1. On straight arms, push your buttocks up and come onto your hands and knees into a crawl position.

2. In this position, you can crawl to furniture close by to assist you in getting up.

Push your buttocks up into crawl position.

STEP 3:

1. Crawl to furniture close by.

2. Use your hands to pull yourself up.

3. Slowly begin to rise, using your strongest leg first, one leg at a time,

4. Then your other leg.

Crawl to furniture close by and pull up into standing.

STEP 4:

1. Stand up.

2. Slowly twist around and sit on the chair. 

3. Relax, settle and tell a friend or family member (and your doctor) that you have fallen.

Stand up and twist around into seated position.

VIDEO: HOW TO GET UP OFF THE FLOOR WHEN YOU HAVE FALLEN

How to get up off the floor after a fall

2B) I CAN'T GET UP: WHAT TO DO IF YOU CAN'T GET UP

In a situation where you find you are unable to get up off the floor, ask yourself the following questions: 

Can I Attract Attention?

The first thing to do is see if there may be anyone close by who may be able to come to your help.

• Call out to someone near to assist you.

• If you have your phone or pendant alarm on you, use it to get help.

• If nobody is within close proximity and you don’t have your phone or pendant alarm on you, make loud noises in whatever way you can (e.g., if you use a walking stick, bang it on an object within reach), or call out as loud as you can to get the attention of those close by.

Attract the attention of someone for help.

CAN I GET COMFORTABLE?

If your calls for help go unanswered, it’s now time to make yourself comfortable (and warm) the best you can, as you may be in this position for some time until help arrives.

Use a nearby cushion, blanket, or a rolled-up piece of clothing and place it under your head as a pillow.

Can I Keep Warm?

You also want to keep yourself warm as best as you can.

• Cover yourself with anything nearby - clothing, a blanket or a rug if possible.

Use items close by to get comfortable/warm.

 Can I Keep Moving?

• Change positions regularly to avoid pressure on certain areas and pressure sores (your skin breaking down).

• Move all your joints to prevent stiffness and help with circulation.

• If your bladder is to "let go," roll away from any wet areas.

• Continue to keep making noise and yelling for help from time to time as someone may hear your calls.

• Wait patiently and calm until help arrives. Help will arrive eventually. You will be ok!

Keep your body moving.

HOW TO ASSIST SOMEONE WHO HAS FALLEN

Here are some general guidelines that you can use to assist someone who has fallen get back on their feet.

Note before: NEVER attempt to pick the person up. This could lead to further injury to the person who has fallen, or yourself getting injured or being pulled to the floor with the person.

Your job is only to help guide them in getting up. It’s essential you allow the fallen person to do the work. Never at any moment lift the person’s weight.

Never try to get a person up if they are injured - call emergency services. 

If the person is a resident in care, tell the staff immediately. 

1. The first step is to relax and stay calm when a friend or loved one has fallen. Do not try and get the person up straight away. You can place a pillow or something soft under their head while you assess the situation.

2. Determine if the person is in pain. Ask them. If they have pain, determine where it is and the severity.  Examine them for visible injuries like bleeding, bruises, broken bones or sprains. 

3. If they are injured, call emergency services. While you wait, keep them comfortable and warm.

4. If they don’t have any pain or injuries, get them to move their arms and legs gently. If they still don’t report any pain and think they can get up, you will now guide them gently and slowly in getting up. 

   If they can’t perform any of the below steps at any time, get stuck, experience pain or become too tired - stop!

5. Gently prompt the person to roll onto their side into a side-lying position. 

6. Now get two chairs which will be used to help get the person into a sitting position. Place one chair near their head and one chair near their feet.

7. Prompt the person to push up from the side-lying position onto their hand and forearm and then into a half-sitting position.

8. Now prompt the person to keep pushing up until they are in a crawl position, on all fours, facing the chair. If the person gets knee pain, you can place a cushion, towel or something soft under their knees to make this step more comfortable.

9. Direct the person to use the chair in front of them to help them get into a kneeling position on both knees. Only gently guide their movements.

10. Once on both knees, ask the person to bring one leg forward so they kneel on one leg with the other foot firmly on the floor. They should be in a kneeling lunge position with the chair in front of them and their hands on the chair, using it for support.

11. Now prompt them to push up with their arm and legs, using the chair in front of them to assist.

12. Once they are up, help guide them to sit on the chair behind them. 

13. Examine again for injuries. Falls can be a scary experience and they will usually be in a heightened state. Encourage them to relax until they are feeling calmer before they try standing up and walking around. 

14. Check the person can safely stand and walk before they are walking on their own.

15. Notify the person’s doctor of the fall and keep an eye out for any pain or signs of injury which may occur later.

SHOULD I TELL MY DOCTOR AFTER A FALL?

It is natural to want to downplay a fall after it has happened. It's common to think that a fall is an embarrassing indicator of decline or that it may now signal the need to rely on others for assistance. THIS IS NOT TRUE!

When you tell your doctor, they will check for any injuries you may have missed following the fall and assess your situation for the possible causes, which will help prevent future falls.

Yes, some changes may need to be made to ensure you prevent falls as much as possible. But all changes and measures taken by your doctor and other health professionals will be directed towards maintaining and improving your situation as best as possible for your ongoing independence.

Not telling your doctor may limit your independence in the long run as you may not get the appropriate support and interventions you require.

Don't just get up and shake it off… TELL YOUR DOCTOR OR OTHER HEALTH PROFESSIONAL ABOUT IT.

FINAL WORDS

And there we have it.

We have now covered everything required to decrease your risk of falling to a large extent and also prepare you if you were to fall.

If any new information comes up about falls, I will continue to update these pages so your falls prevention information is always up to date.

As you have seen in this guide, the thought of falling is scary, but many things can be done to prevent them. It does not have to affect your life. Do what needs to be done, and live your life as best you can.

For life is meant to be lived!

If you have any questions about falls, join the More Life Health Facebook Community. CLICK HERE to join.

For any updates and to ensure you are doing all you can to prevent falls, sign up to the More Life Health mailing list below. When you do, you'll be sent a free 4-week eBook to help you improve your health and fitness.

AND ONE MORE THING BEFORE YOU GO: MAKE SURE TO SHARE THIS FALLS PREVENTION SECTION.

Everyone over 60 should read this guide and be knowledgeable about falls. We all know falls are a huge problem.

Please share this article and the More Life Health website if you know anyone who would benefit from reading it.

It's now time to get out there and do everything that makes you happy.

Keep Active! Keep Happy! Keep Smiling!

- Mike

SOURCES

TO VIEW ALL SOURCES USED IN THIS ARTICLE AND FOR ADDITIONAL RESOURCES, CLICK HERE.

THE ULTIMATE GUIDE TO FALLS PREVENTION FOR SENIORS - PART 2

10 STEPS TO PREVENT FALLS FOR GOOD

In Part 1 of this Falls Prevention Guide we covered that falls are not just a normal part of ageing. We looked at how a falls cycle can develop and the risk factors associated with falling.

When we understand the factors that increase the risk of falling, we can eliminate or minimise them as much as possible, thus preventing falls.

This is what we will be doing in this section, Part 2. Taking the appropriate steps to prevent falls.

What we will be covering in Part 2:

• STEP 1: Stop What’s Putting You At Risk - Take Care and Ask For Help

• STEP 2: How To Exercise To Prevent Falls - The Best Exercise For Falls Prevention

• STEP 3: Improve Your Vision And Hearing To Prevent Falls

• STEP 4: The Best Shoes to Prevent Falls and How To Take Care Of Your Feet

• STEP 5: Simple Changes To Make In And Around Your Home To Prevent Falls

• STEP 6: Be Aware of Health Conditions and Medications Putting You At Risk of Falling

• STEP 7: Decrease Your Falls Risk With Good Nutrition

• STEP 8: Get A Good Night’s Sleep Naturally, Every Night

• STEP 9: Slow Down and Be Mindful To Prevent Falls

• STEP 10: Walking Aids & Assistive Devices - How They Can Help and How They May Put Your at Risk Of Falling

Before we start, if you feel you’re at risk of falling, maybe you’ve even had some near misses or have fallen. Do not keep this to yourself! Let your doctor know so you can determine why this is happening and can undertake what’s required to prevent further issues.

Furthermore, although I outline these 10 steps to decrease falls that you can follow, you should not and do not have to go it alone. Many services are available to help, which can be organised through your doctor.

STEP 1:STOP WHAT'S PUTTING YOU AT RISK - Take Care and Ask For help!

The first step in preventing falls is re-thinking how you do those tasks or habits that could put you at risk.

All of us are guilty of doing things we shouldn't.

Earlier in life, certain tasks you do, which could have little risk, aren't usually an issue. However, when physical abilities change over time, there is less room for error.

The tasks that could put you at risk of a fall change for each person and their capabilities.

Some examples could be using a ladder or a chair to perform specific tasks, such as changing a light bulb. We all know this can be dangerous. Or it could be as simple as not using a walking aid when you know you should be.

You may also not be aware you are putting yourself at risk.

Some habits may seem harmless but are a common cause of falling, e.g., not putting on seeing glasses, especially at night, when needing to go to the bathroom or reading something while walking, such as a magazine, mobile phone or tablet.

After many years of carrying out these tasks or habits, changing them can be difficult.

Moreover, being independent and self-sufficient throughout life, it isn't easy to rely on someone to now do jobs for you. We all want to know and show that we are still capable.

Sometimes you may know you should ask for help or want to ask for help, but the act of asking can be difficult. For many of us, asking isn't easy, and when we need to, it can be uncomfortable. You may feel that your requests could be silly, and you don't want to burden anyone or take up their time.

But there comes a time when you must do what's best for you and need to just swallow your pride…. If you need help with something, ask!

It takes little time for someone to change a light bulb for you, get some items from the top cupboard, or trim a tree branch every so often.

You don't want to fall doing something risky, and NO ONE wants something bad to happen to you. No one wants you to have a fall!

If you need help and want to ask, know it's ok. It isn't a loss of your independence, and you aren’t any less a person for not being able to do something and getting help.

You aren't a burden on anyone, and even if you are a slight burden on someone, WHO CARES!

You deserve the support for being there for others throughout your life, so put your feet up and enjoy watching someone help you for once.

DON'T BE AFRAID TO ASK FOR HELP!

OTHER OPTIONS - WHEN YOU DON'T HAVE HELP

If you live in a big city and have no one to ask for help or still can't shake the feeling you'll be a burden if you ask, you can speak to your doctor about what services are available to help you.

You can also get help through certain websites.

An example website is Airtasker (In Australia or UK). On these websites, you can pay reasonable rates to have someone do jobs for you.

You can put up absolutely any job you want to be done, such as painting your house, trimming a tree branch, or hanging a painting. Whatever!

Once you put your job up, people will give their offer, and you can then choose a suitable person.

There are different websites for different countries, so if you want a little help, search for a similar site in your country.

IT’S UP TO YOU TO CHANGE

Firstly, be aware of certain things you do that could put you at risk of falling.

If you know you are increasing your risk of falling by doing certain tasks or engaging in risky behaviours, make a conscious effort to stop or change these habits. One unexpected fall can make a considerable change to your life.

Take, for example, the glasses situation above. You may think it's not much of an issue not wearing your glasses at night. But it only takes one slip or trip from not seeing what's in front of you to cause a fall.

Start wearing your glasses at night and put them in easy-to-see and reach places like the top of your bedside table, so you remember to wear them.

Another example is reaching for items in hard-to-reach places like the top of your cupboard.

You may think standing on a chair is fine, although you've noticed your balance and coordination isn't as good as it once was. One moment of lapsed concentration, and you could fall off the chair. 

Put items currently in hard-to-reach places in easy-access cupboards (or get a friend or family member to place them there for you) or obtain a reach stick or step stool with a handle to be safe.

Think about tasks you are doing that could put you at risk and change them.

We will cover more of this in-depth in STEP 5: MAKING YOUR HOUSE FALLS PROOF.

RISK-TAKING & FALLS SUMMARY

• Eliminate the need to undertake risky behaviours and change habits to ensure you are safe.

• If you wear glasses, wear them, especially at night, and watch where you are going (and how you are moving).

• Improve your balance by taking steps to reverse the age-related decrease in your physical abilities.

• Don't be afraid to ask for help.

STEP 2: How To Exercise To Prevent Falls - The Best Exercise For Falls Prevention

Now that you're avoiding those things you do that could be putting yourself at risk, the next step…. and THE MOST IMPORTANT STEP, is to improve your physical abilities. 

The best way to do this is by increasing your overall activity levels and doing specific exercises to help prevent falls.

Not only will you decrease your falls risk by moving better, but you will also gain many other added benefits, including improved health and general well-being, looking and feeling younger and improved confidence.

It's never too late, or you are never too old to get active!

REMEMBER THIS: GETTING OLDER IS INEVITABLE; BECOMING FRAIL ISN'T!

As we get older, we must consider and accept factors out of our control. Changes in our body (physiological) do and will occur over time. We are never going to be like our much younger selves. We must accept this!

However, the main reason we see changes in our physical abilities as we get older is not because of the ageing process but because we do less as we age.

Common belief has it that "ageing" is the reason for these changes, but it's NOT!

Our life habits start involving less and less activity over time. As the years go on, we find ourselves sitting more and moving less. We find ourselves doing what's most comfortable and easiest.

With less movement and exercise, we start seeing a decline in physical abilities. 

As time goes on, the tasks you have always done become more difficult. It's also quite common to be worried about falling and getting injured, leading to further avoidance of activity. 

The decline in activity causes a decline in physical abilities over time!

The good news is: physical abilities can be retrained at ANY age!

This means that you can improve your physical abilities no matter your current capabilities or how old you are.

You just need to believe this and start getting active more so! And you don’t need to go it alone; a Physiotherapist can help!

If you start making a few changes, increasing your activity levels and exercise within your capabilities and progress over time, you WILL improve. You WILL get stronger, fitter and balance better!

You will begin seeing and noticing these changes.

Life will feel much more effortless!

Start exercising and start making improvements today!

When you improve your physical abilities, you want to focus on all aspects of physical fitness to help prevent falls.

The decline in physical abilities increasing the risk of falling and fall-related injuries, due to lack of activity and exercise, is illustrated in the diagram below.

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Physical changes (risk factors) that can lead to a fall and injury.

HOW TO IMPROVE YOUR PHYSICAL CONDITION

[Note: Always speak to your doctor before starting any exercise program or coming to any conclusions about your health. I recommend you see a Physiotherapist for an assessment to determine your falls risk, areas to be worked on and for an individualised exercise program].

When you undertake physical activity, you can improve and maintain all of these aspects of physical fitness shown in the diagram above.

Anything caused by lack of use can be re-trained and improved. 

You can improve your physical abilities and therefore decrease your falls risk.

So let's get started.

STEP 1) GET MOVING

You may have heard me say that one of the first and most important steps we should take to improve our health and life is to increase the amount of physical activity we are doing.

The same goes for preventing falls. The first and most crucial step in decreasing our chances of having a fall - is to just get moving!

We must get off the couch and move our bodies more often.

MOVEMENT IS HEALTH! MOVEMENT IS MEDICINE.

Find a physical activity that you enjoy doing or would like to do! And begin doing more of it!

You do need to do some extra specific exercises each week to improve your balance, strength, coordination, flexibility, cardiovascular fitness and posture (which we will cover below). Eventually, you'll start enjoying these too. But for now, focus on just increasing your activity levels each week.

By doing enjoyable activities, you'll get better results than any exercise program you don't enjoy doing. When it's enjoyable, you'll keep it up! 

You'll get the results without the stress of doing something that feels like a chore and stick to it.

Consistency is the key, and enjoyable activities bring consistency.

Find an activity that excites you and get moving!

Some ideas: Walking in nature, swimming, playing with the grandkids more often, trying a new activity - Tai Chi, dancing, lawn bowls, bocce, ten pin bowling, tennis, aqua aerobics, golf, tennis, yoga, cycling. The ideas are limitless. 

Find the inner child inside you! Get outdoors and enjoy what mother nature has to offer. 

If you're stuck on choosing activities, I recommend walking every day for at least 10 minutes to start.

Have fun on your walk. Do different types of walks. Attempt different terrains. Walk up stairs, down stairs, walk on grass or in the shallows and sand of your local beach. Go on safe bush walks. Walk faster. Slower.

These different terrains train your body in different ways without you knowing it. 

You are training your heart which will make you fitter; you are training different muscles in your body, which will make you stronger (even the little ones that help with balance); you are ensuring your joints don't stiffen up. You are also training your body to respond to different terrains. All abilities, when improved, will decrease your falls risk.

You are also doing wonders for your stress levels and mind; over time, you will improve your confidence. 

Obviously, don't get carried away and do too much too soon and don't try anything out of your capabilities (no risky behaviours, remember). Always start small, but also challenge yourself a little and increase how much you walk or do the activity over time. Give time for your body to adapt to the exercise you are doing.

Take breaks. Don't wear yourself out or push yourself too hard. Ask a friend or family member to come along for safety and to have some company. 

Take your walking aid if you need to. Be smart, be safe AND most importantly, enjoy it!

Always think of ways to incorporate more activity into your life and keep moving!

STEP 2) GET SPECIFIC, STAY CONSISTENT AND ALWAYS CHALLENGE YOURSELF

Once you've begun increasing your physical activity levels by doing activities you enjoy, it's important to incorporate specific exercises into your life each week. This will further decrease your falls risk and improve your physical abilities.

Your program should include a wide array of exercises to improve your balance, strengthen your whole body (with particular focus on your legs), improve your posture, flexibility, cardiovascular fitness, body awareness, and reaction time. These exercises will also keep your bones strong!

Once you begin incorporating specific exercises into your weekly routine, the next step is to make gradual progressions (continually challenging yourself), so you will continue to improve.

Ways to progress your exercises include increasing the number of repetitions, increasing the weights you are using, walking longer distances or doing more challenging exercises.

If you are new to exercise, the best place to start is with my 4-week exercise eBook, which covers all you need to get started. For a FREE copy, join the More Life Health Mailing list (click to Join); by signing up, you’ll have many other exercise videos, articles and more.

For exercises specifically for falls prevention, click HERE.

You will also find beginner exercise videos on this page HERE.

I also cover exercises for seniors in videos on the More Life Health YouTube Channel, so be sure you subscribe to the channel. Also, join the Facebook Support Community if you have any questions and to help you on your journey.

Let's start working on each aspect of your physical fitness to help prevent falls.

THE BEST EXERCISEs FOR FALLS PREVENTION

BALANCE EXERCISES TO PREVENT FALLS

Decreased balance, or becoming unsteady on your feet, makes it more challenging to carry on with your activities of daily life, making it much harder to remain upright without falling.

A loss of balance is one of the main reasons people fall over. 

HOW OFTEN TO DO BALANCE EXERCISES TO HELP PREVENT FALLS

Improving your balance is essential to decreasing your falls risk. So it is imperative to perform specific exercises at least three times a week, ideally each day, to prevent falls.

Only five minutes each day of dedicated and focused specific balance exercises will do wonders in helping you prevent falls. 

To improve your balance,  CLICK HERE for all the balance resources you need.

Also, make sure to check out my in-depth article THE STEADY SENIOR - THE COMPLETE GUIDE TO GREAT BALANCE OVER 60 (CLICK TO READ), which will give you everything you need to test and help you improve your balance.

And CLICK HERE for THE 10 BEST BALANCE EXERCISES FOR SENIORS.

STRENGTH EXERCISES TO PREVENT FALLS

Loss of muscle strength, specifically in the legs, is another major factor causing one to fall.

To decrease your falls risk, you MUST increase your leg (and core) strength which will also make your day-to-day tasks much easier. We use our legs in almost every task we do.

HOW OFTEN TO DO STRENGTH EXERCISES TO HELP PREVENT FALLS

If doing strength exercises is new to you, you will start seeing a difference by completing them at least twice weekly. Progress to three times per week and then every day over time. 

If using weights, resistance bands or other types of strength equipment, it’s always better to keep a day in between to allow your body to recover.

To improve your strength, CLICK HERE for all the strength resources you need.

Also, check out my in-depth article THE STRONG SENIOR: THE COMPLETE GUIDE TO GETTING STRONG AND STAYING STRONG OVER 60 (CLICK TO READ) which will help you get and stay stronger.

And CLICK HERE for the 10 BEST LEG EXERCISES FOR SENIORS.

IMPROVING FLEXIBILITY - STRETCHES TO PREVENT FALLS

Decreased flexibility makes movement more difficult, changing the natural movement pattern, which can increase falls risk.

To decrease your falls risk, you also want to improve your flexibility. 

HOW OFTEN TO STRETCH TO HELP PREVENT FALLS

A simple 10-minute gentle stretch routine will do wonders to help you improve your flexibility and help you to feel better and will go a long way to help you prevent falls.

You will find 10-minute stretch routines on this page HERE - STRETCHES FOR SENIORS which also includes many other videos for stretches to help you prevent falls.

Also, check out my in-depth article THE SUPPLE SENIOR - REGAINING FLEXIBILITY AFTER 60 - A STEP BY STEP GUIDE (CLICK TO READ) to help improve your flexibility.

CARDIOVASCULAR FITNESS AND FALLS PREVENTION

With decreased fitness comes breathlessness and faster muscle fatigue. When you are more tired from the activity, you are doing and your muscles fatigue more quickly, this increases your risk of falling due to your inability to handle the demands that the task requires.

To improve your cardiovascular fitness, start slowly and progressively increase your activity levels AND begin doing the More Life Health exercise videos.

HOW MUCH CARDIO TO HELP PREVENT FALLS

To improve cardiovascular fitness, you want to exercise at least three times per week at an intensity that gets the heart rate up.

A simple way to know the intensity of the exercise you are undertaking you can use a Rating of Perceived Exertion (RPE) Scale.

To learn more about the RPE Scale, I cover this in the exercise section of my article: BETTER BREATHING: IMPROVING THE HEALTH OF YOUR LUNGS OVER 60 (CLICK TO READ).

A simple way to improve your fitness is regular brisk walks.

For more on walking and doing it safely, check out my article: ALL ABOUT WALKING: HOW TO WALK MORE WITHOUT PAIN!

TO DOWNLOAD and PRINT an RPE scale to use, you can do this HERE.

POSTURE EXERCISES TO PREVENT FALLS

Over a lifetime of poor postural habits and a lack of proper activity, changes in posture occur (such as rounded shoulders, forward head, etc.).

This change in posture changes your centre of mass, making it much harder to maintain balance.

To improve your posture, CLICK HERE FOR POSTURE EXERCISES and more to help you improve your posture, which can help you prevent falls.

Aim to incorporate these exercises into your exercise routines at least three times per week to see improvements.

OTHER FACTORS OF PHYSICAL FITNESS TO IMPROVE

REACTION TIME EXERCISES AND FALLS PREVENTION

When younger, if something unexpected happened, e.g., you were to step on uneven ground, you were bumped accidentally, or something like a cat or dog would get between your feet - you could react much more quickly. Your body would unconsciously react and undertake the required movements to respond to these unexpected situations.

If we do not continue to move sufficiently as we get older, the messages sent from our senses to our brain to evoke a response - become much slower and hence a slower reaction time. This means a higher chance of falling due to the inability to react, as required, to external situations.

PROPRIOCEPTION AND FALLS PREVENTION

Proprioception is the ability to sense or be aware of where our arms and legs are in space. Take, for example, lifting your foot to clear an obstacle on the floor but thinking your foot was much higher than what it actually was. This can cause a trip hazard.

Over time, this awareness can decrease, making it more challenging to know where our arms and legs are in regard to our environment; this can increase the risk of having a fall.

Your reaction time and proprioception will improve as you stay consistent with the exercises.

BEING OVER/UNDER WEIGHT AND FALLS PREVENTION

When we do less activity and consume excess calories, we'll put on weight (usually fat).

On the other hand, and less commonly, some people may lose weight from a lack of activity and calories. In an already frail person, this can cause many issues.

Being overweight or underweight can put you at a higher risk of falling. When overweight, movement may be more difficult, fatigue levels increase, and balance may decrease.

When underweight, there is usually a loss of strength and muscle mass, leading to a higher falls risk. There is also a higher chance of a fracture during a fall.

To maintain as close to optimal weight as possible, exercise and nutrition is essential. Stay consistent with the exercises and speak to your doctor or a nutritionist to get you started on a healthy diet to help.

BRITTLE BONES AND FALLS

This is not so much a contributor to falls but more a reason why injuries are more severe following a fall.

Healthy and strong bones decrease the chances of fracture following a fall.

For more on improving bone density, check out my three-part article on healthy bones, THE COMPLETE GUIDE TO STRONG BONES OVER 60 (PART 1).

HOW MUCH EXERCISE TO PREVENT FALLS

After reading this section, you may be a little overwhelmed at all these different components of fitness and what’s recommended to improve each component to decrease your risk of falls.

Keep it simple so you don’t get overwhelmed. It will all start making sense as you stay consistent and dedicate time each week to completing exercise.

I recommend completing exercises at least 3-4 times a week and aim to do at least 20-30 minutes on these days. 

Always start slow and gradually increase the amount you are doing. Always give your body adequate rest between sessions.

And stay consistent. This is not a sprint! Treat movement as medicine for your body. Something you should be doing each week, without fail!

You can do it!

PHYSICAL EXERCISE AND FALLS SUMMARY

• Being active and doing exercises is the most important step you can take to decrease your risk of falls.

• Increasing your weekly physical activity is the first step to improving your physical capabilities.

• The second step to decreasing your falls risk is doing specific exercises.

• The third step is staying consistent and slowly progressing your exercise over time.

• For exercises specifically for falls prevention, you will find them on this page HERE.

• To make it easier for you to keep exercising, join the More Life Health Support Community and the More Life Health mailing list for a FREE 4-week exercise ebook to help get you started and regular workouts, health tips and more sent to your inbox.

• For generalised exercise videos that cover all components of fitness, head to the Exercise section of the More Life Health website, which offers an array of exercises to get you started and keep you going.

• I also cover exercises for seniors in YouTube videos on the Facebook page. So make sure you subscribe to both.

• Following these workouts and increasing your physical activity will decrease your falls risk. Plus, give you many more added benefits that come with exercise.

STEP 3: IMPROVE YOUR VISION AND HEARING TO PREVENT FALLS

The next step in preventing falls is to ensure your vision and hearing are the best they can be.

I'm sure it is no surprise that low vision increases falls risk. A little more surprising, however, is that hearing loss can increase falls risk also.

Both vision and hearing decline as we age. However, the good news is that there are ways to improve your sight and hearing which will decrease your falls risk.

VISION LOSS AND FALLS IN SENIORS

There are many causes of low vision as we age; the good news is, in most cases, the causes are treatable. They can be fixed!

A significant cause of vision-related falls is cataracts which, after surgery, can improve vision and decrease falls risk.

Another cause of vision-related falls is wearing bifocal and multifocal/progressive glasses (glasses with different focal lengths in the same pair). Falls due to this issue are even seen in people who have worn these glasses for a long time.

However, this does NOT mean you need to immediately obtain single-vision glasses and throw away your multifocal ones!

Although the data is clear on this issue, the solution is not so straightforward and is dependent on several factors, e.g., your general health and mobility; if you have fallen in the last year; how often and where you use your glasses, particularly outside the home and if you have any problems with steps or stairs [1]. Based on these factors, you and your optometrist may decide that having an additional pair of single-vision glasses for use outside the home and/or on stairs may reduce your falls risk [2].

Bifocals, multifocal and reading glasses can impair the ability to see the distance between objects (aka depth perception) and the ability to distinguish two similarly coloured objects between each other or their environment (aka our contrast sensitivity).

When depth perception decreases, it is more difficult to know how far away items are. This makes it hard to navigate surroundings and increases the likelihood of bumping into objects, such as furniture or walls.

Additionally, depth perception allows us to determine how fast an object moves toward us. Think about how important this is when crossing a road or driving a car.

Decreased contrast sensitivity, on the other hand, makes it difficult to distinguish between objects. For example - trying to see a dark object in a dimly lit room or when stepping down from a curb/pavement when the pavement is the same, i.e., the contrast is poor between the curb and the street.

Or walking down a whole flight of the same coloured steps - with a decreased ability to differentiate the contrast of the steps, the stairs may start blurring together.

These three common tasks become difficult with a decline in contrast sensitivity.

FALLS HAZARD: With poor contrast sensitivity, stairs like this become hard to differentiate.

SAFER STAIRS: Easier to differentiate, and with grip to help avoid slips.

MORE TIPS FOR DECREASING FALLS RISK & VISION

Get a yearly check-up by an optometrist to make sure there you don’t have any underlying eye issues.

As said earlier, the majority of low vision issues are treatable. For more on healthy eyes, make sure to read my article: HOW TO CARE FOR YOUR EYES AFTER 60.

Keep in mind that when you receive new glasses or a change in your lens prescription, your risk of falls increases temporarily.

Objects may now appear smaller and further away than they are, or it could be the opposite effect and objects now look bigger and closer than they are. This magnification can change the way you walk and can make it difficult on stairs.

If you have been given a new pair of glasses, or have new lenses, be aware that it may take some time to get used to them. It’s a good idea to wear them in a familiar place first, i.e., your home, before going into unfamiliar territory. Be patient and allow your eyes to adapt.

If you wear bifocal or multifocal glasses and spend a lot of time in outdoor activities, or in unfamiliar settings or have difficulty with steps/stairs it’s a good idea to speak to your optometrist about supplying a pair of single-vision glasses [3]. This is an effective way to help prevent falls.

To further optimise your vision with the help of an optometrist, there are certain alterations you can make around the house to help you see hazards and decrease your falls risk. We will cover this further in step 5 (Making Your House and Yard Falls Proof).

VISION LOSS AND FALLS SUMMARY

• The majority of the causes of age-related low vision are treatable.

• Aim to see an optometrist at least yearly.

• Bifocal, multifocal and reading glasses increase falls risk.

• Single vision lenses are an effective way to help prevent falls outdoors, on steps or stairs and in unfamiliar environments.

• New glasses take a while to get used to. Wear your new glasses in familiar places first.

• Ensure adequate lighting in low contrast areas such as stairs.

HEARING LOSS AND FALLS IN SENIORS

Many Health Professionals dismiss poor hearing for playing a part in falls, and 95% of the material for preventing falls neglects hearing loss as a point of focus.

However, hearing loss can play a role in putting you at risk of a fall.

In a 2012 study, researchers determined that even a small loss in hearing (from no hearing loss to mild hearing loss) can TRIPLE the risk of having an accidental fall. This risk increases with more significant hearing loss, making hearing loss a risk factor that must not be ignored.

When hearing is lost, a whole lot more energy is used up dealing with the added stress hearing loss places on someone. Fatigue sets in much sooner, making it more challenging to maintain balance and the adequate strength required to respond if needed.

Furthermore, with decreased hearing, not having the full ability to stay aware also increases the risk of falling.

HOW TO DECREASE FALLS RISK FROM HEARING LOSS

Improving your hearing can help you prevent falls.

The first step is to get your hearing checked regularly (every two years) by an audiologist.

If diagnosed with hearing loss, hearing aids most likely work to prevent falls in addition to other benefits, e.g., improved communication, health and quality of life [4, 5].

If you have hearing aids, make sure you wear them and make sure you regularly clean and service them. If you have difficulties doing this, get a friend or family member to help you.

HEARING LOSS & FALLS SUMMARY

• Even a slight loss in hearing can dramatically increase the risk of falls.

• Hearing loss places extra physical and mental stress on you and decreases your ability to respond to your environment.

• Wearing hearing aids can improve balance and decrease falls risk.

• Make sure to regularly clean and service hearing aids

STEP 4: The Best Shoes to Prevent Falls and How To Take Care Of Your Feet

Do you ever take the time to look after your feet?

Or, have you ever stopped to think if your shoes could be putting you at risk of having a fall?

It’s a good idea to understand how the shoes you are wearing (and the health of your feet) could put you at risk of falling and how to provide your feet with some care to help prevent falls.

SHOES AND FALLS RISK IN SENIORS

The quality of your shoes and particular shoes can play a big part in increasing falls risk. 

The characteristics of a shoe which could be putting you are risk of falling are:

WORN, LOOSE OR BACKLESS SHOES/SLIPPERS

Worn or shoes stretched out of shape become a slip and trip hazard. When they become like this, you should replace them.

If your shoes are too big for your feet, or you spend a lot of time in your slippers or backless shoes, these shoes can slip off your feet, becoming a trip hazard and increasing your risk of falls.

THONGS (AKA FLIP FLOPS OR JANDALS)

In Australia, we call footwear like the below picture thongs.

In other parts of the world, they are called flip flops (USA) or jandals (NZ). And I am sure they have different names in different parts of the world.

If you're anything like me and love wearing thongs (the type that goes on your feet) during summer, you must know that these can be difficult to keep on your feet at times and can trip you up.

Safer alternatives are sandals with a velcro back strap, or buckle, which will allow you to move around freely and keep them on your feet.

Flip Flops (thongs) - a trip hazard

Safer alternative to flip flops (with fasteners)

SHOES WITH SOFT OR WORN SOLES

Shoes with worn or soft soles can cause slips, especially in wet weather. 

If the soles of your shoes are worn thin or soft, get them re-soled or purchase a new pair.

HIGH HEELS OR PLATFORM SHOES

When wearing high-heeled shoes, there is less contact with the shoe to the ground. This makes you less stable and puts you at a higher risk of falling.

Some women find it hard to let go of wearing high-heeled shoes, but these shoes are not suitable for your feet, and by wearing safer shoes, you can decrease your falls risk.

Worn soles can cause slips

A falls risk, for obvious reasons

Replacing potentially unsafe shoes with safer shoes will go a long way in keeping yourself from falling.

When purchasing a new pair of shoes, it's a good idea to buy a pair of shoes that protect you from having a fall. So let's now look at what makes up a safe shoe to help you prevent falls.

View fullsize

What Makes a Safe Shoe

• Firm heel cup - to improve stability while walking.

• Laces, buckles or Velcro fastening - Hold the shoes to your feet, avoiding any tripping hazards. Velcro or clips are best for those with decreased hand or finger dexterity.

• Firm but thin soles will give your brain great feedback when walking as it allows your feet to 'read' the underlying surface.

• Textured sole/tread to prevent slipping.

• Correct length to allow normal foot function.

• Low and wide heel to increase contact with the ground.

• Bevelled heel to prevent slipping.

• Wide toe box - If you suffer from bunions or pain in the ball of your feet, a wider toe box (the section where your toes sit) can give your toes the room they need. This will provide greater comfort and can decrease falls risk.

Now I know these shoes won't always be as pleasant on the eye as other shoes, but they'll go a long way to keeping you on your feet.

OTHER FOOT-RELATED FACTORS THAT CAN CONTRIBUTE TO A FALL

Besides your footwear, other factors related to your feet could put you at risk of falling.

BARE FEET AND SOCKS 

Bare feet and wearing socks make you more prone to slipping than with shoes on. 

As we age, the grips on our feet can decrease.  

If you’re at risk of falling, wear footwear with appropriate tread to help prevent slips

If you want to wear socks, grab some non-skid socks, which will help stop you from slipping. 

ENSURE APPROPRIATE FOOTWEAR  

Get into the habit of wearing appropriate and safe footwear for the type of activity you are doing. 

CERTAIN FOOT CONDITIONS 

Pain, decreased sensation, claw toes, bunions and ingrown toenails can increase your risk of falling by changing your gait and affecting your balance. 

If you have any of the above issues, see your Doctor or Podiatrist, who can help eliminate and manage these foot conditions. A podiatrist can also fit you with appropriate shoes.

SIMPLE FOOT CARE ROUTINE FOR SENIORS

In addition to ensuring proper footwear and taking care of any conditions of your feet, you can improve the health of your feet to decrease your falls risk by undertaking simple foot care each week.

Here are some ways to help take care of your feet.

• Inspect your feet and nails every week.

• Cut your toenails regularly, or book in with a Podiatrist who can do this for you. (If you have a nail condition, a Podiatrist may be required to cut your nails).

• Wash your feet using a mild soap daily.

• Always dry your feet thoroughly after showering or sweating to prevent infection.

• Apply a good quality moisturiser to keep the skin on your feet healthy and prevent any dry, itchy or cracked feet.

• Wear appropriately fitted shoes with the features of a safe shoe (see diagram above).

• Wear good quality, breathable socks.

• Book and attend regular Podiatrist visits, if required.

SHOES, FOOT CARE AND FALLS PREVENTION SUMMARY

• Particular shoes can put you at risk of falling.

• To decrease your risk of falling, wear shoes that can reduce your risk and keep your feet healthy.

• Walking without shoes, wearing socks without grip, and conditions of the feet can increase your risk of having a fall.

• Following a simple foot care routine, like the one above, can decrease your risk of falling and keep your feet healthy and looking good.

• Regular appointments with a Podiatrist can help keep your feet in good condition, and they can advise on appropriate footwear for you.

STEP 5: Simple Changes To Make In and Around Your Home to Prevent Falls

PREVENTING FALLS IN THE HOUSE AND YARD

It's now time we focus on making the environment you spend most of your time safer.

We will now identify hazards in and around your house that could put you at risk of falling.

We will then get into ways to eliminate the risk, decreasing your chances of having a fall.

Some of these tasks listed below will be too difficult to undertake on your own, so help will be required. Additionally, your doctor may be able to organise an Occupational Therapist to assess your home and help make the appropriate changes to decrease your falls risk, so speak to your doctor about this.

FALLS HAZARDS IN THE HOME

Before we go into specific risk factors common around homes and backyards, I want you to remember an acronym to help you be aware of environmental risk factors that could put you at risk of a fall.

That is, F.L.A.T.S.

FEET – Your feet could be putting you at risk of a fall. Wear appropriate footwear (see step 4) to ensure you don't fall. 

If you like to wear socks, make sure they are non-slip socks and know that wearing no shoes on certain surfaces could increase your risk.

LIGHTS – Take extra care in low light areas and remember to put on your glasses, especially at night. (see step 3).

ACTIVITIES (RISKY ACTIVITIES) – Rather than performing behaviours that could be risky – ask for help (see step 1).

 Specific assistive devices can help you with certain tasks while decreasing fall risk. (Step 9).

TRIPS – Remove clutter and keep your house clear of trip hazards such as toys, rugs and cords. 

If you have one or more pets, always be aware of their whereabouts (discussed below).

SLIPS - Consider using non-slip products to remove risk in slippery areas. Mop up any spills quickly (the main areas of concern are your bathroom and kitchen).

We'll now get into the specific fixes you can make around the house to decrease your falls risk.

PREVENTING FALLS IN THE HOUSE

KEEP WALKWAYS TIDY AND FREE FROM TRIP/SLIP HAZARDS

• Check that all carpets or rugs are fixed firmly to the floor so they won’t become a trip hazard. Don’t use throw rugs or small area rugs as they are a known trip hazard.

• Remove or fasten loose electrical and telephone cords. Keep them away from walking paths. Use cable covers to cover loose cables that cannot be removed or secured (see next section).

• Remove clutter -Always tidy up toys, paper, books, clothes, shoes etc., keeping them out of walking paths.

• Your animal could be a potential trip hazard. Always keep a lookout for your pets and stay aware of their whereabouts when walking.

• Put non-slip strips on tile and wooden floors. These can be bought at your local hardware store.

• Arrange your furniture, especially low coffee tables and other items, so they are not a potential trip hazard.

• Keep off newly washed floors. Allow them to dry.

• Wipe up spills as soon as they occur.

• If there is broken glass, clean it up immediately.

ELIMINATE THE NEED TO UNDERTAKE RISKY ACTIVITIES/TASKS

• Keep those items you often use in easy-to-reach places or cupboards.

• Use a “reach stick” to get items in hard-to-reach places.

• Never stand on a chair, table or step ladder to get those items in hard-to-reach areas.

• If you need to use a stool to step on, make sure it is sturdy with a handrail (see next section).

• If you need to perform a task that could be putting you at risk of a fall, ensure you have someone to assist for safety reasons. Remember: it’s ok to ask for help (see step 1).

• Ensure that your couch or your chairs are not bucket-style, making it difficult for you to get in and out. Your couch and chairs should be the right height for you to easily get in and out of.

• As mentioned earlier, one of the most common places to fall is next to the bed when needing to move around at night (usually having to go to the bathroom in the middle of the night). Have light switches/lamps, telephone, your seeing glasses and mobility aid (if required) close to your bed to decrease your risk of falling in this situation.

ENSURE YOU CAN SEE WELL AT ALL TIMES

• Avoid walking in the dark. Ensure there is adequate lighting in all places throughout your house and backyard.

• Use night lights and consider motion-sensor lights.

• Remember to wear your glasses at all times, especially at night. Put them on if you wake after sleeping and need to get out of bed.

• Remember to use the lights and ensure the switches are in easy-to-reach places.

• If lighting is poor, take extra care.

• Do your best to avoid walking in the dark.

WEAR APPROPRIATE FOOTWEAR

• See previous step (step 4) above.

PREVENTING FALLS IN THE BATHROOM (& KITCHEN)

ELIMINATE SLIP HAZARDS

• Wipe up spills quickly.

• Place non-slip mats in areas that are commonly wet. Consider using a non-slip mat or strips in the shower.

• If using rugs on tiles, consider non-slip underlay or non-slip rugs.

• Use FIRMLY FIXED grab rails on the inside of your shower, bath and near toilets. DO NOT use suction cup grab rails; these can be dangerous. Over time they may be unable to withstand the force placed upon them and become unstuck.

• Keep the thermostat of your water heater set at 50 degrees Celsius (120 Fahrenheit) or lower to avoid scalding your skin and a frenzied reaction to the heat.

• Place a night light in your bathroom.

• If you have difficulty getting off the toilet, use a toilet seat riser to make it easier to get on and off.

PREVENTING FALLS ON STAIRWAYS

MAKING CHANGES TO YOUR STAIRWAYS TO PREVENT FALLS

• Place handrails on at least one side of the stairs, preferably both sides. Handrails should extend the whole length of the staircase and beyond the first and last steps.

• Ensure handrails on the stairs are tightly fastened.

• Ensure stairs are free of clutter or trip hazards at all times.

• Ensure adequate lighting in stairways. Improve the lighting on your stairs.

• If you have difficulty distinguishing your steps from one another, even with good lighting, place brightly coloured tape on the steps for improved contrast.

• Hold the handrails when going up and down stairs.

• When carrying objects while moving up and down stairs, hold on to the object with one hand and use the handrail with the other.

• Don’t let what you are carrying block your view.

• Improve your leg strength and muscular endurance if you have difficulty walking stairs.

PREVENTING FALLS IN YOUR YARD

Falls occur more frequently outdoors than indoors (1).

Being outdoors is something everyone should be enjoying; however, the outdoors presents potential hazards.

There are trip hazards, possible slip hazards, different terrains, uneven footpaths, gravel, and possible holes (some hidden from view). There are curbs to step up, cars, bikes, streets to cross, different-sized steps, and kids on scooters or balls being kicked about. These are some of the many potential fall hazards!

It's always important to be alert when outside and take extra care.

HOW TO PREVENT FALLS IN THE YARD

ELIMINATE SLIP HAZARDS

Keep garden areas and backyard free from moss; it is slippery. 

If certain areas of your yard are known to get wet and slippery (for example, your pool area), consider non-slip sealers for the tiles or place non-slip strips or mats around the pool area.

ELIMINATE TRIP HAZARDS

Look out for and eliminate any loose pavements, pots, toys or other trip hazards (such as exposed tree roots or backyard items).

TAKE CARE WHEN ON STAIRS

Examine your outdoor stairs and decide if any of the tips for altering indoor stairs (mentioned above) are required to prevent falls.

USE THE RIGHT ASSISTIVE DEVICES

Sometimes a walking aid may not be required when indoors, but when outside, due to the inconsistencies and unfamiliarity, one may be required.

Take a walker or walking stick (if required) to increase your confidence, help with balance, improve your walking and decrease your falls risk when outside.

WEAR APPROPRIATE FOOTWEAR WHEN OUTSIDE

See previous step (step 4) above.

STEP 6: Be Aware of Health Conditions and Medications that put you at risk of falls

HEALTH CONDITIONS AND FALLS PREVENTION

The next step in preventing falls is knowing how specific health ailments, medical conditions, and medications can put you at risk of falling.

By being informed and understanding the risks, you can take preventive measures to ensure you prevent falling the best you can.

HEALTH AILMENTS & MEDICAL CONDITIONS

Certain medical conditions can increase falls risk.

These medical conditions include Parkinson's disease, dementia, arthritis, osteoporosis, diabetes (impacting the sensation in feet), postural hypotension (drop in blood pressure when standing resulting in dizziness and/or fainting unexpectedly), foot problems, incontinence, vision and hearing loss.

Additionally, if you feel under the weather with a cold or flu (or other viruses) or are in pain, you are at a higher risk of falling.

In this section, I will be covering the most common:

• COLDS & FLU AND FALLS

• INFECTION AND FALLS

• PAIN AND FALLS

• DIZZINESS/VERTIGO/LIGHTHEADEDNESS/POSTURAL HYPOTENSION AND FALLS

• INCONTINENCE & FREQUENT URINATION, AND FALLS

• MEDICATIONS AND FALLS

COLD & FLU AND FALLS

When we get sick or are feeling under the weather, we are usually much weaker, our balance may be off, our muscles ache, and we may also experience dizziness.

This makes it not surprising that the incidence of falling is increased when sick with a cold or the flu.

When we are sick, our body is sending warning signals, letting us know it's not well and needs rest and recuperation to get back to good health.

It's the most crucial time to give our body the care it requires to ensure we get back to good health as soon as possible.

By this, I mean eating well, staying hydrated, getting sunlight, staying stress-free and resting up!

Besides small amounts of gentle walking and stretching, which will make you feel better; everything else can wait!

When you have a cold or flu, this isn't the time to be pushing yourself to continue with all the exercise and physical activity you've been doing or get into some heavy chores. Save this for when feeling better.

Understand that your falls risk increases when sick with the cold and flu.

Take caution, be patient, rest up and once feeling better, you can get back into your usual activities like you were once doing when not feeling under the weather.

INFECTION AND FALLS

Another health ailment that can hit unexpectedly and put us at risk of falling is infections.

The effect an infection can have on us as we get older usually comes as quite a surprise.

We think a minor infection, although important to get treated, is not such a big deal. We can just go to the doctor and take some antibiotics, which will take care of it.

However, among other symptoms, infections can lower blood pressure and cause dizziness and lightheadedness, all of which increase the risk of a fall.

This goes for ALL people. Although infections increase as we age and in those with dementia, these symptoms also occur in people under 65 [1].

The most common type of infection that leads to a fall is a urinary tract infection (UTI) [1]. This infection is most common in women, and susceptibility increases with age.

If you're feeling under the weather, it's always best to see your doctor and get checked for any infection. Know that if you do have an infection, you're at a higher risk of having a fall, so take extra care until the infection has subsided.

Healthy habits, exercising and eating well decrease the chances of infection. Keeping your pelvic floor muscles strong will also aid in helping to reduce recurrent UTI infections.

PAIN AND FALLS

Being in pain also increases your risk of having a fall. Pain can either be short-term from a recent injury or surgery (aka acute pain). 

Or pain can also be long-term. Pain that has been with us for some time (aka chronic pain). Common chronic conditions that can cause pain over the long term could be osteoarthritis or osteoporosis.

When we are in pain, our bodies don't work like they are supposed to, and our bodies compensate in certain ways to avoid aggravating the painful areas.

ACUTE PAIN

When dealing with an acute episode of pain, it is another instance of your body trying to protect the area. What's required is resting the area, utilising any pain-management techniques and providing adequate nutrition to allow the body's tissues to heal.

As per your doctor, analgesia may be required, at times, to manage pain. If taking medication for pain, know that certain analgesia medications, especially the stronger ones, may have side effects which put you at an even higher risk of falling.

Speak to your doctor about this and, if taking medications, have greater awareness and take extra care during this time.

CHRONIC PAIN

On the other hand, for chronic pain or pain that has been with you for some time, REST is not the answer and a different holistic approach is required to get your pain under control. It can be done! Don't believe anyone who says you have to just put up with the pain; there is always something that can be done to help you with your pain symptoms.

For more about pain and to help you overcome it, read the four-part pain series here. 

PAIN IS NOT AN INEVITABLE PART OF AGING. YOU DO NOT HAVE TO BE IN PAIN

By getting your pain under control, your chances of having a fall will decrease.

DIZZINESS, VERTIGO & LIGHTHEADEDNESs AND FALLS

Vertigo is a type of dizziness, which is the feeling that your head or the room is spinning, or lightheadedness, which is the feeling that you are about to faint. Vertigo has a rotational element. Lightheadedness has no rotational element.

As we age, our body systems lose effectiveness. This leads to disrupted sensation, balance and visual inputs to our Vestibular System (system of the inner ear). This system is responsible for helping us stay standing.

When this system is not working as it should, dizziness or vertigo can develop and the risk of falling increases.

Although many different medical conditions can cause dizziness, the leading cause is disorders of the inner ear, with Benign Paroxysmal Positional Vertigo (BPPV) being the most common cause. The good news is this condition is treatable [2].

Additionally, the effects of anxiety and depression and making changes in your life (e.g., taking new medications or wearing new glasses) may lead to dizziness, and further increase falls risk [3].

As mentioned earlier, this is not normal, and the underlying cause of the dizziness must be found and eliminated. Speak to your doctor, so the underlying issues are determined and treated.

By working with your doctor, or other specialists, to help treat dizziness, your risk of falling will decrease.

POSTURAL HYPOTENSION AND FALLS

Postural hypotension is caused by a drop in blood pressure when moving from lying down or sitting to standing. Due to this drop in blood pressure, dizziness or even fainting can occur, putting one at risk of falling.

If you have experienced these symptoms before, see your doctor immediately to get to the cause of this low blood pressure.

Always take your time when standing from a seated or a lying position. Never rush straight into walking.

Stand up. Take a few deep breaths, and assess how you feel before slowly walking.

For any cases of dizziness, you may require a mobility aid for safety when getting about.

INCONTINENCE AND FREQUENT URINATION

Problems with bowel and bladder control can impact the ability to stay active, healthy and independent.

Urinary incontinence (or when the bladder lets go) is a falls risk, and the following factors can cause this:

INCREASED RUSH COMBINED WITH DECREASED PHYSICAL ABILITIES

With decreased physical abilities such as poor balance, poor vision (especially at night), decreased lower limb strength and/or poor walking ability, reaching the toilet in time when needed may be challenging. Reduced physical abilities combined with the need to rush to the bathroom is a fall waiting to happen.

Additionally, with age, hand and finger function may decrease. This makes tasks, such as removing clothing for the toilet, more difficult; increasing the need to rush to get to the bathroom in time and the high possibility of making risky moves in this frantic movement.

On the other hand, you don't want to get caught in the cycle of doing less activity and being less social to avoid an embarrassing situation. Doing this leads to further loss of physical abilities and additional problems.

MEDICATIONS FOR INCONTINENCE

Some medications used to treat incontinence can cause postural hypotension, a factor that can cause a fall. 

NEEDING TO GO TO THE TOILET AT NIGHT

Waking at night to go to the toilet puts you at higher risk due to the darkness, and it can also result in inadequate sleep, which is also associated with increased fall risk.

STRATEGIES TO REDUCE FALLS RISK FROM INCONTINENCE, FREQUENT URINATION & FALLS

• Familiarise yourself with the strategies above and start actioning them.

• Strengthen your pelvic floor muscles.

• If incontinence is becoming an issue for you, speak to a doctor, continence advisor or specialist.

• Improve your physical abilities (walking, strength and balance).

• Improve your hand and finger function.

• Do not avoid life. Keep socialising and continue with your normal daily activities.

• Wear clothes that are easy to remove or get undone.

• Use pads to avoid any embarrassing situations.

• Keep the pathway to the toilet obstacle-free and leave a nightlight in the bedroom/bathroom at night.

• If you wear spectacles, make sure you put them on at night when waking to go to the bathroom.

• Take your time when going from lying/sitting to standing. Take deep breaths, and get your balance before moving.

For more on the pelvic floor, including pelvic floor dysfunction, managing incontinence, and pelvic floor strengthening exercises, read THE OVER 60s GUIDE TO THE PELVIC FLOOR & HOW TO STRENGTHEN THE PELVIC FLOOR.

MEDICATION AND FALLS

Another area regarding falls risk that needs to be covered is the medications taken.

There are two factors regarding medications and falls risk that require caution.

The first and the most risk factor is too high an initial dose when starting a new medication. When this is the case, the side effects could impair your physical abilities and give other unwanted symptoms increasing your risk of falling.

The second is the number of medications you take. Even taking just one medication may increase your risk of falling. This risk increases with each medication you take, and taking more than four medications raises your risk significantly [4].

REDUCING FALLS RISK & MEDICATIONS

The risks of falls can easily be minimised by being very careful when starting a new medication and taking extra care until you see what effect the medication will have on you.

If you take four or more medications or any medications for sleeping issues, depression or anxiety, speak to your doctor. Discuss having your medication reviewed and gradually reduced/discontinued to non–pharmacological alternatives if this is possible.

Natural/non-pharmacological alternatives to medications for sleeping issues, depression and anxiety include:

• Getting more exercise/physical activity (step 3).

• Getting your sleep habits in order (step 8).

• More time spent on relaxation and mindfulness. Find what works for you to help you relax (step 9).

• Getting support and reassurance – speak to family members and friends more often.

HEALTH AILMENTS, MEDICATION AND FALLS RISK SUMMARY

• Specific health ailments and medical conditions, both acute and chronic, can put you at risk of falling.

• Proper caution should be taken when unwell, and strategies to minimise the effects of each health ailment or medical condition should be undertaken.

• Your doctor should discover the root cause of your health ailments so they can be treated sufficiently and your falls risk decreased.

• More than one medication and certain medications can increase your falls risk.

• If you take four or more medications or any medications for sleeping issues, depression or anxiety, speak to your doctor. Discuss having your medication reviewed and gradually reduced/discontinued to non–pharmacological alternatives if this is possible.

STEP 7: DECREASE YOUR FALLS RISK WITH GOOD NUTRITION

(Your SIMPLE GUIDE TO NUTRITION, CALCIUM, VITAMIN D, ALCOHOL AND THE EFFECT OF NUTRITION on FALLS)

It's important now we discuss nutrition and how we eat can improve our health and can also play a role in preventing falls.

We know that what we eat is very important for general health. But these same effects that good nutrition has on our health also decrease our chances of having a fall.

Healthy eating keeps our muscles strong, our minds alert and also gives our bones the nutrients they need to stay strong.  

When we increase our physical activity and exercise, our metabolic demands increase. What this means is we should ensure we are getting adequate nutrition.

We want the nutrients required to keep us healthy and the energy to fuel our body, undertake daily activities and help make us stronger and healthier versions of ourselves.

Nutrition is a large and complex topic. Learning what's required to improve your life can take some time, but when you do and put what you have learnt into action, you will see the results. 

I have written some simple-to-read articles on nutrition over the years and given guidelines to help you keep healthy and help decrease falls.

NUTRITION & PREVENTING FALLS

To get started with a basic understanding of nutrition, make sure to read my article: 

• A VERY QUICK INTRODUCTION TO NUTRITION FOR SENIORS: LEARNING THE BASICS.

Once done, also make sure to read my other articles:

• HEALTHY EATING FOR SENIORS: HOW TO BEGIN EATING HEALTHY - THE FIRST STEP [PART 1]

• HEALTHY EATING FOR SENIORS: HOW TO BEGIN EATING HEALTHY - THE FIRST STEP [PART 2]

And check out the Nutrition/Healthy Eating section on the More Life Health website.

There are also some vitamins and minerals (micronutrients) that aid in keeping your bones strong and can help with falls prevention.

CALCIUM AND FALLS PREVENTION

One of those is calcium.

Calcium is important in preventing falls, keeping your muscles strong, helping you move more efficiently and maintaining your bone strength.

For more on calcium, make sure to read my article on this important mineral here - CALCIUM IN OLDER ADULTS: HOW MUCH CALCIUM SHOULD YOU GET?

Another essential nutrient in preventing falls and keeping us strong and balancing well is vitamin D.

VITAMIN D AND FALLS PREVENTION

We make vitamin D when our skin is exposed to the sun. As we age, we tend to spend less time in the sun, especially in the winter months, making vitamin D deficiencies prevalent in seniors.

Vitamin D is essential for bone strength, muscle function, and preventing falls.

It assists in preventing falls by improving postural balance, improving movement and aiding in propelling and helping with navigation abilities during walking [1].

Aim to get 20 minutes of direct sunlight daily, avoiding the hottest part of the day. Make sure not to overdo it and burn your skin.

By getting a healthy amount of sun, you will keep your vitamin D levels topped up, helping to keep your muscles and bones strong, improve your balance and decrease your falls risk.

Some foods do also contain vitamin D in small amounts. These foods include oily fish (tuna, salmon, herring and mackerel), egg yolks, liver and some fortified products. If you live in a part of the world where it is difficult to get sun during winter, do your best to consume more foods containing vitamin D.

A common question I am often asked is: Should I supplement with Vitamin D plus calcium?

It has been shown that Vitamin D plus calcium supplements reduce fracture incidence, including hip fracture, following a fall [1]. I recommend getting your vitamins and minerals from real food, but supplements can help if your diet lacks these minerals.

Suppose you feel your diet may lack good nutrition and/or you may not be getting adequate vitamins and minerals (including vitamin D and calcium). In that case, I recommend you see a qualified nutritionist or your doctor for assistance.

I also cover more about calcium and magnesium and their role in stronger bones in PART 2 - THE COMPLETE GUIDE TO STRONG BONES OVER 60.

ALCOHOL AND FALLS PREVENTION

Finally, regarding what we put into our bodies and falls, I want to add some information on alcohol and its effect on falling.

Most of us enjoy a drink or two (maybe more), and it would be common sense to think that increased alcohol would put us at risk of falling.

And this is true!

However, there is evidence that light alcohol consumption may decrease your risk of falling.

I’ll explain the reasons why this could be:

Light alcohol consumption can increase confidence, help relieve stress, lift mood and is usually done in the company of others. All these factors have been shown to DECREASE falls risk.

Increased confidence in doing tasks usually equates to improved performance; thus, falls risk will decrease.

So there is little reason why you have to stop enjoying a few drinks to prevent falls.

Overconsumption of alcohol, however, will put you at an increased risk of falling. Excess alcohol consumption disturbs balance and affects judgement, and when under the influence, you may put yourself in risky situations that could lead to a fall.

These are the times that we need to take caution. 

Excess consumption of alcohol is not conducive to good health or your fall risk. It’s best to limit your alcohol consumption, but if you enjoy drinking socially, there may be times you overdo it, so extra caution is required. 

If you feel your drinking is out of control and something you’d like to get help with, you should speak to a Doctor or a qualified Professional.

But know that light alcohol consumption is ok and will not put you at higher risk of falls. 

Enjoy yourself. Enjoy Life!

 NUTRITION AND FALLS SUMMARY

• What we eat is essential for good health, preventing falls and decreasing the risks of serious injury if you fall.

• Eat a diet with adequate calories comprised of sufficient protein, carbohydrates and fats and high in vitamins and minerals. For more on nutrition, CLICK HERE.

• Most of the population is not getting enough calcium and vitamin D, nutrients vital for health and bone strength.

• Aim to get 20 minutes of sun exposure avoiding the hottest part of the day for adequate vitamin D.

• Vitamin D and calcium supplementation have been shown to reduce fracture incidence.

• Light alcohol consumption has been shown to not increase falls risk.

• Heavy alcohol consumption can impair judgement and balance and increase the likelihood of risky behaviours, which could lead to a fall.

STEP 8: GET A GOOD NIGHT'S SLEEP NATURALLY, EVERY NIGHT

It's well known that when we are not getting enough sleep, we are not performing at our best. We are usually weaker, less alert, fatigued, and our mood is down. 

Furthermore, lack of sleep can increase your risk of falling [1, 2].

By making sleep a priority and getting a good night's sleep each and every night, you are decreasing your falls risk, and your general health and wellbeing will also improve.

Getting a good night's sleep each and every night is one of the best things you can do to improve your health and will go a long way in decreasing your falls risk.

For tips on how to get a good night's sleep, read my article - SLEEP IS GREAT MEDICINE: HOW TO GET A GOOD NIGHT'S SLEEP OVER 60.

SLEEP AND FALLS IN SENIORS SUMMARY

• There is no change in the amount of sleep needed as we get older. The amount of sleep required remains the same for all ages.

• You can take many steps to improve your sleep naturally (i.e., enhancing your sleep environment, getting active, getting the right light, getting social, eating healthy, and reducing stress).

• Speak to your doctor if you are having difficulty sleeping. If you are currently taking sleeping medications, let your doctor know you'd like to try a natural alternative.

STEP 9: SLOW DOWN AND BE MINDFUL TO PREVENT FALLS

Are there times when you are continually making silly mistakes or doing clumsy things? Maybe it's bumping into things, stubbing your toe or hurting yourself somehow? Dropping items or frequently losing something? Or leaving behind items at certain places?

Do you find yourself overthinking things? Do you find that your head can be kind of chaotic at times?

Perhaps you can't stop worrying?

If you're stressed with a busy mind, if you are not present, your mind is elsewhere. This is when mistakes or accidents usually happen. This is the time when you are most likely to have a fall.

Furthermore, stress directly affects balance. When you are stressed, balance and other physical abilities may not be as good as they could be. Something I see commonly in my patients.

With decreased physical capabilities - your falls risk will increase!

Additionally, people experience dizzy symptoms during periods of stress.

With a stressed, chaotic mind, life is just much harder.

If your mind is busy, you'll get many benefits from practising mindfulness daily or taking time out of your day to calm the mind.

When we are calmer, there is less stress, our physical capabilities improve, our balance is better, we are healthier, and everything feels easier.

Calm the mind, and you WILL become more aware of your body and what's around you. YOU WILL DECREASE YOUR FALLS RISK.

DECREASING STRESS AND RELAXATION THROUGH MEDITATION

It is important to improve your health and decrease your falls risk, that you are doing what you can to reduce stress.

Meditation is one of the best ways to decrease stress, calm the mind, and be more present.

Meditation doesn't have to be a very disciplined, monk-like practice.

Think of meditation as spending a set amount of time, with intention, on doing something good for yourself to help reduce stress. That's it! It's that simple.

I have previously written an article on meditation, including a simple meditation technique.

If you're interested in a simple meditation technique, you can use to decrease stress, calm your mind, get healthier and reduce your fall risk, CLICK HERE - DECREASING STRESS AND RELAXATION MADE EASY. 

MINDFULNESS AND FALLS PREVENTION SUMMARY

• Stress and rushing can increase falls risk.

• Mindfulness/meditation can help decrease stress, make you more alert, aware, mindful, and present, improve physical capabilities, and reduce your risk of falls.

• Don't neglect the mind-body connection.

STEP 10: Walking Aids & Assistive Devices - How they help and how they may put you at risk of falling

We should always strive to be in our best physical condition and health by being active as much as possible and exercising, regardless of age.

Sometimes, however, for various reasons, there may come a time when a little assistance is required to help keep you steady, active and living your life safe from falling.

That assistance might be the use of a walking aid. I have covered mobility aids, including the different types, how to use one and how to fit them correctly - CLICK HERE FOR YOUR QUICK GUIDE TO WALKING AIDS.

Furthermore, incorrect use of a mobility aid or not using one when you need one is also a common cause of falls.

There are some steps you can follow to ensure you are using your mobility aid correctly and will decrease your chances of having a fall.

Here are some tips to follow when using a 4-wheeled walker to prevent any issues:

• Ensure your walking aid is suitable for your abilities. Don't think any walking aid will be fine. You require the one most suited to you.

• Ensure the walking aid is fit to you correctly.

• When getting used to your walking aid, have someone with you until you can walk safely on your own. This will help build confidence.

• Ensure you wear appropriate footwear always when using your walking aid

• Clothing – ensure clothes cannot come entwined with the wheels.

• Tripping – Not only tripping over the walking aid itself but also clutter and hazards in the house.

• Repair walking aids regularly. Have it serviced once a year; it's inexpensive and a simple tip. Chat to your local mobility needs store to have this organised.

• Replace worn wheels, tips or glide skis. It's always good to have extra parts in case something fails. The most common issues are worn wheels, skis or handle grips, frayed brake cords, and brakes that are not working.

• Tie down or remove any items sticking out of the walking aid that could get caught on objects when walking, e.g., items in your basket or brake cords that stick out.

• Ensure you are walking with your walking aid correctly. When sitting down, get as close to chairs or furniture as possible before letting go of your walker.

• If you're leaning over too much when using your walker, practice upright walking (rather than adjusting the height) and take more rest until you can walk longer with an upright posture. This will prevent or decrease any back pain you may be experiencing when walking.

• When sitting on a walker, ensure the brakes are in a locked position. Place the walker against a wall for added stability.

• When opening the walker after storing it, ensure it is locked in place (open) before using it.

OTHER ASSISTIVE DEVICES

There are other assistive devices on the market designed to help prevent falls. These items can go a long way in helping you prevent falls.

I have also covered 10 ITEMS THAT CAN HELP YOU PREVENT FALLS - make sure to check them out (COMING SOON).

WALKING AIDS, ASSISTIVE DEVICES AND FALLS SUMMARY

• There may come a time that a walking aid is required for YOU to keep you moving well and prevent falls. Don't feel shame or embarrassment if this is the case.

• Always see a Health Professional to have a walking aid prescribed and fitted.

• Not all mobility aids serve the same purpose. Never borrow someone's walking aid unless you're sure it's the right one required for you after checking with a Health Professional.

• Ensure your walking aid is fitted correctly and that you use it correctly and safely.

THE FINAL STEP

And there we have the 10 steps to decrease your falls risk... by a lot!

By implementing these 10 steps above and working on overcoming your fear of falling, you will have done all that you can to ensure you do not have a fall.

Finally, there is one last part we must cover! There is always that chance that you may still fall even if you do absolutely everything possible. 

Continue onto the next part, Part 3, where we cover (in detail) how to sufficiently prepare yourself for a fall, what to do if you fall to avoid injury, how to get up off the floor and how to help someone off the floor safely.

PART 3 - BE PREPARED - WHAT TO DO IF YOU FALL

SOURCES

TO VIEW ALL SOURCES USED IN THIS ARTICLE AND FOR ADDITIONAL RESOURCES, CLICK HERE.

THE ULTIMATE GUIDE TO FALLS PREVENTION FOR SENIORS - PART 1

THE GUIDE TO PREVENTING FALLS FOR OLDER ADULTS

As a Physiotherapist specialising in seniors' health, I have witnessed firsthand the harsh reality of falls.

Throughout my career, I have often been called upon as a first responder in aged care centres after someone has fallen, to assess for injuries, direct the appropriate response and help as needed.

I have also rehabilitated many patients following a fall-related injury, helping them improve their physical condition so they can return to independent functioning in their daily lives.

Furthermore, I have been heavily involved in falls prevention. This included implementing falls prevention plans and exercise programs in various settings while assessing thousands of patients' mobility, physical condition and falls risk.

Due to my expertise and experience, I have spoken numerous times at many nursing homes and community centres across Australia about how best to prevent falls.

With falls being a huge problem facing everyone over the age of 65, I felt it was important to write this guide about preventing falls and do my bit to further decrease this problem.

Before we get started and dive deep into how to prevent falls however, the first thing you must know is……. falls are NOT a normal or inevitable part of ageing! 

I'll repeat... FALLS ARE NOT A NORMAL OR INEVITABLE PART OF AGEING!

Yes, falls ARE a huge problem facing older adults, but many things can be done to prevent them!

This doesn't mean avoiding everything you enjoy, everything fun, to ensure you don't fall…. NO!

Preventing falls simply means being aware and doing what's required to significantly reduce your risk of falling so you can go on living the life you want to.

Rather than ignoring this problem and putting it to the back of your mind in hopes that it won't happen to you or, in some cases, again, it's time to tackle this issue head-on, for good!

Once done, you can enjoy life as you wish in your golden years, without fear!

Now let’s get started preventing falls.

- Mike

[Note: To get the most out of this guide, make sure you spend the time to read it in its entirety. Once you have done this, you can skip through to any section by heading to the Falls Prevention main page and clicking on the appropriate links.

Also, please share this guide with anyone you feel would benefit from it, and make sure you sign up to the mailing list for a free exercise ebook, regular exercise videos for seniors, and more].

PART 1: THE IMPORTANCE OF FALLS PREVENTION

INTRODUCTION - HOW TO PREVENT FALLS

I like to think of preventing falls the same way we avoid a possible fire in our home or workplace.

We all have some risk of a fire occurring, especially when we cook, use electricity, iron, use the heater or get the fireplace going. 

But what do we do to avoid a fire? We decrease our risk, and we decrease it A LOT!

Fire safety usually looks something like this:

STEP 1: We educate ourselves about the dangers of fire to ensure we remain aware.

STEP 2: We become aware of the risk factors of fire and eliminate them best we can, to prevent any fire from happening.

We prepare ourselves by undertaking proper fire safety. This includes keeping our house up to date with appropriate fire standards, e.g., installing smoke detectors, putting fire extinguishers or fire blankets around the place, familiarising ourselves with fire exits and knowing the emergency phone numbers.

We don't give up here; we take precautions to maintain fire safety to guard ourselves against a fire and put our minds at ease. This may include removing dry leaves from guttering during hot, dry periods, having the fire extinguishers checked as required or changing the battery on smoke alarms.

STEP 3: We still know there is always the chance of being caught in a fire even when we eliminate the risk. We make sure we know what to do if a fire breaks out. For example: get down low and GO, GO, GO! and call emergency!

We cover everything to decrease our risk of a fire happening and what to do to keep ourselves safe if one were to occur. We have done all we can.

We trust our plan. We trust our equipment. We trust ourselves and the fire service. We trust everything will be ok.

We don't sit around in a fireproof suit with a hose, waiting for a fire, all ready to go.

WE GO ON LIVING AND ENJOYING OUR LIVES WITHOUT WORRY!

This guide will take a similar approach to the fire prevention plan above to prevent falls. Carry on to the next section for the falls prevention plan.

THE FALLS PREVENTION PLAN

In PART 1 of this guide, we will go through the consequences of falls to ensure you remain aware and learn everything that could put you at risk of falling.

In PART 2: We will go through what changes to make and how to make these necessary changes to decrease your fall risk as much as possible. You will also work on becoming as healthy and in good physical condition as possible to help you prevent falls. 

As it’s impossible to completely eliminate all risk of falling, there is always the chance that even if you have done everything you possibly could, you still fall. So we want to be prepared for this situation.

In PART 3, we cover how you can be prepared and what to do if you fall to handle the situation safely and effectively.

Once you have completed all parts of this guide, you will have peace of mind and confidence, knowing you have done everything possible to prevent falls, and be prepared.

Furthermore, you will get many added health benefits when you undertake what's set out in this guide. You will improve your physical abilities, you will be stronger, moving better, balancing better, you will be sleeping better, you will have decreased stress, you will feel better and much more!

WHY YOU SHOULD BEGIN PREVENTING FALLS TODAY

A FALL CAN HAPPEN TO ANYONE!

There was once a time I was walking through the dining room in a Residential Home, lost in thought about all the jobs I needed to get done before the day was out.

While rushing around the place deep in thought, I had failed to notice one of the cleaners had just mopped the floor.

I was also wearing shoes I shouldn't have been. The grips on the soles of my shoes were worn down. "I'll be right!" I thought to myself a few weeks earlier when I noticed the soles wearing thin. I liked these shoes, so I wasn't ready to replace them just yet.

It was lunchtime, and the room was packed with residents eating their lunch.

As I was walking through the room, suddenly I slipped. The next minute, I was down on the floor, on one knee in front of everyone.

I remember hearing one of the ladies shriek in fear, worried I'd been hurt and seeing other ladies jump when they saw it. 

There was silence. Everyone was looking at me.

"Aren't you the guy that's meant to stop us from falling?" a man named Merv chimed in laughing, while I'm still down on one knee.

"I'm just stretching, Merv," I replied, jokingly, with a smirk on my face while faking a stretch. 

Merv was right; I had fallen. The Physiotherapist, an expert on falls prevention, much younger than everyone else in the room, had fallen for all to see.

AND, this fall could have easily been prevented!

AND..... I knew my shoes were putting me at risk. It was not like these shoes were stopping me from replacing them or the slippery floor made me rush over it.

I just never thought it would happen to me.

A few of the ladies asked me if I was ok. I was fine, luckily. Not a scratch. 

I got back up and got on with what I was doing. 

Whoa, close call! That could have been much worse.

Luckily, I was young with good physical capabilities. If not, this could well have been a different story.

Most of us assume that an incident won't occur to us. We usually think, "that just happens to other people". 

But, A FALL CAN HAPPEN TO ANYONE!

This story is to highlight the importance of falls prevention. Take falls prevention seriously, because you could fall too!

THE FACTS ABOUT FALLS

Roughly 30-50% of people over the age of 65 are at risk of falling; this risk increases to the higher end (50%) as we continue to age [1].

Once over 65 and having already fallen, this risk increases again [1].

Our falls risk increases for many reasons as we get older (covered below). Combine this with bones becoming weaker, our muscle mass decreasing and usually less fat covering our bones, the chances of a falls-related injury are increased and injuries sustained are usually more severe.

The most common injuries are fractures, with hip fractures being the most serious and occurring more commonly in women [2].

Furthermore, our recovery time following an injury increases as we get older, taking longer to get us back to where we once were.

Now, don't be too alarmed. The primary physical injuries - broken bones, cuts and knocks to the head occur in only a small percentage of falls. Most falls result in only minor cuts and bruises, if that.

But they can also be frightening and an unwanted fall cycle can be triggered, affecting life in other ways [See Diagram below].

View fullsize

From the above diagram, a fear of falling can develop after a fall.

Due to this fear of falling, physical activity is usually undertaken less (or in some cases avoided), leading to decreased physical abilities. Consequently, the risk of falling is further increased.

The cycle continues, and it becomes increasingly difficult to undertake the activities required for daily living.

As you can see, falls have both physical and mental effects. They can cause injury and disrupt quality of life in a big way.

You may have also read or heard the very scary statistics or some horror stories about falls and associated fractures, which can compound this fear of falling. I won't go into these statistics. A simple search will find them.

Yes, these statistics can be frightening, and we must do all that is possible to ensure we prevent falls, which is 100% possible. However, there is no need to get caught up in these statistics surrounding falls. 

In my career as a Physiotherapist, I have helped rehabilitate hundreds, after a fall, and it is very rare someone does not make a full recovery. Those that don't are usually much older and/or frail and tend to have limited cognitive abilities.

Worrying about the dangers of falls is impractical for preventing them. 

Any fears causing you to avoid movement or certain activities are holding you back from living life and making progress in preventing falls. These fears usually require more than just an understanding to overcome. However, they are possible to be overcome and you can make big progress.

Overcoming the fear of falls is complex, I have written an article covering it a little, and how to overcome it here: OVERCOMING THE FEAR OF FALLING

You can get to the bottom of why you are falling and improve these areas of your life causing your falls. These improvements will help prevent any more falls.

You want to be doing everything to ensure you're not avoiding any movement or activities in your life, but of course, taking precautions if/and where necessary.

It starts by changing your focus from avoiding falls to doing what's required each day, getting yourself in the best physical and mental shape to prevent falls and eliminating or minimising the factors putting you at risk (discussed next section).

This Falls Prevention article aims to help you to continue living your life the way YOU want to and doing what's required to prevent falls. This is the key to a good falls prevention plan and the key to overcoming falls.

From this point onward, we will stop focusing on the scary what-ifs of a fall. Instead, we will focus on the things within your power that CAN be changed to prevent falls, which we will cover in this article, and we will start putting these into action.

To do this, let’s now take a look at what could put you at risk of falling.

What’s Putting You at Risk of Falling - Risk Factors For Falls

To prevent falls, it's important to be aware of the different factors that could be putting you at risk of falling [1, 2, 3, 4].

Once identified, every risk should be eliminated or minimised, one by one. We will discuss all the risk factors in greater depth in the upcoming sections.

Factors that could be putting you at risk of falling are:

Physical Changes

• Decreased physical abilities (e.g., decreased vision, decreased balance, strength, proprioception and gait issues)

• Chronic health conditions (e.g., vertigo, arthritis, dementia, diabetes, incontinence, stroke)

Behaviours

• Risk-taking behaviours out of one’s capabilities

• Lack of awareness of one’s own risk of falls - cognitive decline

• Fear of falling leading to avoidance behaviours

Habits

• Lack of activity/exercise

• Poor sleep patterns

• Inadequate nutrition

• Alcohol abuse

• General lifelong habits which now pose a risk

The Environment Around You

• Hazards around the home (indoors and outside)

• Other indoor and outdoor risk factors

  • These hazards above include trip and slip hazards, uneven surfaces, poor lighting or glare and no handrails on stairs or grabrails in bathroom

Medications

• Certain types of medication (and quantity of medication) pose a fall risk

Clothing/Equipment

• Loose-fitting, long or baggy clothing

• Footwear -  worn, incorrectly fitted or not appropriate for the foot (e.g., heels)

• Wrong or incorrectly fitted mobility aid

• Not using mobility aid or other assistive equipment prescribed by Physiotherapist/Occupational Therapist

In the next chapters, we will look at eliminating or minimising these risk factors, so your falls risk decreases by a large extent.

Here is a diagram that sums up the risk factors of falling. Have a read and see if any could be putting you at risk of a fall.

View fullsize

Falls Risk Factors

Now we have identified the risk factors that could be putting you at risk of falling. It’s now time to start working on eliminating the risk factors to prevent falls.

We will cover all you can do to prevent falls, including exercise and more in the next section, PART 2: 10 STEPS TO PREVENT FALLS FOR GOOD

SOURCES

TO VIEW ALL SOURCES USED IN THIS ARTICLE AND FOR ADDITIONAL RESOURCES, CLICK HERE.

PREVENTING FALLS - OVERCOMING THE FEAR OF FALLING

RETURN TO FALLS PREVENTION HOME

HOW TO OVERCOME THE FEAR OF FALLING

IDENTIFYING A FEAR OF FALLING

Do you lack confidence doing activities you once did with ease in fear you may have a fall?

Or have there been times when you have limited or avoided certain activities you once did effortlessly due to fear?

These activities could include anything; crossing the road, going outside or maybe going to the shopping centre makes you feel a little uneasy.

If you answered yes to the above questions, you have a fear of falling.

However, you're far from being alone.

In a study on the prevalence of fear of falling in older adults, 90.5% of the subjects reported a fear of falling in at least one activity.

A fear of falling is common among older adults, especially if physical capabilities start to decline (i.e., weaker legs or increasing unsteadiness when walking) or after a fall.

WHY A FEAR OF FALLING CAN DEVELOP

There are many reasons why the fear of falling can develop.

It could be you are feeling not as steady on your feet as you once were. Maybe you are feeling weaker doing certain activities. Perhaps you've heard stories of friends having a fall and don't want the same happening to you. Or, maybe you've had a fall and, understandably, don't want it to happen again.

Falls can be a scary ordeal, especially when older and the body isn't as strong, steady, mobile and reliable as it once was.

Fear is healthy and normal. Everybody experiences fear.

Fear is our mind's way of alerting us to the dangers present and it can protect us from entering dangerous situations.

However, if the fear is uncontrollable, something that you think about a lot and is negatively impacting your life, this fear must be dealt with.

You want to be able to keep up your physical activity and your life. 

When you start limiting activities and avoiding life due to your fears, your physical abilities decrease and your chance of falling increases.

When you start managing and overcoming this fear, you can improve your physical abilities and continue to do those things you love.

Your falls risk decreases. You can live the life you want to.

HOW DOES THE FEAR OF FALLING CAUSE MORE FALLS

You may think that worrying about something will make you more cautious and decrease your risk of falling, but this is untrue.

The fear of falling will make you overthink every move and you may begin avoiding the activities that keep you moving well.

When you do less activity over time, your body becomes weaker and your balance worsens.

When physical abilities deteriorate, daily life becomes more difficult. This makes it more challenging to do the physical activity that will get you strong and decrease your risk of falls.

Confidence is lost and it's common to become overly cautious, regardless of what the physical abilities actually are.

A negative falls cycle develops (see below). Remember this fall cycle discussed in PART 1 of the ULTIMATE GUIDE TO FALLS PREVENTION FOR SENIORS.

View fullsize

Activities in life are avoided and balance/stability issues increase; again, further increasing falls risk.

This downward spiral also impacts mood and well-being; thus decreasing social interactions. It's a vicious cycle that needs to end.

BE CONFIDENT AND GO ON LIVING LIFE

Overcoming the fear of falling isn't as easy as just snapping out of it and getting on with life.

Your mind is sending out warning signals out of your voluntary control. This fear is real and must be overcome like any other fear.

And it can be.

Firstly, by reading all the steps in the Falls Prevention guide (and implementing all strategies), your confidence will increase, and your fears surrounding falling will begin decreasing.

But more may need to be done.

You may know that you are capable of undertaking your daily activities and understand your fears are irrational.

But fear is an emotion, and when big emotions grip us, we can become powerless. We always automatically revert to what's safest and what's comfortable.

To be free of the fear, you start by changing your thoughts surrounding it; this is done by listening to and feeling your worries about falling, then reframing them.

Once you have reframed your worries, you now focus on the new reframed thoughts, especially when your fears arise. And gradually do more and more activities that help build your confidence.

A TASK TO HELP OVERCOME THE FEAR OF FALLING

The goal of this task is to decrease your fears surrounding falls. By doing this, you will reduce your falls risk.

You will become less sensitive to your fears until they do not have control over you. By letting go of these fears, you will remain cautious (healthy), just not overly cautious (unhealthy), which leads to a decreased quality of life and increases fall risk.

After completing this step, you will be more confident and can get on living life.

Take your time during this step; it will be worth it. Now let's begin.

Write down EVERY fear or thought you have about falling in EVERY situation and reframe them into something positive.

Example 1) If I fall, I may injure myself.

REFRAME: I have spoken to my doctor, and he says it's ok for me to walk. I have done everything to decrease my falls risk as set out in this guide. I am doing my exercises. I am eating well and moving well; I will walk within my capabilities and take a rest if I feel tired. I will live my life. I will be ok!

Example 2) If I fall, I will look stupid in front of people.

REFRAME: I will not fall. I am walking to the best of my abilities. I have done everything possible to prevent falls. 

However, if something unexpected happens and I do fall, people do not care about how I look and would be more concerned if I am ok.

I can deal with it. I will live my life.

Example 3) If I fall, I may not be able to get up.

REFRAME: I am now always prepared if I do fall. I am also doing everything to improve my physical abilities. If I do fall, I know help will be on the way.

Example 4) If I ride my bicycle, I may fall.

REFRAME: The last time I fell off my bicycle was right before I started to pedal. Now, before I start pedalling, I make sure that I am balanced and that no clothing, straps, etc., can get caught in the pedals or gears. In addition, I have done strengthening and balance exercises, thereby decreasing my falls risk. I will continue to enjoy riding my bicycle!

Now it's your turn. Think of ALL the reasons why you fear falling. Go through them one by one, answering the question "I am afraid of falling because?"... Then reframe the fear.

Continue for as many fears as you have surrounding this!

This process of reframing, repeating these new reframes, and taking small steps to do what you fear is known as desensitisation. Over time you will be desensitised to the fear.

This is one of many techniques to help you overcome the fear of falling

Remember, you will also need to continue to do the activities required that you want to be doing. Take your time with this and gradually increase your confidence. If you need extra guidance, get help from a professional (e.g., Physiotherapist).

With a slow and controlled approach, you'll start making significant progress. 

It won't be long until you're on your way to overcoming your fears and back to doing more of what you most love to do.

IF YOU'VE FALLEN BEFORE

If you've previously fallen and the fear is constantly on your mind and is impacting your life, I recommend you speak to a psychologist or a counsellor.

A fall can be just like any traumatic event. The sooner you come to peace with the past event that once happened to you, the better your life will be.

As said earlier, educate yourself on falls, eliminate the risk factors for falls, put safety measures in place and improve your physical abilities.

Read everything within this guide and implement the strategies. Then continually challenge yourself by doing the things you fear, gradually, and your confidence will begin to increase. Your fear of falling will start to dissipate.

To speed up the process, work with a Physiotherapist, Psychologist or other suitable Allied Health Provider.

FEAR OF FALLING SUMMARY

• A fear of falling is common in seniors.

• A fear of falling can put you at a higher risk of falling.

• By implementing a falls prevention plan and doing what's required to help decrease your falls risk, you can increase your confidence surrounding a fear of falling.

• Many psychological techniques can help you overcome the fear of falling - one technique is desensitization.

• If your fear of falls persists or you want help with overcoming your fear of falling, speak to your doctor or a psychologist or counsellor.

• A physiotherapist can help you improve your physical capabilities, and will help guide and assist you through the process to getting stronger and balancing better, which will help build your confidence.

SOURCES

TO VIEW ALL SOURCES USED IN THIS ARTICLE AND FOR ADDITIONAL RESOURCES, CLICK HERE.

YOUR QUICK GUIDE TO WALKING AIDS

FIRST PUBLISHED: 11/15/2017. LAST UPDATED: 8/7/2022

INCLUDES HOW TO FIT A WALKING AID

WHAT’S COVERED IN THIS ARTICLE:

• TYPE OF WALKING AIDS

• HOW TO FIT A WALKING AID (ROLLATOR AND WALKING STICK)

• WHICH SIDE DO YOU USE A WALKING STICK ON

• SAFETY TIPS TO FOLLOW WHEN USING A WALKING AID

We should always strive to be in our best physical condition and health by being active as much as possible and exercising, regardless of age.

Sometimes, however, for various reasons, there may come a time when a little assistance is required to help keep you steady, active and living your life safe from falling.

That assistance might be the use of a walking aid.

Walking aids can give benefit in many ways. 

If you find you are becoming unsteady on your feet, they can provide stability to keep you standing. They can allow you to walk further if you are short of breath or fatiguing. And, they can make it easier for you to get around when in pain, recovering from injury or following surgery.

When these benefits of using a walking aid are felt, your confidence will also increase, knowing that getting about your day will be safer and easier.

All these benefits — yet many people still feel reluctant to use one, usually due to thoughts of it being a sign of losing independence or the shame of identifying with their use.

There is no need to feel either. When using a walking aid, you aren't losing any independence. Using a walking aid allows you to remain independent by keeping you safe from falling, allowing you to continue to do the things you want to do with greater ease.

If you have been told by a Health Professional that using a walking aid is required, drop any shame surrounding using one. Do not worry about what others think. Use it to allow you to get more out of life and use it confidently!

Let's now look at the common walking aids used and in which instances they are suitable. 

Note Before: Always see a Physiotherapist before making any decisions about a walking aid. They will determine if you need one, which type is required and fit one for you.

Never borrow a walker from a friend or family member unless you're sure it's the right one required for you, it's the perfect fit, and it is in good condition.

TYPES OF WALKING AIDS

WALKING STICKS/CANES

Walking Sticks

Walking sticks can come in different shapes and sizes.

They can come with one, three or four points (see diagram).

They can be adjustable and even foldable to easily store away.

Walking sticks can provide added stability when moving about and can give confidence when entering unfamiliar or uneven territory.

If you feel yourself reaching for furniture now and then, a walking stick could benefit you. 

As with any walking aid, ensure your walking stick is adjusted correctly for you.

ROLLATOR FRAME/FOUR-WHEELED WALKER

Rollator/4-Wheeled Walker

A rollator frame (or four-wheeled walker) is a medical device that helps people with mobility issues to walk independently.

It typically has four wheels, a seat, handrails and usually a basket you can put your belongings in. A rollator can be folded up for easy transport and storage.

Rollator frames are an excellent option for those who need a little extra help getting around but don't want to use a wheelchair. They provide support and stability while still allowing for some independence.

There are a few things to consider when choosing a rollator frame.

First, think about the size and weight of the person using it. Second, consider the terrain on which the frame will be used. A basic frame will suffice if it is used mainly on flat, even surfaces. However, a frame with bigger wheels and more features (such as suspension) might be necessary if it is used on rugged or hilly terrain.

TWO-WHEELED FRAME

Two-Wheeled walker

These walking aids are a mix of the Four-Wheeled Walker/Rollator (covered previous) and the Pick-Up Frame (covered next).

They often have skis on the back to allow continuous movement (no lifting required) when walking.

They should be used for times when you need to place some weight onto the walker (but not all) when walking causes you to become fatigued or unsteady on your feet.

They should not be used outdoors or on rougher terrain.

Some people use this walker as an alternative when travelling due to its lighter weight than the Four-Wheeled Walker/Rollator (above).

PICK-UP FRAME

Two-Wheeled Walker

This walker has no wheels and is picked up for every step. This walker does not allow for continuous movement.

These walkers are used when you need to place a significant amount of weight on the walker, with less weight through your legs (e.g. after a hip or knee replacement surgery).

Or, if you have limited walking ability and only walk very short distances. This could be due to painful joints in the legs, or other reasons.

As this walker has to be picked up and placed for every step, it can get tiresome if walking for longer distances.

It is not appropriate for times when only a little balance support is needed while walking. A two or four-wheeled walker is better in these instances.

HOW TO FIT A MOBILITY AID

It’s not uncommon to see walking aids fitted incorrectly.

Most of the time, they are set correctly by a Health Professional, but over time it’s very common for them to lose their correctly fitted settings.

Or, they are purchased without any education on how to use and fit them correctly.

It is recommended you see your Health Professional to have your walking aid fitted correctly. However, if required, here is a quick guide to assist you in fitting your walking aid.

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Fitting A Walker and a Walking Stick

STEPS TO FIT A WALKING AID:

1. Wear your everyday shoes and place your arms by your side.

2. Keep your shoulder relaxed and not elevated.

3. Set the height of the walker/cane to your wrist crease. Bring the walking aid up to the crease of your wrist and lock the clip/screw in.

4. You should have a 20°-30° bend in your elbows when using the walker/cane and standing upright.

5. Once you have adjusted the length correctly, check that all clips/adjustments are fully locked.

WHICH SIDE TO USE A WALKING STICK ON

When using a walking stick for injury, weakness or pain, hold the walking stick on the opposite side of the injured leg or the stronger, unaffected leg. 

If you are using a walking stick for balance, hold it in your stronger hand or what’s most comfortable. This will give you more control and stability. 

Whichever reason you’re using a walking stick for. Make sure to practice using it before venturing out into the world. 

SAFETY TIPS WHEN USING A WALKING STICk/FOUR-WHEELED WALKER

When using a mobility aid, you must use the walking aid properly and avoid any issues that could cause a fall.

For tips on properly using a walking aid to prevent falls, check out Step 10 of THE ULTIMATE GUIDE FOR FALLS PREVENTION FOR SENIORS.

The Steady Senior: The Complete Guide To Great Balance Over 60

FIRST PUBLISHED: 22/5/2017. LAST UPDATED: 10/2/2024

Good balance is essential to keep you steady on your feet, prevent falls and ensure you get the most out of life!

With good balance, you can go about your days effortlessly!

As we get older, however, it's common for our balance to worsen, which means life becomes harder (and not to mention more dangerous)!

But, BALANCE IS A SKILL! A SKILL THAT CAN BE RE-TRAINED AT ANY AGE!

And,

YOU CAN IMPROVE YOUR BALANCE, NO MATTER YOUR CURRENT CAPABILITIES!

In this guide, I will teach you all you need to improve your balance, show you how you can test your current balance and give you all that is required to begin balance training and keep you balancing well, for life!

All in the comfort of your own home!

You don't need special equipment, and you don't need to join a gym. 

It's easy, and it can be enjoyable.

Oh, and by applying what's in this guide, not only will you build great balance, the same exercises help you get stronger, fitter, look better, feel better and increase your confidence!

We are going to make some real progress!

So let's get balancing well!

WHAT WE WILL COVER IN THIS GUIDE:

PART 1: ALL ABOUT BALANCE FOR SENIORS

1.1 WHAT IS BALANCE

1.2 HOW YOUR BODY KEEPS YOU UPRIGHT

1.3 WHY BALANCE WORSENS WITH AGE

PART 2: HOW TO TEST YOUR BALANCE

2.1 EQUIPMENT TO IMPROVE AND TEST YOUR BALANCE

2.2 HOW TO TEST YOUR BALANCE

2.3 HOW TO KEEP TRACK OF YOUR BALANCE

PART 3: HOW TO IMPROVE YOUR BALANCE OVER 60

STEP 1 - GET MOVING

STEP 2: DO SPECIFIC BALANCE EXERCISES

THE BEST BALANCE EXERCISES FOR SENIORS

STEP 3: ALWAYS CHALLENGE YOURSELF

STEP 4: HOW TO BE MORE MINDFUL

Before we get started, remember, this guide will only help you if you apply these strategies. Just reading what's here and trying the exercises maybe once will not help you improve your balance. 

If you want to improve your balance, read the article and undertake what's set out in this article. 

Pledge to incorporate at least 5-10 minutes of balance work into your life a few times each week. Make it simple. Make it fun!

To make it easy for you; I create workouts for mailing list subscribers. So make sure you join up!

PART 1. ALL ABOUT BALANCE FOR SENIORS

1.1 WHAT IS BALANCE

If you had to guess what balance is, most would probably guess something along the lines of “being able to stand upright, without falling”.

Which is good, and all you need to know! However, a better definition is this: 

“BALANCE is the ability to maintain the line of gravity of a body (vertical line from the centre of mass) within the base of support with minimal postural sway” [1].

Let’s break this definition down, so it’s easier to understand.

When you gain a better understanding of balance, you know why we do the exercises to improve balance and why we could, or do, fall. 

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Diagram 1: To lose balance my sway has to move past my limits of stability.

1)      Centre of Mass – The easiest way to think of our centre of mass is the point where our weight is concentrated most (orange circle in diagram 1). The lower our centre of mass, the easier it is to stay balanced.

2)     Base of Support (BOS) -  The area beneath a person that includes every point of contact that the object or person makes with the supporting surface [2, 3]. 

In this photo (yellow line), my feet are together- a reduced base of support, which means less stability.

A wider base of support increases our stability. 

Standing with our feet apart makes standing a whole lot easier because it increases our stability.

Using a cane or a walker makes us sturdier, why? Because we have increased our base of support by increasing the area within the support surface (that being the floor).

3)     Sway - The horizontal movement (red arrows at the top of diagram 1) between each side of the centre of gravity (green line) even when a person is standing still [1].

What happens when we are trying to balance in challenging positions? We sway from side to side.

Here is another picture to help you understand everything a little better:

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Diagram 2: By standing on one leg my base of support is decreased. Less sway is required for me to become unstable and lose balance.

By decreasing our base of support, (standing on one leg), we decrease stability. It is much easier to sway outside of the limits of stability (blue lines). It now becomes easier for us to lose balance and fall.

We can also decrease the base of support in exercises, to make them more challenging, which, over time, will help improve balance.

To increase our base of support, we can hold onto the chair in front of us to provide more stability and lessen our chance of falling.

There are two types of balance; static balance and dynamic balance.

1)      Static Balance - The ability to balance while at rest, e.g., standing still on the spot. (The diagrams above are examples of static balance.)

2)      Dynamic Balance - The ability to balance while moving, e.g., walking or reaching forward.

Both types of balance are equally important and both need to be practised to have great balance.

Your aim should be to become as stable as possible by doing balance exercises consistently, without having to rely on any assistive devices (walker, cane, etc.).

An aim that is entirely possible by putting in the work of doing the correct balance exercises.

[Note: Only stop using an assistive device if it is safe to do so. Always get a professional opinion to decide on this].

1.2. HOW OUR BODY KEEPS US UPRIGHT

So how does our body keep us upright? Notice I didn't say "how do we stay upright?"! That's because balance is usually an automatic process (unless compromised in some way).

For every task we undertake, our body automatically receives information from our senses. This information is from our muscles, joints, ligaments and other sensory receptors such as touch, pressure, temperature and pain.

Sensory information also comes from our visual system (our eyes) and our vestibular system (our ears).

This sensory information is sent to our Central Nervous System (CNS) to be processed.

The CNS then cues our musculoskeletal system (system for our muscles, bones, ligaments, joints) into action to perform the appropriate movement.

When we are walking (or undertaking any other tasks), our central nervous system continually sends signals to our musculoskeletal system.

If we were to come across uneven terrain or obstacles or were to trip, for example, during our walk, our musculoskeletal system will receive the information via our CNS and make the correct postural adjustments to maintain our balance and keep us from falling.

This is an automatic process that all happens very, very fast, but slows as we age!

As this process slows, combined with the loss of other factors, e.g., decreased leg strength or proprioception (perception or awareness of the position and movement of the body), it becomes increasingly difficult to maintain balance.

When you train balance and improve balance, this process becomes more effective, ensuring you stay on your feet.

Decreased eyesight (or closing your eyes) or conditions of the inner ear (vertigo, Meniere's disease, ear infections, or prolonged dizziness), also affect balance.

Additionally, certain medications and hypotension (low blood pressure) - leading to dizziness and lightheadedness - can also affect our balance.

1.3 WHY BALANCE WORSENS WITH AGE

As I mentioned above, the process of maintaining our balance slows or deteriorates as we age.

There are factors out of our control that we must accept.

That is, changes in our body (physiological changes) do happen because of ageing itself. We will never be like our young 20, or 30-year-old selves.

However, the good news is, the primary contributor to these physiological changes is not due to ageing in itself, but because we do less as we age.

As we start reaching adulthood, the pressures of life take hold, and we find ourselves with more obligations.

We also get into some poor habits (e.g., sit more often in lousy postures), and we do less and less activity.

A lot of us put these physical changes we see (such as decreased balance, posture and strength, etc.) down to ourselves getting older. 

However, the majority of the time, these changes occur because we do less activity throughout the years.

It’s simply because we sit more and move less, that we see a lot of these changes in our physical condition.

We are creatures of comfort designed to do what is most comfortable and, after time, it becomes increasingly difficult to do more activity.

These physical changes we see from lack of use include:

• Generalised weakness throughout the body.

• A generalised decrease in fitness (our whole body becoming less fit, leading to faster muscle fatigue and shortness of breath).

• Decline in posture, changing our centre of mass.

• Decreased reaction time.

• Decreased balance.

It’s time to accept that the main reason staying active and upright has become tougher and you are not moving as well as you could be is not because of ageing itself but because we have progressively done less and less activity.

You must get it out of your head that decreased balance and, also falls, are a normal part of ageing. This is a myth.

Your BALANCE CAN BE IMPROVED, and FALLS CAN BE PREVENTED

Now that we know this, we should do everything in our power from now on to improve our balance and keep it that way for the many benefits it will bring us. 

PART 2: TESTING YOUR BALANCE

You do not need to go to a Professional (e.g., a Physiotherapist) or join a gym to get your balance tested.

You DO, however, have to be careful and take the correct steps for safety reasons.

And... You can also get a more comprehensive test when getting your balance tested by a professional. It is also a good idea so you can rule out any vestibular or visual issues as the cause of any balance problems.

However, when done safely (with a helper and the correct equipment), testing your balance at home is a great way to take your health into your own hands and start making changes.

I've chosen some simple tests you can do to test your balance, and I'll show you how to do them as safely as possible, in the comfort of your own home.

2.1 HOW TO TEST YOUR BALANCE

There are many tests we can use to measure balance.

The aim of testing your balance is to get a rough guide on how well you can balance, and then use these measures as a guide of progress after doing balance training.

I have chosen four tests to give you a rough guide of your balance.

However, before we get into the tests, there is some basic equipment you will need:

EQUIPMENT YOU WILL NEED:

To test and train your balance sufficiently, I recommend the following:

· A tape measure

· Masking tape - Preferably coloured as it is easier to see.

· Timer - You can use the timer on your mobile phone.

· Chair – Standard chair with arms. Not a couch.

· Sturdy piece of furniture - (e.g., kitchen bench, rail, etc.).

· A Wall.

· A helper – grab a family member, friend, exercise partner, whoever to help take measures.

BALANCE TESTS

Now let's get into the testing.

TEST 1 - FOUR POINT BALANCE TEST

Equipment For Test: You will need a timer and a chair

Details of Test:

This first test is a test of our static balance (balance while stationary). This test will challenge your balance in four increasingly difficult foot positions.

How To Perform The Test (photos below):

1. Standing next to the back of a chair or a rail or sturdy piece of furniture, (e.g., kitchen bench) for safety reasons.

2. Starting by holding onto the chair and taking up the first foot position of the test (see below).

3. When you are ready, take your hands off the chair and start the timer.

Do this test without holding onto the chair.

4. During the test, you can move your arms to retain balance (holding onto the surface if required). Once your feet move out of position, the test is stopped and the time recorded in the chart below.

5. If you can safely manage the position for 30 seconds, you can continue on to the next challenging foot position and continue until the final (4th) foot position.

Alternate feet for the single feet stances.

6. Record your results in the table following this section.

NOTE: If you are unable to manage 30 seconds for this foot position, stop the test and record your time.

If you are unable to maintain 30 seconds for foot positions 1 and 2, keep practising these movements, train these movements each day, until you can safely manage 30 seconds for each before continuing.

If you are not improving, see your doctor or Physiotherapist for a more personalised program. 

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FOOT POSITION 1) Feet Side by Side:

1. Feet as close together as possible, side by side.

2. Chair or rail close by for safety reasons.

3. Hold for 30 seconds, or as long as possible.

4. If you can hold for 30 seconds, safely move on to the next position.

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FOOT POSITION 2)  Semi Tandem Stance:

1. Standing with the big toe of one foot in the arch of the other.

2. Toes facing forward.

3. Chair or rail close by for safety reasons.

4. Hold for 30 seconds, or as long as possible.

5. If you can hold for 30 seconds, safely move on to the next position.

6. Alternate Feet.

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FOOT POSITION 3)   Tandem Stance

1. Standing with heel on one foot touching toes on other.

2. Chair or rail close by for safety reasons

3. Hold for 30 seconds, or as long as possible.

4. If you can hold for 30 seconds, safely move on to the next position.

5. Alternate Feet.

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FOOT POSITION 4)      Single Leg Stance

1. Standing on one leg.

2. Chair or rail close by for safety reasons

3. Hold for 30 seconds, or as long as possible.

4. If you can hold for 30 seconds, safely move on to the next position.

5. Alternate Feet.

Understanding Your Results:

Scoring 30 seconds on each test means your balance is good for this test. 

No matter your capabilities, you can always be improving. To do this, you must challenge your balance even further by making the balance training harder (discussed later).

There is always work we can do.

Scoring less than 30 seconds on any of the tests, do not be hard on yourself; it just means you need to be practising your balance more so.

Do not be concerned if you score less on one side compared to the other side (i.e., your left foot vs your right foot); this is common.

If you are over 60 and score less than 10 seconds on the tandem stand, you are at increased risk of falling.

No matter your results, write them down with an aim to improve them after your training period.

TEST 2 - STANDING REACH TEST

Equipment For Test: You will need a chair, a bare wall, a tape measure and a helper for safety reasons.

Note before: You can stick a tape measure on the wall to make this easier for you.

Details of Test:

The standing reach test is used to assess our balance when standing and reaching for objects [4].

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How To Perform The Test:

1.      Standing perpendicular to a wall, place a piece of tape on the wall at the level of your shoulder. This is to reference your start position.

2.      Keep a chair within reach for safety reasons.

3.      Now stand perpendicular to the piece of tape and roughly 15 cm from the wall, facing straight ahead and feet hip-width apart.

4.      Now with the arm closest to the wall, lift your arm to 90 degrees, parallel to the floor. Keep your hand in a fist and stay relaxed, with your feet or torso not moving out of position.

Mark the position of your knuckle on the wall, with a piece of tape. This is the start position (position A).

5. Now reach out in front of you as far as safely possible, keeping your arm parallel to the floor.

Ensure you remain balanced without your feet coming out of position. This is the final reach position (position B).

6.      When you have reached out as far as you can, have the person helping you mark where the knuckle of your fist is with a piece of tape.

Ensure you don't overreach and lose your balance.

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A - B = Reach Distance

7.      Using the tape measure, measure the distance from the two tape points and record the results in the table following this section.

8.      Complete a practice run and then have three attempts of this test.

9.      Average the results of the three tests and record your results for later use.

Understanding Your Results:

Scoring less than 18.5 cm indicates you have an increased risk of falling.

No matter your results, write them down with an aim to improve them after your balance training.

TEST 3 - TIMED UP AND GO (TUG TEST)

Equipment For Test: Chair, Tape Measure, Tape, Helper

Details of Test:

The TUG is another test of our balance and our mobility.

In this test, you will stand from a chair, walk 3 metres over a line, turn around, walk back to the chair and sit down.

How To Perform The Test (photos below):

1. Ensure you have a friend or family member with you to help you with this test.

A friend can take a more accurate reading of the time it takes you to do the test and, additionally, if your balance is not so good, it’s good to have them there for safety reasons.

As with all balance tests, ensure they do not assist you with any parts of the test, but it is a good idea to have them standing alongside you.

2. Place your chair in an open area of your house, on flat ground without any obstacles or trip hazards in the way.

3. Using your tape measure, mark 3 metres from the chair and place a piece of tape to mark this spot.

4. Start seated in the chair, with your hands on the armrests and back against the backrest.

5. Your helper will say “GO” and will start the timer. You are to stand from the chair, walk to the line, turn around, walk back to the chair and then sit back down. Walk at your normal pace.

6. Once your buttocks have touched the chair, the test is complete, and your helper will stop the timer.

7. Complete a practice run of the test to get the hang of the test but give adequate rest before the scoring test to ensure you are not tired.

8. Perform this test twice and average your results.

Note: If you usually use a walking aid of some sort (for example walking stick, walker), use this during the test.

Understanding Your Results:

Studies have shown that if your time is over 13.5 seconds, you may be at a greater risk of falling [5].

No matter your results, write them down with an aim to improve them with balance training.

TEST 4 - Sit to Stand For Five Test

Equipment Needed For Test: A Chair, A Timer, A Helper.

Details of Test:

This test is used to test our lower limb strength and power. It is a functional test as sitting and standing from a chair is something we do many times during the day.

This test measures how long it takes you to stand up and sit down five times.

How To Perform Test:

1. Have a helper to time you or hold the timer in your hand.

2. Start seated on the chair. 

3. You’re going to time how long it takes you to stand up and sit down [You will start the test (and the timer) as soon as your buttocks leave the chair. And stop the timer (finish the test) when your buttocks are on the chair after the fifth stand].

4. Place your arms across your chest, not holding onto the armrests. Feet hip-width apart.

[If you need to hold onto the armrests, this is fine. However, note it down. You will most probably find after training and improving your balance and strength you will not need to hold on anymore.]

5. When standing up - ensure your knees and hips are straight, and the back of the knees aren’t touching the chair.

6. Ensure when you sit down it is in a controlled manner, not flopping down into the chair.

7. Practice one stand and sit before commencing the five attempts, to get the hang of the test, but do not tire yourself.

7. Perform this test and record all results for later use.

Understanding Your Results:

The normal measures for age ranges are as follows [6]:

• 60 to 69 years old: 11.4 seconds to complete the test.

• 70 to 79 years old: 12.6 seconds to complete the test.

• 80 to 89 years old: 14.8 seconds to complete the test.

No matter your results, even if you can’t perform one sit to stand. Write it down with an aim to improve them after training your balance.

2.3 TRACKING YOUR BALANCE

When you start performing balance exercises consistently, you will begin feeling the differences in many ways.

You'll be more confident going about your day and movement will be effortless.

However, if you are super keen and want to track how much you are improving with your balance, I have created a table to help you track your results. To download this table, click the button under the video below.

After training (next section), you can then retest and compare your results to see how you are progressing.

If you found you had some trouble with these tests, this is fine. These tests are only a guide to check your balance and track your progress.

On the other hand, some of you may find the tests very easy and scored quite well in them.

Great. It means your balance is at a level where you can function well in your day-to-day life. However, this doesn't mean you shouldn't do balance exercises.

No matter what stage you are at with your balance, there are always ways to challenge yourself and be improving. With exercise comes many benefits.

For an easy to follow balance tracking video, watch the video below.

Seniors Balance Test - Balance Test for Seniors

Also, you can track and record your balance by downloading the below.

CLICK TO DOWNLOAD YOUR FREE BALANCE TRACKING FORM

CLICK TO DOWNLOAD YOUR FREE BALANCE TRACKING FORM

Now we’ve got an idea of where your balance is at, let’s now start improving your balance!

PART 3: HOW TO IMPROVE YOUR BALANCE FOR SENIORS

STEP 1 - GET MOVING

The first and most important step in improving our balance and our quality of life is to get active. You need to get off the couch and get your body moving.

Movement is health. Movement is medicine.

Being active or exercising doesn't have to be boring or a chore.

Do what you can to make it easy. Do what you can to make it fun. Do whatever it takes to ensure you'll stick to moving more. Consistency is what's most important.

Go for a walk in nature, go for a swim, try a new activity if you can (examples - Tai Chi, lawn bowls, ten pin bowling, aqua aerobics, golf, tennis) the ideas are limitless, just get moving, within your capabilities.

My recommendation is to go walking every day outdoors for at least 10 minutes.

Have fun with it. Mix it up. Go on different walks. Attempt different terrains. Walk up stairs. Down stairs. Walk on grass or in shallows, and sand of your local beach. Go bushwalking. Walk faster. Slower.

Have fun and find the inner child we all have inside of us. Get outdoors and enjoy what mother nature has to offer.

Don't get carried away and do too much too soon, however. Don't try anything out of your capabilities.

If you're walking up many stairs for the first time in a long time, take breaks, use the rail and ask a friend or family member to come along for safety and to have some company. Take your walking aid if you need to.

Hurting yourself or falling would make both of us unhappy.

So make sure you slowly progress your walks, mix it up and continue to challenge yourself each week.

Yes, you're at higher risk of falling by getting off the couch, but done safely and when you enjoy the activity, you stay consistent.

There are many reasons why staying active is essential for better balance and better physical health.

You are training your heart which will make you fitter; you are training all the muscles in your body which will make you stronger (even the little ones that help with balance), you are ensuring your joints don't stiffen up, you are training your body to respond to different terrains. You will be decreasing your falls risk and improving your balance.

START NOW!

Get the all-clear from your doctor and begin with at least 10 minutes a day of some physical activity that you enjoy. Only 10 minutes, you can do it!

Always be thinking of ways you can incorporate more activity, or exercise, into your life.

STEP 2 - DO SPECIFIC BALANCE EXERCISES

Now we are moving more; we are going to incorporate some balance exercises into our life to directly improve our balance.

When performing these exercises, ensure you focus on proper technique; this is the golden rule for any exercise.

Quality is more important than how many of the exercises you can do, how fast you do them or how much weight you lift (if doing some resistance training).

With that in mind, if you feel the exercises do not feel right, causing pain or at first sign of fatigue, stop them.

You want to ensure you are performing the exercises correctly, working within your capabilities and, at the same time, challenging yourself, so you are getting the most out of the exercises and hence, improving your abilities.

THE BEST BALANCE EXERCISES FOR SENIORS

Specific balance exercises are essential to improve your balance and you want to be performing the best exercises to make greater improvements in a shorter time.

CLICK HERE FOR THE BEST BALANCE EXERCISES FOR SENIORS

Make sure you have read this entire article, from the beginning, before progressing to these next steps.

Additionally, for videos you can follow along with to improve your balance, head to the balance section of this website (click here) and follow along with the balance videos.

STEP 3 - ALWAYS CHALLENGE YOURSELF

For some of you, performing these balance exercises may be too difficult. For others, they could be too easy.

A one size fits all program is not possible. We are all unique people with different capabilities.

The good news is, by understanding more about your balance and your base of support, you can modify the exercises to make them easier or more challenging depending on your capabilities.

Remember that if we increase our base of support, we are more stable. When we decrease our base of support, we are less stable.

If any of the exercises are too hard and you find yourself swaying too much, we can take it back a little and make it easier by increasing our base of support.

If you find the exercises are too easy, it’s time to make them harder, to challenge yourself.

Always take note of your support base for each exercise as it’s a good way to see how much we can progress and improve each week.

Here are some ways to vary our base of support to make it easier and harder.

Each variation starts at less challenging to more challenging:

1. Using Walking Aid: e.g. - Walker, Four Point Cane, Single Point Cane

2. Change Upper Body Supports: e.g. - Two Hands, One Hand, One Finger, No Hands

3. Change Feet Position: e.g. - Legs Wider Apart, Legs Closer Together, Semi Tandem, Tandem, Single Leg Stance

4. Change Surface: e.g. - Stable Ground, Foam Pad, Pillow, Cobble Surface, Wobble Board

Other ways we can challenge our exercises are by:

• Challenging our hearing systems (vestibular) and visual systems.

  • Challenging Hearing System – Turn Head from side to side.

  • Challenging the Visual System – Close Eyes.

• Add challenges/tasks: e.g., catching a ball, solving problems, holding a glass of water, turning your head, adding resistance bands or dumbbell, adding a foam board.

Examples:

If you find the single-leg stance too easy, you can close your eyes or turn your head to each side during the exercise. This will make it more challenging.

You can also add in a pillow or a foam board.

If you are finding the single-leg stance too hard, you can make the exercise easier by holding on with one hand and working up to the time required.

STEP 4 - HOW TO BE MORE MINDFUL

I want you to think for a second and tell me, are you one to lose things?

Are you easily forgetful? Have you been known to be clumsy? Bump into things?

If so, I hate to break it to you, but you have a busy mind.

When our minds are busy, we are less present, and we tend to do careless things.

We've always got bruises because we bump into things. We can never find our wallet or keys. We trip because we didn't see that garden hose in front of us.

We are away with the fairies and mindfulness is our tool to bring us back.

Mindfulness is not usually something thought of when trying to improve our balance.

However, it is something I want you to really think about and take seriously.

Mindfulness techniques are growing in popularity, and it's not just a modern trend. There is increasing evidence of the benefits of mindfulness to wellness and other areas of life. In short, it works.

As with everything else I've mentioned on your journey to good balance, you must ensure you are doing what you can to decrease stress and have a clear head/calm mind, every day.

Stress directly affects our balance.

Higher stress levels can cause a decrease in balance performance. Additionally, many patients report an increase in dizzy symptoms during periods of stress.

In a calmer mind, there is less resistance; we are stronger, everything feels easier. When we have a busy mind, everything is harder.

Calm the mind, and we become more aware of our body and our environment around us. Our balance improves and our chances of falling will decrease.

It took me a long time to get into meditation myself to decrease stress. Once I began, stayed consistent and noticed results, I got hooked.

Consistency is the key to any mindfulness practice and 10 minutes is the perfect place to start.

I recommend 10 minutes of meditation each day from now on. You will still get improvements in balance without the meditation and by just doing the exercises; but if you want to make improvements in all areas of your life, this is a great tool to improve your health.

MINDFULNESS TECHNIQUES:

There are plenty of apps and guided meditations online.

Alternatively, here is a mindfulness technique you can use:

1. When alert, not sleepy, sit in a comfortable chair with your feet flat on the floor. Get comfortable but do not lay down. You don't want to fall asleep.

2. Set a timer for 5-10 minutes of undistracted time. No distractions, whatsoever. Complete focus. I meditate for 20-minute sessions, but when I first started, I did 10 minutes for quite some time. When you start seeing the benefits and enjoying meditation, you will want to increase the time you sit down.

3. Play soothing music or sit in silence during your session. A simple YouTube search can help with this.

4. Ok, now you're ready to go. Start by taking a deep breath all the way in through the nose, and all the way out through the mouth. Repeat this five times with your eyes open

5. It's now time to close your eyes.

6. Now take slow controlled breaths in through the nose and out through the mouth. Nice and slow. Continue these slow, controlled breaths.

7. Continue to focus on the breath. Your mind will wander, this is ok. Do your best to bring your attention back to the body, focusing on relaxing all areas of your body and letting go of any tension or resistance.

8. Once you start to feel yourself relaxing, shift your focus to the top of the head and slowly move your attention all the way throughout the body, to your feet and back. Focus on relaxing each and every part of your body.

9. Repeat with the focus on your breath and relaxing all areas of your body for the time set.

Note: It does not need to be perfect. Don't worry if you are struggling. Sit in silence, relax and just enjoy the quiet time. Over time, you will get better.

If you are having a difficult time concentrating, spend the first couple of sessions (maybe a week) just sitting down in silence and processing your thoughts. Listen to them; let them go.

This whole process will get easier with consistency, so vow to make it a daily habit, and you WILL see the results.

ENDING NOTE

There we have it, the guide to improving your balance.

By incorporating all these strategies into your life, you'll begin seeing significant changes in your balance. Stay consistent with the exercises, and it won't be long before you have great balance and are doing more each day, getting more out of life and also decreasing your falls risk.

 Good luck on your journey to better balance!

- Mike

SUMMARY TO IMPROVE YOUR BALANCE

To ensure you are on your way to great balance and to make sure you have covered everything, tick the boxes below when done.

• 🔲 Learn what's necessary to improve your balance.

• 🔲 Test your balance.

• 🔲 Include more physical activity in your daily life.

• 🔲 Perform balance exercises weekly (preferably daily) and make sure you follow along with my exercise videos.

• 🔲 Become more mindful daily.

• 🔲 Ensure you are eating and sleeping well.

• 🔲 Challenge yourself with your balance as you make progress, be patient and stay consistent.

Do you need to improve your balance?
Have you improved your balance by performing these exercises?
I’d love to hear from you.

Leave a comment below, or join the More Life Health Facebook Support Group.

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SOURCES

TO VIEW ALL SOURCES USED IN THIS ARTICLE AND FOR ADDITIONAL RESOURCES, CLICK HERE.

Adhesive Capsulitis - The “Frozen Shoulder”

The Best Exercises For Frozen Shoulder

Adhesive capsulitis, more commonly known as “frozen shoulder”, is a condition characterised by pain, stiffness and an increased difficulty (or an inability) to lift the affected arm.

With frozen shoulder, what was once simple activities - like lifting something overhead, tucking in a shirt or doing up a bra can become very, very difficult.

The good news is, frozen shoulder is not permanent. It does take some time, usually ranging from 9 months to 3 years; however, it will resolve, and a full, functional recovery is usually made.

There are solutions to help with the pain and loss of range of motion with frozen shoulder, and certain exercises and stretches can be done to help with a more successful recovery.

In this article, we will look at what frozen shoulder is and the best exercises you can do (video included) to help with this condition.

CONTENTS OF ARTICLE:

• A QUICK LOOK AT THE SHOULDER JOINT

• WHAT IS FROZEN SHOULDER (ADHESIVE CAPSULITIS)

• SYMPTOMS OF FROZEN SHOULDER

• RISK FACTORS FOR FROZEN SHOULDER

• WHAT TO DO FOR FROZEN SHOULDER FOR BETTER RECOVERY

• THE BEST EXERCISES FOR FROZEN SHOULDER (SHOULDER MOBILITY EXERCISES)

• VIDEO: FROZEN SHOULDER EXERCISES FOR SENIORS

A QUICK LOOK AT THE SHOULDER JOINT

Our shoulder is made up of three bones: Our clavicle (the collar bone), our scapula (the shoulder blade) and our humerus (the upper arm bone).

The three bones of the shoulder

Our shoulder also consists of two joints - the glenohumeral joint and the acromioclavicular joint.

When you think of the shoulder joint, the joint you’d most probably be thinking of is the glenohumeral joint. The glenohumeral joint is the joint mainly responsible for moving the arm.

The glenohumeral joint is a ball and socket joint. What that means is the end of the upper arm bone (the humerus) is shaped like a ball. The ball-shaped part of the humerus fits nicely into a shallow, cup-like socket of the scapula, known as the glenoid. Hence gleno (glenoid) - humeral (humerus) joint. 

Where the humerus and scapula meet are covered with smooth, elastic cartilage, allowing for smooth movement.

The shoulder joint

The ball and socket mechanism allows for the variety of movements we can do with our arms. Compare this to the knee joint, which allows only a few movements.

The shoulder joint is encapsulated by connective tissue to protect and support it, known as the shoulder capsule.

WHAT IS ADHESIVE CAPSULITIS (FROZEN SHOULDER)

Adhesive capsulitis, or frozen shoulder - occurs when the shoulder capsule (the connective tissue surrounding the shoulder joint) becomes inflamed and therefore thicker which causes increased stiffness. “Itis” = Inflammation.

Frozen shoulder can arise spontaneously without a known cause, this is known as primary adhesive capsulitis or secondary which occurs with a known cause.

Secondary adhesive capsulitis can occur after a trauma/injury to the area, from a period of immobilisation, or a complication arising from shoulder surgery.

STAGES OF FROZEN SHOULDER

Adhesive capsulitis follows three stages:

1. The Freezing Stage - This is when the joint starts to stiffen.

   In this stage, movement of the shoulder causes pain, and the range of motion of the shoulder begins to become limited.

2. The Frozen Stage - This is when the joint plateaus at its stiffest.

   In this stage, pain eases. However, the shoulder stiffness increases, and it becomes more difficult to use the arm.

3. The Thawing Stage - This is when the shoulder starts to recover.

   In this stage, the range of motion of the shoulder begins to improve.

RISK FACTORS FOR FROZEN SHOULDER

Frozen shoulder most commonly affects women over 40.

Other factors which increase the risk of a frozen shoulder is a long period of immobilisation of the shoulder joint. This could be from a past shoulder or arm injury, stroke, or recovery from surgery.

Certain diseases also increase the risk of frozen shoulder, including diabetes (as mentioned above), cardiovascular disease, hyper/hypothyroidism, Tuberculosis and Parkinson's disease.

SYMPTOMS OF FROZEN SHOULDER

The main symptoms of frozen shoulder are increased difficulty moving the arm, stiffness and pain. The pain usually worsens over time.

Common difficulties associated with frozen shoulder include:

• Difficulty, or inability, reaching behind the back to put on a belt, tucking in a shirt, or doing up a bra.

• Difficulty, or inability, reaching above shoulder height.

• Difficulty, or inability, putting on a seatbelt or reaching to the side.

• Inability grasping for something quickly.

• Pain when sleeping or laying on your side.

One of the first indicators of frozen shoulder is commonly pain in the shoulder at night time. 

NOTE: These symptoms may or may not be frozen shoulder, and a thorough assessment will be needed to determine your condition. If you have the above symptoms, see your Doctor or Physiotherapist.

WHAT TO DO FOR FORZEN SHOULDER FOR BETTER RECOVERY

Frozen shoulder usually resolves in nine months to three years.

In the initial stages, the freezing and the frozen stage, pain management may be required. Your doctor may recommend and prescribe anti-inflammatory medication and analgesia.

Analgesia can be combined with other methods of pain management.

Ice or heat can help with a flare-up of pain (IE you have overused the arm in some way aggravating the area).

Other pain management techniques could include gentle massage of the neck or shoulder or TENS (transcutaneous electrical stimulation), which is small, battery-operated device that reduces pain by sending small electrical signals.

To ensure a better recovery, it's important to also focus on restoring your body to the best health possible, which I touch on in many of my articles. Ways to do this include getting a better night's sleep, reducing stress and eating a healthier, nutrient-dense diet.

This will help improve the health of your body and decrease overall inflammation.

Additionally, exercises focused on improving the shoulder's range of motion and eventually strengthening the shoulder, and surrounding areas as pain levels improve should be the cornerstone of treatment.

We will now get to the best exercises for frozen shoulder and a video of exercises you can follow along to.

THE BEST EXERCISES FOR FROZEN SHOULDER - SHOULDER MOBILITY EXERCISES FOR SENIORS

With exercises for frozen shoulder, you want to stretch to the point of tension but not pain.

You do not want to aggravate the area, as aggressive stretching beyond the pain threshold can result in inferior outcomes, particularly in the early phase of the condition.

Using a heat pack on the area before doing these exercises will help warm up the area and loosen your muscles.

Note: Remember to consult your Doctor or Physiotherapist to ensure these exercises are appropriate for you. A physiotherapist can help you with specific exercises and apply manual treatments to assist in recovery. If these exercises cause an increase in pain or other symptoms, stop the exercise and make sure to speak to your Doctor or Physiotherapist.

NECK STRETCH

Neck muscles connect to the shoulder. It helps to stretch the neck muscles as this area can become tight and take on tension.

1. SIDE FLEXION NECK STRETCH

How To:

Sitting up tall in your chair, in good posture.

Bring your ear down to your shoulder as close as you can, keeping your face looking to the front.

You will feel the stretch in the opposite side of your neck.

You can increase the stretch by applying a gentle pressure with your hand on the side of your head.

Hold this position for 30 seconds and change sides.

SHOULDER RANGE OF MOTION EXERCISES

2. SHOULDER ROLLS

How To:

Sitting up tall in your chair, in good posture.

Bring your shoulders up back and around in a rolling motion

Complete this 5 times.

3. PENDULUMS

How To:

Standing next to a bench or behind a chair. Lean over as far as comfortable.

Relax your shoulders.

Allow your affected arm to hang down.

Swing the arm in a small circle — about a foot (30 centimetres) in diameter. You can hold a light weight (0.5-1kg) to increase the stretch.

Perform 5-10 revolutions in each direction.

Also swing your arm back and forth gently. Repeat 5-10 times.

As your symptoms improve, increase the diameter of your swing, but never force it.

4. ACTIVE ASSISTED SHOULDER FLEXION WITH WAND (LYING)

This exercise uses your unaffected arm or a stick (pipe or a piece of dowel - any light weight stick) for assistance.

How To:

Lay on a flat surface (the floor or a firm bed).

Keep your legs and arms straight.

Hold onto your stick in both hands, with your arm straight

Lift your arms vertically and backward as far as you comfortable can to the floor (towards your head and over) with the help of the unaffected arm.

Or, without the stick, use your unaffected arm to hold the elbow of the injured arm to help guide the arm towards the head or into the overhead movement.

Keep reaching until a stretch is felt.

Repeat 5-10 times.

6. ACTIVE ASSISTED SHOULDER EXTERNAL ROTATION WITH WAND (SEATED)

How To:

Similar to the previous exercise.

Sitting up tall in your chair with good posture, keep your elbows tucked in at your side at a 90-degree angle, holding onto your stick.

Rotate the affected arm out away from your body using the unaffected arm.

Repeat 5-10 times.

7b. WALL CRAWLS - FLEXION

How To:

Face a wall.

Reach out and touch the wall, at the height you are able to, with the fingertips of the affected arm.

Keeping your elbow slightly bent, slowly walk your fingers up the wall like a spider. Use your fingers, not your shoulder muscles.

Do this until you've raised your arm to shoulder level or as far as you comfortably can.

Slowly lower the arm (with the help of the good arm, if necessary) and repeat.

Perform this exercise 5-10 times.

7c. FINGER WALL CRAWL - ABDUCTION

How To:

As per the previous exercise, this time, face side on to the wall. 

Reach out and touch the wall, at the height you are able to, with the fingertips of the affected arm.

Keeping your elbow slightly bent, slowly walk your fingers up the wall like a spider. Use your fingers, not your shoulder muscles. 

Do this until you've raised your arm to shoulder level or as far as you comfortably can. 

Slowly lower the arm and repeat. 

Perform this exercise 5-10 times.

8. TOWEL STRETCH

The ability to place a hand behind the back becomes difficult with a frozen or stiff shoulder. This exercise helps stretch the shoulder for movements reaching behind the back.

How To:

Holding onto a rolled-up towel on the unaffected side, bring your arm over your head so the towel hangs behind you.

Now grab the other end of the towel behind your back with your affected arm.

Use your good arm to gently pull up, allowing the affected side to feel a bit of a stretch.

Hold for 10 seconds and repeat for 2-3 sets. Increase the time as you are able to.

9. POSTERIOR CAPSULE STRETCH

How To:

Sitting up tall in good posture. 

Place your arm on your opposite shoulder, use your unaffected arm to lift your affected arm at the elbow, and bring it up and across your body.

Apply gentle pressure to stretch the shoulder. 

Hold the stretch for 30 seconds.

SHOULDER STRENGTHENING EXERCISES

10. SCAPULA RETRACTIONS

This exercise gently stretches the front of the body (chest muscles) and is a basic strengthening exercise for the scapular muscles.

How To:

Sitting up tall in your chair, in good posture.

Squeeze your shoulder blades together and hold for 5 seconds.

Repeat for 5 times.

11. ISOMETRIC SHOULDER EXTERNAL ROTATION

This will help strengthen the shoulder muscles.

How To:

Sitting up tall in your chair, in good posture.

Keep the elbow of your affected arm tucked in at your side and at a 90-degree angle.

Now place your hand of the unaffected arm on the wrist of the affected arm

Apply a gentle pressure inwards on the unaffected arm and resist with the affected arm pushing out, keeping the arm in position.

Hold this for 5-10 seconds.

Repeat for 5 times.

FROZEN SHOULDER EXERCISES FOR SENIORS - SHOULDER RANGE OF MOTION EXERCISES (VIDEO)

DAILY SHOULDER EXERCISES VIDEO

SOURCES

1. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384535/

2. Upper extremity: emphasis on frozen shoulder https://pubmed.ncbi.nlm.nih.gov/17141009/

3. Physical therapy in the management of frozen shoulder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917053/

All About Spinal Stenosis & What You Can Do About It!

Relieving Spinal Stenosis
(Includes Best Exercises For Spinal StenosiS)

The word “stenosis” is used in medicine to describe a narrowing of a passage of the body.

Spinal stenosis, as you may have already guessed, is the narrowing of an area of the spine.

Spinal stenosis is a condition that can more commonly affect those over 60. It can lead to various symptoms, including lower back pain, weakness in the legs or arms, numbness in the buttocks or legs, or balance and mobility issues.

The symptoms associated with this condition can make daily life difficult. However, there are many effective treatments available and by taking the right steps, YOU CAN GET RELIEF!

In this article, we are going to look at spinal stenosis and what you can do about it! (including exercises, with an exercise video that will help).

WHAT’S COVERED IN THIS ARTICLE:

• UNDERSTANDING SPINAL STENOSIS (TO BRING RELIEF)

  • ABOUT OUR SPINE

  • ABOUT SPINAL STENOSIS

• WHAT CAUSES SPINAL STENOSIS

• SYMPTOMS OF SPINAL STENOSIS

• HOW IS SPINAL STENOSIS DIAGNOSED

• GETTING RELIEF FROM SPINAL STENOSIS

• EXERCISING TO IMPROVE SPINAL STENOSIS

  • BEST EXERCISES FOR SPINAL STENOSIS

    • 5 BEST EXERCISES FOR LUMBAR STENOSIS

      • EXERCISE VIDEO - LUMBAR STENOSIS EXERCISES

    • 3 BEST EXERCISES FOR CERVICAL STENOSIS

Note: Do not self-diagnose based on the information in this article. If you are experiencing any of the symptoms discussed in this article, make sure you see your Doctor or Physiotherapist before coming to any conclusions.

UNDERSTANDING SPINAL STENOSIS (TO BRING RELIEF)

ABOUT OUR SPINE

To better understand spinal stenosis, a little knowledge of the spine is needed. Let’s take a look at that now.

The Regions of the Spine

Our spine is a strong structure that supports our upper body. It keeps us upright and standing straight.  

It’s also a flexible structure that allows certain movements. It can bend forward (flexion), bend backward (extension), twist to each side (rotation) and bend to each side (lateral flexion).

Our spine comprises 29 smaller bones that run from our neck to our pelvis (to the tail bone). 

There are seven bones in the cervical region (the neck), twelve in the thoracic region (the upper back), five in the lumbar region (the lower back) and five bones, which are fused (and don’t move), in the sacral region (the pelvis).

These bones are called vertebra or vertebrae (plural). 

Between each of our vertebrae are intervertebral discs which act as little cushions and provide shock absorption.

Vertebrae, Intervertebral discs and spinal cord

The intervertebral discs also allow our spine to move.

In the middle of our spine, a column of nerves runs through these bones. This column of nerves is our spinal cord. The space in which the spinal cord sits is known as the foramen.

The spinal cord is quite delicate and it is protected by the surrounding vertebral bone and other tissues.

Nerves of the spinal cord branch off at every level of the vertebrae to allow signals from the brain to reach the rest of the body. 

ABOUT SPINAL STENOSIS

Throughout life, changes to the spine can occur for various reasons.

These changes can cause the spaces the spinal nerves pass through to become narrowed (aka spinal stenosis).

Any narrowing where the nerves pass through can pinch the nerves leading to pain and neurological symptoms that can affect walking, balance and sensation, and cause paralysis.

Spinal stenosis can happen in any part of the spine but most commonly occurs in the lumbar and cervical regions.

Lumbar stenosis is the most common type of spinal stenosis.

CAUSES OF SPINAL STENOSIS

Changes to the spine that cause spinal stenosis are:

OSTEOARTHRITIS

Over the years, our joints experience wear and tear, otherwise known as osteoarthritis. Osteoarthritis is the most common cause of spinal stenosis. 

Osteoarthritis can cause the spaces the nerves pass through (the foramen) to become narrowed.

The wear and tear can also lead to abnormal bone growth, called osteophytes or bone spurs, which can cause narrowing of the foramen and put pressure on the nerves.

INTERVERTEBRAL DISC ISSUES

Additionally, as we get older, the discs between our vertebrae lose height and become dehydrated (this is why we lose height as we age). 

As the discs become thinner, there is now increased pressure on the spinal joints, and it can also lead to narrowing of the foramen.

The intervertebral discs can also bulge, pushing into the spinal canal, leading to spinal stenosis.

LIGAMENT THICKENING

Another cause of spinal stenosis is a thickening of the spine's ligaments, caused by osteoarthritis and inflammation. [1]

SYMPTOMS OF SPINAL STENOSIS

With spinal stenosis, the symptoms vary between each person.

The most common symptom is pain radiating down the legs. This pain is usually felt in both legs but can occur in only one.

The pain is usually aggravated when hyper-extending the back (leaning/bending backwards). See diagram below.

Position of most pain - extending.

Additionally, prolonged walking or standing also commonly increase the symptoms.

Other common symptoms of spinal stenosis are numbness and weakness in the legs, which can lead to balance and mobility issues.

On the other hand, certain positions relieve pain, which is characteristic of spinal stenosis.

Bending forward relieves the pain (e.g. leaning forward on a table when standing, or a shopping trolley, or walking aid, when walking).

HOW IS SPINAL STENOSIS DIAGNOSED

If you are experiencing any symptoms discussed above, see your doctor or Physiotherapist for an appropriate assessment and diagnosis. 

Your doctor may order medical images/scans (X-ray and/or MRI).

As mentioned at the beginning of this article, there is no direct link between the severity of stenosis seen on medical imaging and symptoms. One may have severe stenosis on scans and no pain, and another can have mild stenosis on scans and severe pain.

How is this possible? Because scans CANNOT tell you what is causing your pain. Pain is caused by a variety of reasons. 

Scans can, however, give an idea of what is going on in your back, which helps with recovery.

Therefore you mustn't get too caught up in the results of your scans or the diagnosis of spinal stenosis. Instead, turn your attention to applying what's required to remedy your pain.

I cover medical imaging and beliefs around pain in detail in my articles on chronic pain. You can find all these articles HERE. In Part 1 of my Pain Series articles - Pain is More than Meets the Eye we look at pain from a different angle and Part 2: The Real Causes of Pain - I demonstrate, backed with studies, that what is identified on scans is not the sole cause of your pain.

Once you have an idea of what is causing your pain, your doctor will help you decide on the appropriate treatment. A conservative, exercise and lifestyle-based approach is usually the first line of treatment for spinal stenosis.

Now let's get to what you can do to help bring relief from spinal stenosis.

GETTING RELIEF FROM SPINAL STENOSIS

We have now covered that multiple factors contribute to pain and other symptoms in spinal stenosis and other chronic, painful conditions.

I discuss these factors that usually contribute to chronic pain and other symptoms in more detail in my article: “Overcoming Pain - Empty Your Cup” - (click to read).

When symptoms from spinal stenosis are increased, the best solution is to rest and avoid what is aggravating them.

At these times, management techniques can help also. These techniques include analgesia (speak to your doctor about this), heat packs, heat rubs/creams, cryotherapy (ice), herbal remedies, TENs (Transcutaneous Electrical Stimulation), ultrasound, acupuncture, cupping, stretching, amongst many others.

Rest and analgesia are not long term solutions and will eventually lead to further issues.

Exercise, along with other lifestyle changes, on the other hand, are long term solutions!

A gradual return to movement and activity is necessary as symptoms improve.

Additionally, other factors such as changing your views surrounding pain, shifting your focus on leading a healthier life, reducing stress, sleeping better, eating healthily, getting moving/exercising and doing specific exercises (covered in the next section) will help you overcome your symptoms.

I discuss lifestyle changes in more detail in my article “Overcoming Pain - Empty Your Cup Article”. And, In Part 4 of the Pain Series articles, “Overcoming your pain”, make sure to check them out.

The articles I have linked to above will give you new ways to think about your pain and solutions to begin living a healthier life and help bring relief from your spinal stenosis.

There are also many health professionals and clinics that can help you with your condition. So speak to your doctor or Physiotherapist or seek the right Health Professional for you who can help.

Being in pain/suffering is NOT a normal part of aging. There are many things you can do to help bring relief. You do not have to put up with the symptoms of spinal stenosis.

EXERCISING TO IMPROVE SPINAL STENOSIS

When in pain, the urge may be to avoid exercise altogether. In the beginning or during a flare-up of symptoms, this is ok.

However, exercise and movement are vital to manage and help overcome spinal stenosis (and any painful, chronic condition). This will ensure you remain moving well and your muscles and joints stay strong and flexible.

I recommend seeing a Physiotherapist if you are experiencing symptoms from spinal stenosis (or any back pain for that matter) as they can determine what physical issues could be contributing to your pain and develop an individualised exercise program for you.

They will also teach you specific exercises, ensure you are doing them correctly, keep track of your progress and modify your exercises where need be.

EXERCISES THAT MAY AGGRAVATE SPINAL STENOSIS

Avoiding any body movements can lead to further issues - such as increased stiffness and weakness.

However, with all painful conditions, there may be specific movements at times that will aggravate your pain, especially when symptoms are increased.

As discussed earlier, extension movements, movements leaning backwards, are common positions that cause pain with spinal stenosis.

I am demonstrating some movements in the extension position in the pictures below.

Seated lumbar extension

An increased lumbar extension stretch - Hyperextension

On the other hand, flexion movements (covered in the next section) will help ease your symptoms of spinal stenosis.

Also, stretches in standing may increase symptoms. Seated or lying stretches may be better.

Other activities that may aggravate symptoms of spinal stenosis are strengthening exercises (free weights), other high-impact exercises (for example, dancing, jogging or certain sports) and long walks (longer distances and time).

Although you may need to avoid, limit or modify certain exercises or activities initially, it does not mean you have to avoid them for good. These activities and exercises mentioned above bring many health benefits.

Free weights can be an excellent tool for a stronger body and help with back pain, provided they are performed correctly, and you have a clearance from your doctor or Physiotherapist. 

Walking is another excellent form of exercise, and exercise everyone should be doing as they are able. Start with shorter, gentle walks before progressing. For more on this, make sure to check out my article on walking HERE.

It is important to have a healthy outlook on your pain. Aim to return to your previous levels of activity, and then eventually moving beyond that and doing more types of exercise as your symptoms and movement improve over time.

EXERCISE CHOICES FOR SPINAL STENOSIS

There are always alternate exercise options if you cannot do certain activities or exercise due to your pain or other symptoms. 

One of those options is swimming or exercising in water (hydrotherapy).

Although swimming puts you in a more extended position, most people experience less or even no symptoms due to the non-weight bearing, low impact nature. 

Swimming allows you to exercise your body with decreased stress/impact.

Additionally, if you are having difficulty doing exercises due to pain, exercising in water (known as hydrotherapy) can allow you to exercise your body without increasing symptoms due to your increased buoyancy (or decreased weight-bearing) in the water. 

Furthermore, heated pools can help relax muscles and reduce pain, which will make the exercises more manageable and allow a greater range of movement compared to when out of the water, leading to more benefits.

After some time exercising in water, land-based exercise will begin feeling easier.

Other types of exercise that may help with your pain include smaller walks (building this up over time), yoga, pilates, or riding a stationary bike.

BEST EXERCISES FOR SPINAL STENOSIS

5 BEST EXERCISES FOR LUMBAR STENOSIS

Here are the best exercises you can do to help bring relief from your symptoms of spinal stenosis. There is an exercise video in the next section, which you can follow. The video will make it all easier.

If you have trouble getting up or down off the floor, I recommend doing these exercises on a firm bed.

Aim to complete these exercises once per day.

Go at your own pace and repeat for the repetitions stated below. 

As you continue with the exercises, gradually increase the repetitions, time and sets over time.

Note: Remember to consult your Doctor or Physiotherapist to ensure these exercises are appropriate for you. If these exercises cause an increase in pain or other symptoms, stop the exercise and make sure to speak to your Doctor or Physiotherapist.

1. KNEE TO CHEST FLEXION STRETCH (DOUBLE)

How To:

Lie on your back, with your body comfortable and relaxed.

Bring both your knees to your chest and hug them, keeping your spine relaxed throughout.

Hold this position for 10 seconds and then slowly lower the legs.

Repeat 5 times.

2. SINGLE KNEE TO CHEST FLEXION STRETCH

How To:

Similar to the exercises above, this time drawing one leg up at a time.

Lie on your back, with your body comfortable and relaxed and legs extended.

Bring one knee to your chest and then bring it closer to your chest by placing your hands either at the back of the thigh or just below the knee.

Hold this position for 5 seconds and then slowly lower the leg, and alternate legs.

Repeat 5 times each side.

3. LUMBAR ROTATIONS

How To:
Lie on your back, with your arms by your side and with your knees bent at 90 degrees,.

To begin keep both feet flat against the floor.

Slowly rotate the knees to the left side as far as you can, then slowly rotate the knees to the right side.

The soles of your feet will lift off the ground when doing this exercise.

Repeat this for 5 repetitions each side.

4.  BRIDGE

How To:
Lie on your back with knees bent at 90 degrees , your arms by your side and palms against the floor.

Squeeze your buttocks and raise the hips off the ground to bring the torso into a straight diagonal line.

Hold this position for 5 seconds then slowly lower your bottom back to the ground.

Repeat 5 times.

5. SEATED LUMBAR FLEXION

How To:

Sit in a firm chair with both feet on the floor.

Slowly bend yourself forward and reach towards the floor.

Hold the fully bent position for 5 seconds.

If you need to increase the pressure, hold your ankles and move into the stretch a little more.

After holding for 5 seconds, release and return to the full, upright seated position.

BEST EXERCISES FOR LUMBAR STENOSIS (VIDEO)

3 BEST EXERCISES FOR CERVICAL STENOSIS

Exercises for cervical spinal stenosis also work to improve the strength and flexibility of the neck and upper back.

Here are some upper back and neck exercises for spinal stenosis.

1.  BACKWARD SHOULDER ROLLS

How To:

Sitting up nice and tall in your chair with your feet flat on the ground.

Lift your shoulders up toward your ears and then roll them back and down.

Now relax into the starting position.

Repeat this rolling motion.

Complete for 10 repetitions.

2. SEATED SHOULDER SQUEEZES

How To:

Sitting upright in your chair in good posture.

While seated, draw your shoulder blades together, hold for a second or two, and then lower back to the start position

Repeat for 10 repetitions.

3.  CHIN TUCKS

How To:

Sitting upright in your chair in good posture

Maintaining this upright posture retract your chin out and slowly tuck your chin all the way in.

Do not move your head up or down during this movement.

Ensure you maintain the upright seated posture

Repeat for 10 repetitions.

SOURCES

1. Spinal Stenosis. https://www.ncbi.nlm.nih.gov/books/NBK441989/

Better Breathing: Improving The Health of Your Lungs Over 60

THE KEYS TO HEALTHY LUNGS FOR SENIORS (INCLUDES BREATHING EXERCISES)

Our lungs! An amazing and hard-working organ!

With each breath of air we take in, our lungs extract the oxygen we need to fuel our body. With each breath out, our lungs expel carbon dioxide, a waste product of the cells of our body doing their work.

Healthy lungs are essential for optimal functioning through all stages of life, but, just like all areas of the body, our lungs are not immune to changes as we get older.

However, when we get a better understanding of our lungs and our respiratory system and what can happen through the years, we can take charge of our health and do what’s necessary to improve the health of our lungs.

There are many things that you can be doing, right now, to improve your lung health.

So today, we are going to go through everything you need to do this.

In this article, we will look at how the lungs work, we will cover how our lungs change as we get older and look at a few lung conditions that are more common as a result of aging.

We will then go through what to do right now to improve your lung health (and your overall health). We will cover, in detail, exercising for better lung health (in general and with a lung condition). Finally, at the end of the article, we will go through some specific breathing exercises (with a video you can follow along to) to help improve your lung health and breathing.

CONTENTS:

• HOW YOUR LUNGS WORK

• WHAT HAPPENS TO OUR LUNGS AS WE GET OLDER

• LUNG CONDITIONS THAT CAN OCCUR IN SENIORS

• IMPROVING LUNG HEALTH OVER 60

• HOW TO EXERCISE TO IMPROVE LUNG HEALTH

  • HOW OFTEN SHOULD I EXERCISE TO IMPROVE LUNG HEALTH

  • HOW HARD SHOULD I EXERCISE TO IMPROVE LUNG HEALTH

  • HOW LONG SHOULD I EXERCISE TO IMPROVE LUNG HEALTH

  • WHAT TYPE OF EXERCISE SHOULD I DO TO IMPROVE LUNG HEALTH

• EXERCISING WITH A LUNG CONDITION

• EXERCISES FOR BETTER BREATHING

• BREATHING EXERCISES FOR HEALTHY LUNGS - VIDEO

NOTE: Try not to skip any parts of this article. Doing what’s important for your health does take more time and effort, but the results are ALWAYS WORTH THE EFFORT. So, take the time to read this article from start to finish, and, if you know anyone who would benefit from this article, make sure to send it on.

Now, let’s begin!

HOW YOUR LUNGS WORK

To understand what can happen to your lungs as you get older and what you can do to keep your lungs as healthy as possible, we will look now at the lungs and how they work in a bit of detail.

Our lungs serve two main functions. 1) To take oxygen in the air we breathe and circulate it around the body, which is vital for all cells, and 2) remove waste gases (carbon dioxide) from the body. This process is vital for life.

I’m sure you know we have two lungs: The right lung and the left lung.

When we take a breath in, the air moves down our trachea (windpipe) into the bronchi, which is the first branch of the trachea. The bronchi allow air to move both in and out of the right and left lungs.

View fullsize

THE LUNGS (RESPIRATORY SYSTEM)

The bronchi divide into increasingly smaller branches, known as the bronchioles. At the end of each bronchiole, there are clusters of microscopic, balloon-shaped air sacs, known as alveoli.

[For a better understanding see the diagram above of the respiratory system].

As we breathe, oxygen from the air is absorbed into the blood. The now oxygen-rich blood flows to the heart and is pumped to each cell, for fuel, throughout the body. As the cells of our body do their work, carbon dioxide, made by the cells, moves into the blood and returns to the heart.

The heart then pumps this carbon dioxide-rich blood to the lungs, passing into the alveoli, which then travels back out the trachea and is exhaled through the mouth or nose.

Our lungs expand with inhalation, as the alveoli fill with air and shrink with exhalation as carbon dioxide is expelled.

You’d most probably assume that the lungs contain muscles to aid in this expansion and contraction. This is not the case! Our lungs contain no muscles.

However, a strong, dome-shaped muscle is beneath the lungs known as the diaphragm. The diaphragm is the primary muscle that aids in the expansion and contraction of the lungs when we breathe, and separates our chest and abdominal cavities.

Additionally, other accessory respiratory muscles (of the abdomen and ribcage) aid the diaphragm in inspiration and expiration.

Our lungs are also supported and protected by our rib cage, which moves slightly to help our lungs expand and contract.

WHAT HAPPENS TO OUR LUNGS AS WE GET OLDER

Our lungs reach full maturation and function around the age of 20-25. [1]

After this, there is a slow, gradual decrease in the function of our lungs and respiratory system due to the normal changes of aging.

These changes occur to the lungs themselves, the muscles and bones which assist our breathing, and a decrease in immune system function over the years can also cause lung issues.

CHANGES TO THE RESPIRATORY SYSTEM WITH AGING:

CHANGES TO THE LUNG

• The alveoli (air sacs) become larger and lose elasticity (decreased elastic recoil during inhalation/exhalation). [2]

CHANGES TO THE MUSCLES (AND OTHER SOFT TISSUES)

• The diaphragm weakens.

• The accessory respiratory muscles weaken and may stiffen up.

• Other soft tissues can also weaken and become stiffer causing increased stiffness of the chest wall.

CHANGES TO THE BONES

• Bones become thinner and change shape.  Due to this, the ribcage can’t expand and contract as efficiently during breathing.

CHANGE TO THE IMMUNE SYSTEM

• Our immune system’s function decreases with age, leading to an increase in inflammation, making it more difficult for the body to fight lung infections. [3, 4]

These changes, combined with being frequently exposed to many environmental toxins over the years (i.e. respiratory infections, air pollution, occupational dust/chemicals, smoke etc.), can take their toll on our lungs. Our lungs become less efficient and more susceptible to inflammation and infection. [5]

Although this may all sound a little worrisome, the changes are mostly natural, are gradual over the years and also subtle. It will only be when exercising that you will notice a difference, such as a decrease in fitness (increased shortness of breath or muscle fatigue) when exercising.

The changes of the lungs described above CAN BE IMPROVED IN SOME WAY, NO MATTER YOUR CONDITION RIGHT NOW! Which we will get to in the upcoming sections.

[If you notice sudden changes with your breathing, however, this includes increased shortness of breath (even when resting), or you are having difficulty keeping up with people your age, or you have persistent respiratory symptoms (for example - a cough that won’t go away) - make sure to see your doctor].

Before we get into what you can do to improve your lung health, let’s now go through some lung conditions in seniors. As I know, some of you reading this may have these conditions.

COMMON LUNG CONDITIONS OVER 60

Lung conditions can occur and do become more common as the years go on. These conditions can make it difficult to function each day.

There are many conditions that can affect the lungs, too many for me to cover them all in this article, however, here are some more common lung conditions that can occur in seniors:

ASTHMA

Asthma is when the lungs’ airways become inflamed and narrowed to the point that breathing is difficult.

Asthma is characterised by difficulty breathing, a dry hacking cough, wheezing and a tight chest.

This narrowing of the airways in asthma is reversible and those with asthma can lead a normal, active life with a healthy lifestyle and proper treatment.

BRONCHITIS (ACUTE)

Acute bronchitis is an infection, that lasts less than three months, of the lining of the bronchial tubes.

Acute bronchitis is usually caused by a viral infection (cold or flu) or sometimes by a bacterial infection.

The most common symptom of bronchitis is a productive cough (brings up mucus). Coughing can become constant and turn into wheezing or difficulty breathing.

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

An umbrella term for the lung diseases emphysema and chronic bronchitis.

• EMPHYSEMA
  In emphysema, the walls between many of the alveoli (air sacs) are damaged. As a result, the alveoli lose their elasticity and shape and become baggy.

This damage can also destroy the alveoli walls, leading to fewer and larger alveoli instead of many tiny ones, reducing the amount of airflow into the lungs and even more so the amount out.

Shortness of breath is the main sign of emphysema. At first, it may be only after exercise. Eventually, it can happen at rest.

• CHRONIC BRONCHITIS
  In chronic bronchitis, the lining of the airways stays constantly irritated, inflamed and swollen (longer than three months). This leads to thick mucus forming in the airways, making breathing difficult.

Most people who have COPD have both emphysema and chronic bronchitis. However, due to the difference in the severity of each condition from person to person, the general term COPD is used.

COPD Is progressive and is usually caused by smoking (or passive smoke) or exposure to other lung irritants such as air pollution, chemical fumes, or dusts.

PNEUMONIA

Pneumonia is an infection of one or both of the lungs. The infections are usually caused by bacteria or a virus. However, sometimes it can be caused by fungi.

The infection leads to inflammation of the alveoli and the alveoli filling with fluid and pus, making it difficult to breathe.

Symptoms include fever, chills, shortness of breath, a chronic, wet cough and chest pain when breathing or coughing.

Those who smoke or have other chronic disease are more susceptible to pneumonia. 

These are some of the more common lung conditions. There are many effective treatments out there for these conditions and many treatments to ease the symptoms.

If you have been diagnosed with a progressive lung disease, there are always things you can do to improve your situation, with many programs and/or Professionals out there that can help. So do not lose hope!

In the next sections, we will cover what you can do to improve your lung health.

IMPROVING LUNG HEALTH OVER 60

Beyond getting active (which we will cover in later sections), there are some steps you can take to improve the health of your lungs throughout your life, these are:

DON’T SMOKE

We all know that smoking is terrible for our lungs. Smoking also compounds the effects of aging.

If you’re a smoker, although this is not easy to do after years of this habit - if you want to improve your lung health and prevent it from worsening - YOU MUST STOP SMOKING!

There are plenty of good programs and apps out there that can help you quit and many people have successfully quit using these programs. You can also speak to your doctor about quitting next time you visit who will be able to guide you.

AVOID TOXIC FUMES - STICK TO CLEAN AIR

Air pollution - both indoor and outdoor, secondhand smoke, chemicals and dust (both in the home and workplace) can cause damage to your lungs.

Avoid secondhand smoke, stay away from harsh chemicals and avoid breathing in damaging fumes (e.g., cleaning and gardening products). Wear a quality mask if these products are unavoidable.

Stick to clean air as much as you can. If you can make a move to a place with cleaner air, you will do great things for your lungs.

I know that it's not so easy to make a move to a place of cleaner air, so consider taking day trips out in nature or to places with cleaner air.

MAINTAIN A HEALTHY WEIGHT & EAT HEALTHY

In obese and overweight people, there is a strong correlation between lung function and body fat distribution.

Obesity causes compression of the lungs, the diaphragm, and the chest cavity, leading to restrictive pulmonary damage. Additionally, excess fat decreases respiratory system compliance, increases pulmonary resistance and reduces respiratory muscle strength. [6]

On the other hand, being underweight has also been associated with decreased pulmonary function parameters due to low muscle mass and reduced strength and force of the diaphragm and accessory respiratory muscles. [7]

Do what you can to ensure you maintain a healthy weight.

GET MOVING - REGULAR EXERCISE

Regular exercise will strengthen your respiratory and skeletal muscles and improve your lung and other body systems' efficiency.

If you are new to exercise, it's just about getting started, staying consistent and progressing over time.

It is important you gradually build up the amount of exercise you do with any type of exercise, ensuring you don't overdo it.

Aim to spend more time moving and less time seated or lying - gradually building this up.

[We will cover exercise in more detail in the next section]

IMPROVE YOUR OVERALL HEALTH

Our body systems are working together, so it is crucial to improve your overall health. Think about other aspects of your health that you can improve and set out on improving them.

This includes:

• Maintaining a healthy weight and getting moving (discussed above).

• Minimising junk food and eating a healthy diet full of nutrient-dense foods, so you’re getting all your needed vitamins and minerals and energy. (For more on healthy eating, click HERE).

• Decreasing stress and worry. Anxiety, worry, fear, and other strong negative emotions take their toll on health and make breathing more difficult. If you are constantly under stress, speak to your doctor about this. Also, set time aside each day for relaxation and letting go of stress. There are plenty of good apps that can help with this.

• Adequate sleep - make this a priority. If breathing difficulties affect your sleep, speak to your doctor about this. (For more on this, click HERE).

• Other steps for improved health include getting adequate sunlight, socialising and proper hydration.

GET REGULAR CHECK-UPS

Regular check-ups with your doctor are very important, even when feeling well.

Lung issues can sometimes get unnoticed until it gets serious.

Make sure you see your doctor every six months for a regular check-up.

HOW TO EXERCISE TO IMPROVE LUNG HEALTH

When exercising to improve your lung health, there are some guidelines to follow that will bring the most benefit.

However, try not to get too caught up in it all and wanting to get everything perfect. What’s most important is to just get moving more so, especially if new to exercise.

The more you move (without overdoing it), the better your lungs and respiratory muscles will function, and your fitness will improve. The less you move, the less efficient your lungs and respiratory muscles will be (decreased fitness). It’s as simple as that!

Remember, when you spend less time seated, and more time on your feet, your lung function and overall health will improve.

You ALWAYS want to work your way up to more activity over time, however. Start small and gradually build on this. Slow and steady to get to your goals.

When you do too much too soon, this is where problems (and injuries) can arise.

This section will go through how to exercise to ensure you’re improving your lung health safely and effectively. In the following section, I will cover the basics of exercising with a lung condition.

EXERCISE FOR HEALTHIER LUNGS

We’ve established that getting moving more is the key to healthier lungs. However, sooner or later - once you’ve got the hang of it, or you notice what you’re doing isn’t giving you the results that you want - you’re going to have to change things up to keep getting results.

There are some guidelines to follow to do this.

To determine how to exercise for improving lung health, we will make this easier by following the F.I.T.T Principle. (Frequency, Intensity, Time and Type).

HOW OFTEN SHOULD SENIORS EXERCISE TO IMPROVE LUNG HEALTH (FREQUENCY)

To exercise for better lung health, you want to be exercising at minimum, three times per week and optimally five times per week of exercise that gets that heart rate up and lungs working. Again, you would build up to more over time.

You’d also want to be doing strengthening exercises at least two days, preferably three days, per week.

Being active on most days, preferably all days in some way, is best. The more you’re moving the better.

It does not have to be a specific type of exercise. You can choose the exercise or activities you enjoy (we will get to this soon).

HOW HARD SHOULD SENIORS EXERCISE TO IMPROVE LUNG HEALTH (INTENSITY)

The intensity of exercise is how hard you exercise during each session. Or, how much you are exerting yourself.

To improve your fitness and lung function, a certain level of stress needs to be applied to the body and respiratory system.

A simple way to know the intensity of the exercise you are undertaking, you can use a Rating of Perceived Exertion (RPE) Scale. [See below]. 

RPE SCALE - To download click above.

To use this scale to determine exertion during exercise, you simply ask yourself, “how hard does this exercise feel to me” based on the numbers and how difficult the exercise feels as per the scale.

If the exercise feels too easy (point 7-9), increase the intensity of the exercise to increase the number/points. If the exercise feels too difficult (point 16+), decrease the intensity of the exercise to bring the number down.

As you can see, this is a simple way to determine and track how much you are exerting yourself during exercise (or the intensity) without using technology and heart rates.

For optimal results to improve your lung health, you want to ensure you are exercising for a set time at moderate intensity. This would be an RPE of 13 (somewhat hard - slight breathlessness, can talk - 70%) to 15 (hard - increased sweating, able to push and still maintain proper form - 80%). 

This may sound confusing, but once you’ve downloaded the table and had a look, it’s quite easy to work out.

You then would want to stay consistent at this level 3 to 5 times per week.

As you stay consistent with the exercise, you will find you are doing more exercise to stay in that 13-15 range.

TO DOWNLOAD and PRINT an RPE scale to use, you can do this HERE.

HOW LONG SHOULD SENIORS EXERCISE TO IMPROVE LUNG HEALTH (TIME)

We now know how much we should be exercising each week and at what intensity.

We now need to determine how long to exercise for each session, each day and each week.

When exercising to improve lung function, aim for 30-60 minutes per session. Or aim to achieve 150 - 300 minutes per week of moderate-intensity physical activity each week.

You can break this up during the day into shorter sessions if you have difficulty with longer, continuous exercise.

As stated earlier, some exercise is better than nothing, and on some days, you will find it hard to get moving. That’s ok! Do your best! And always be nice to yourself. :) 

WHAT TYPE OF EXERCISE SHOULD SENIORS DO TO IMPROVE LUNG HEALTH

Now, it’s about deciding on what type of exercise to do.

When it comes to the type of exercise - the world is your oyster! :) 

There are so many different types of exercise you can do. Get creative.

You can choose between the many MORE LIFE HEALTH EXERCISE VIDEOS. (Click for videos). Or longer exercise routines HERE.

Make sure you’re also signed up to the More Life Health Mailing list to get a FREE 4-week exercise ebook that you can follow along with to help get you started. (CLICK to Join)

Another type of exercise is walking. Walking is an excellent type of exercise to help improve your fitness, and you can vary the difficulties and intensities. Make sure to check out my article on walking HERE.

You can also go hiking, swimming, to the gym, treadmill, cycling, rowing, taking an aerobics or swim aerobics class.

Maybe it’s gardening, playing golf, tennis or playing with the grandkids.

Whatever it is, there are plenty of ways to get moving and to make it enjoyable.

But remember - no matter the type of exercise — always build it up. And always speak to your doctor before undertaking exercise.

If you’re stuck or want to get ideas of what others are doing, join the More Life Health Support Community for help. You can do this by clicking HERE.

PROGRESS THE EXERCISE AS YOU IMPROVE, SO YOU CONTINUE TO IMPROVE

Once you have been exercising for some time and you’re well into the swing of things, your body will be improving.

You’re now consistently exercising - you’re working your skeletal muscles, working your respiratory muscles, working your heart muscles and your lungs and other body systems.

By doing this, your body and lungs are becoming more efficient, and you now have improved tolerance to the demands and stressors of daily life.

Eventually, the exercises will become too easy as your body adapts. To continue to improve your health and fitness, you must gradually increase the exercise.

You do this by increasing the distance, speed, weight, repetitions, or sets, so you continue to challenge yourself and continue to make improvements towards your goals.

IMPROVING LUNG HEALTH - EXERCISE SUMMARY:

• FREQUENCY of exercise:
  3-5x per week of exercise that increases the heart rate.
  2-3x per week of strengthening exercise.

• INTENSITY of exercise:
  Moderate intensity exercise - 13-15 Rating of Perceived Exertion (RPE).

• TIME spent on exercise:
  30-60 minutes per session (or per day if unable), or 150-300 Minutes per week.
  Some exercise is better than no exercise.

• TYPE of exercise:
  The world is your oyster - get creative.

• GRADUAL PROGRESSION of exercise:
  Stay consistent. When you do this, the exercise will become easier. It's now time to progress the exercise gradually so you continue to improve.

EXERCISING WITH A LUNG CONDITION

When you have a lung condition, the thought of exercising can be intimidating and scary, especially when you haven’t done much exercise previously.

Breathlessness can also be scary, and fears can arise around this.

This fear causes many to avoid activities that may increase that breathlessness. With the avoidance of exercise and therefore less activity, your body will become weaker, and the body systems will become less efficient.

As time goes by, it then becomes even more challenging to exercise. The feelings of breathlessness increase as your body now requires more oxygen to work at less effort, and the cycle repeats. The less active you are, the more your symptoms will increase.

I have just described the cycle of inactivity and this can be common in those with a lung condition—[See diagram below].

Negative Cycle of INACTIVITY

This cycle of inactivity demonstrates why getting moving is so important when you have a lung condition.

When you exercise, your musculoskeletal, respiratory and cardiovascular systems are all being worked, which are vital to improving your lung health.

To overcome and avoid this cycle of inactivity and turn it all around, it starts with being aware and overcoming those fears of breathlessness.

Breathlessness during exercise, although uncomfortable, is normal and will help improve the condition of your body and your lungs.

The next step is to get active and remain active.

You do not have to do a lot of strenuous exercises. The key is just to get started and gradually build it up in the same way as we described in the last section.

You don’t overexert yourself, but you go at your own pace and stay consistent.

You don’t want to overexert yourself with exercise. Take it slow. You are in no rush and here for the long term. Doing too much too soon will have the opposite effect.

Once you begin and stick to it, this all gets much easier.

When you do this - you’ve beat the cycle of inactivity and the opposite happens!

As a result, you feel your body getting more conditioned. You feel stronger with less breathlessness (your body is now using less oxygen for the movement and is more efficient). The fitness of your lungs and heart are improved.

You will notice the activities you do, both during the exercise and in your daily life, which were once strenuous, are now getting much easier, and overall you feel much better.

You slowly and gradually build it up as you feel your body adapting to the exercise, and you're getting stronger and fitter. You see the importance of exercise and physical activity, which motivates you to continue. So you do!

A positive activity cycle is your new relationship with exercise, and it becomes the norm. [See diagram below].

Positive Cycle of ACTIVITY

Exercising with a lung condition does not have to be something done on your own.

If you are new to exercise and have a chronic lung condition, I recommend you see a Physiotherapist or join a Pulmonary Rehabilitation Program in your area. Doing this is the best (and safest) way to learn how to exercise if you have a chronic lung condition. It will ease a lot of fears you have around your exercise also.

Additionally, your exercises will be prescribed to you based on YOUR current health status and the goals YOU want to achieve.

These programs can be one-on-one or group sessions and are run by Health Professionals in your area.

Your doctor will speak to you about joining a program like this. Or if they haven’t, bring this up to your doctor next time you speak. Or your can do a quick google search to see if there are any pulmonary rehabilitation programs in your area, and give them a call to find out more.

Getting up and moving more is the key to improving your condition when you have a lung condition.

Aim to spend less time sitting and more time exercising. We are not built to be sitting so much.

There are many ways to go about your exercise if certain ways aren’t working for you. There ARE ALWAYS ways that will work, it is just about finding these ways.

One way is you can break up the exercise during the day into shorter sessions if having difficulty with longer, continuous exercise. You don’t need to do 30-60 minutes at once, 5x per week. Especially to begin with. Break it down, start small and build it up, gradually over time.

Do your best to stay positive. You can and will make progress!

If you’re having trouble with your exercise, working with a professional can help put your worries at ease and help make everything much more manageable and help you get the most out of your exercise.

BREATHING EXERCISES FOR IMPROVING LUNG HEALTH

These exercises below are specific exercises designed to help improve your breathing, strengthen the muscles of your respiratory system and help you relax, which will also help improve your breathing.

You can do these exercises once or twice a day.

NOTE BEFORE: If you feel light-headed or dizzy when doing these exercises, stop the exercises. As with all exercise, make sure you see your doctor before undertaking these breathing exercises.

BREATHING EXERCISES FOR SENIORS

To begin, make sure you’re sitting upright in a chair, you’re comfortable, with your shoulders back and down and your body relaxed.

EXERCISE 1: RELAXATION

This exercise is to help you relax in general and before beginning the exercises. Breathing will be more difficult when more anxious, worried or stressed. Try these breathing exercises throughout the day to help you relax!

HOW TO

1. Begin in the relaxed position above, with good posture. Gently close your eyes.

2. Breathe in gently through your nose and then out gently through your nose.

3. If you can't breathe out through your nose, breathe out through your mouth instead -if you breathe out through your mouth, it's better to breathe out with puckered lips or using 'pursed-lip' breathing - to slow your breathing.

4. Keeping your body relaxed throughout - as you breathe out, let go of any tension in your body.

5. As you continue, gradually try to make each breath slower.

6. Continue until you feel relaxed and ready to move on.

EXERCISE 2: DEEP BREATHING WITH INSPIRATORY HOLD

Deep breathing exercises help get the air into all lung lobes and can help to loosen any mucus making breathing easier.

HOW TO

1. Sitting in the upright posture described above, with your shoulders back and down. Relax - relax your chest and shoulders.

2. Take a slow, long deep breath in through your nose.

3. Hold the air in your lungs for 2-3 seconds before breathing out (this is known as an inspiratory hold).

4. Breathe out slowly, gently and relaxed. Don't force the air out.

5. Repeat 3 – 5 times.

6. If you feel light-headed or dizzy, stop the exercises and take a break - focusing on relaxing your body.

EXERCISE 3: ABDOMINAL BREATHING

Abdominal breathing helps strengthen your diaphragm and other accessory respiratory muscles.

HOW TO

1. Sitting in the upright posture, with your shoulders back and down. Relax - relax your chest and shoulders.

2. Place one hand on your chest and the other hand on your belly.

3. Inhale, taking a long, slow deep breath through your nose and towards the hand on your belly, whilst your chest remains relatively still.

4. You should feel the air moving through your nose into your abdomen, lifting your hand on your belly up and expanding your sides at the waist.

5. Now exhale slowly with puckered lips (or the pursed-lip position) and feel the stomach contracting.

6. Repeat 3 – 5 times.

EXERCISE 4: QUICK SNIFFLES
This exercise can help strengthen your diaphragm and accessory respiratory muscles.

HOW TO

1. Sitting in the relaxed position described above, with your shoulders back and down. Relax - relax your chest and shoulders.

2. Close your mouth

3. Breathe in and out of your nose quickly.

4. Repeat for 15-30 seconds.

BREATHING EXERCISES FOR SENIORS (VIDEO)

Exercises for improved breathing - Exercises for shortness of breath - Shortness of breath exercises - COPD exercises

Do you have a lung condition? Or trouble with your breathing? Have you made improvements with your breathing? Or do you have a story you want to share? What have you found to help with your breathing and improve your lung health? I’d love to know. Let me know in the comments below!

SOURCES

CLICK HERE TO VIEW ALL SOURCES USED IN THIS ARTICLE.

The Complete Guide To Strong Bones Over 60 [Part 3]

PART 3: EXERCISE TO DO FOR STRONG BONES

(INCLUDES EXERCISE VIDEOS FOR STRONG BONES)

Along with good nutrition and cutting out factors that could be decreasing bone strength, exercise should be the first line of intervention in the management of osteopenia and osteoporosis. [1]

A proper exercise regime can improve bone strength and help you become more flexible, agile, and limber, which can help prevent falls and decrease any fractures that could occur.

This part of the article will look at the connection between exercise and stronger bones and the types of exercise most beneficial for healthy and strong bones and prevent falls and fractures.

At the end of the article, I'll share some exercise programs (with videos and pictures) for improving bone strength (and muscle strength) which you can follow along to in the comfort of your own home.

Before we get into part 3, however, if you are yet to read part 1 and part 2, it is a good idea to read part 1 and 2 first, which will give you a better understanding of your bones (and how to keep them strong) and will also help you understand this part more.

For PART 1: WHAT YOU NEED TO KNOW TO GET STRONGER BONES

For PART 2: HOW TO EAT FOR STRONGER BONES (AND OTHER FACTORS THAT IMPROVE BONE HEALTH)

Now, let's get into exercise for stronger bones.

WHAT WE’LL BE COVERING IN PART 3:

EXERCISE & BONE STRENGTH: HOW TO EXERCISE FOR STRONGER BONES

THE BEST TYPE OF EXERCISE FOR STRONGER BONES

• RESISTANCE TRAINING AND STRONGER BONES

• AEROBIC EXERCISE AND STRONGER BONES

• WALKING AND STRONGER BONES

• VIBRATION THERAPY AND IMPROVING BONE STRENGTH

• IS SWIMMING AND WATER EXERCISE GOOD FOR BONE STRENGTHENING?

HOW OFTEN SHOULD YOU EXERCISE FOR STRONGER BONES

EXERCISE PROGRAMS FOR STRONGER BONES/OSTEOPOROSIS

• BEGINNER EXERCISES FOR STRONGER BONES (AND MUSCLES)

• EXERCISE VIDEO - BEGINNER EXERCISES FOR STRONGER BONES

• INTERMEDIATE EXERCISES FOR STRONGER BONES (AND MUSCLES)

• EXERCISE VIDEO - INTERMEDIATE EXERCISES FOR STRONGER BONES

WHAT RESULTS SHOULD I EXPECT BY UNDERTAKING A BONE-STRENGTHENING PROGRAM?

WHAT EXERCISES TO AVOID WITH OSTEOPOROSIS

PREVENTING FALLS

EXERCISE AND BONE STRENGTH - HOW TO EXERCISE FOR STRONGER BONES

In part 1, we discovered that our bones are constantly changing—a constant breakdown of old bone and rebuilding of new bone.

These changes occur gradually in response to the pressure and forces required of them. When we get moving and exercise regularly, our body adapts to the exercise forces by creating denser and more resilient bones.

When we spend less time exercising and less time on our feet, the opposite can occur. Our bones can become weaker!

Any activity where you are putting weight through your feet is known as weight-bearing activity, and it is essential for stronger bones.

Weight-bearing activity puts needed pressure on your bones and challenges your muscle strength against gravity also.

Some examples of weight-bearing activity include walking, jogging, jumping, playing tennis and dancing. On the other hand, seated exercises or swimming are not weight-bearing activities.

The more you can get up, on your feet and active (making sure you are not overdoing it and also supporting your nutritional needs with the right type and amount of food), the more you stimulate your body to produce stronger bones.

GETTING STARTED WITH EXERCISE - BEFORE YOU START

When you've been told you have weaker bones, the thought of exercising can be a little scary. Taking up exercise for the first time can be daunting on its own, even more so if there is a genuine concern for falls and fractures.

For these reasons, seeing a Doctor and Physiotherapist is important before starting a workout routine. Your Doctor or Physio will give you clearance to begin exercise to ensure it's currently safe to go ahead and help clear out any doubts or questions you still might have about any specific activities or exercising in general.

Furthermore, a Physiotherapist can give you professional advice on how to safely and properly undertake exercise.

It's also important when starting a new workout routine to make sure to start slow and build up your exercise gradually, over time, to help avoid any issues. This is particularly important if you have been inactive for an extended period.

If you’re not sure if you are doing too much, the best thing you can do is listen to your body. If things seem off or you feel like you’re overdoing it. Stop and speak to your Physiotherapist.

With any new task, it is always harder in the beginning. After some time staying consistent with the exercises, you will eventually get the hang of everything, and it all becomes much easier.

THE BEST TYPE OF EXERCISE FOR STRONGER BONES

Once you’re ready to get into your exercises, the next step is doing the right type of exercise to produce the best results for strengthening your bones.

So what type of exercise is best for strengthening bones?

There are many types of exercise that can help strengthen bones, and to get the best effects from your exercise, it is more than just targeting the bones alone.

You want an exercise regime that takes into account the many components of fitness.

A regime that not only targets bone strength with weight-bearing exercise (which we will cover below) but also includes muscles strengthening exercises of your whole body. Stronger muscles mean better movement, greater ease of movement, less risk of falls and less strain on those bones.

You also want to improve your flexibility - again, when you are more flexible, you’re going to move much better and have less pain.

Then there are other components of fitness such as aerobic fitness and balance that should be included in your weekly exercise routine. Aerobic fitness and balance are not only weight-bearing activities good for your bones, but they are essential for a healthy body (with a healthy body comes healthier bones) and to decrease your risk of falls.

For stronger bones - exercises should incorporate a mix of the following categories:

• Resistance training (using free weights such as dumbbells and barbells, elastic band resistance, body-weight resistance or weight-training machines)

• Weight-bearing aerobics exercise (brisk walking, dancing, elliptical training machines)

• Exercises to improve balance and posture (balance exercises, chair exercises, tai chi, yoga)

RESISTANCE TRAINING FOR STRONGER BONES

Resistance training, also commonly known as strength training, is a form of exercise focused on improving the strength and size of skeletal muscles.

Weight-bearing exercises are required for bone health, and strength training with relatively heavy weights is known to produce the most effective results. 

Studies show that resistance training, either alone or combined with other exercises, could be the most optimal strategy to improve muscle and bone mass in postmenopausal women, middle-aged men, and the older population. 

In one study, postmenopausal women with osteoporosis or osteopenia underwent 12 weeks of supervised strength training 3 times a week. The results confirmed that lumbar spine and femoral neck Bone Mineral Content increased by 2.9 and 4.9%.

These are just two of the many studies that show the benefits of resistance training for strengthening bones.

Now, for some of you reading this, you’re probably thinking: “Lifting weights? Is he out of his mind?”

I know the prospect of lifting something heavy, especially if your bones are already weaker, might seem scary, counterproductive... or just downright crazy. But this is the right way to strengthen your bones and is safe when done correctly.

As I already mentioned before, if you’re reluctant to start using weights, it is best to see a Physiotherapist in person to know you’re doing everything correctly, which will help give peace of mind.

You don’t have to jump straight into using weights also. If exercise is new to you, start with other exercises (like the beginner bone-strengthening exercises below), and once everything becomes easier, you can progress to using weights.

You’ll get the hang of this weight-lifting business in no time.

For a whole lot more information on strength training and how to do it right, make sure to read my article: HOW TO GET STRONG AND STAY STRONG AFTER 60 - THE COMPLETE GUIDE.

AEROBIC EXERCISE FOR STRONGER BONES

Combining resistance training with a form of weight-bearing aerobic exercise can further help strengthen those bones and increase the strength and endurance of your muscles, with the additional health benefit of improved cardiovascular fitness. 

Weight-bearing aerobic exercise works the bones in your legs, hips, and spine, as they’re designed to support the whole weight of your body. 

Examples of weight-bearing aerobic exercise include walking, dancing, jogging and running, among many other activities. 

WALKING FOR STRONGER BONES

When we spend a lot of time seated or lying down, the body isn’t getting the signal to produce stronger bones. There is less of a need for it.

For stronger bones, it is important to get up and moving more so.

One way I recommend (especially if you’re just getting started) is by walking more.

As far as aerobic activities are concerned, walking is a great way to burn some extra calories, lower your blood sugar, strengthen the heart, and improve your mood. However, walking alone won’t do as much good when it comes to bones than when added with other exercise types.

Now, don’t get me wrong, everyone has to start somewhere - it could begin just by walking more around your home or a stroll around the neighbourhood. This is much better than spending most of your day seated. 

But if you want to strengthen your bones more so, you’ll want to pick up the intensity a little. Instead of a leisurely walk, opting for something more challenging would be a much better choice. 

When going out for a walk, consider not only the pace (brisk walking) but also the duration, as well as the difficulty of the terrain (stairs, hills, different surfaces) you’re walking on. Even though walking may not seem like much exercise, just like any exercise, it can be overdone, leading to pain and injury. It’s important you gradually build up the amount of walking you do and give rest days, especially if it has been some time since you have been out and about. Take your time to build a strong foundation.

Also, if you’re at risk of falling, please take appropriate precautions.

For more information on walking (and how to avoid pain and injuries), make sure to read my article: WALKING AND YOU: THE SENIORS GUIDE TO GETTING MORE OUT OF WALKING!

DOES VIBRATION THERAPY IMPROVE BONE STRENGTH?

As the name suggests, vibration therapy relies on transmitting mechanical vibrations through a device (which the user stands on), causing the vibrations to go through the user’s body. 

These vibrations cause the muscles to contract and relax while also applying forces through the bones. It is suggested that the continuous vibrations increase bone strength by increasing bone formation and decreasing bone resorption. [2]

Whole-body Vibration Platform

Vibration therapy was first developed by scientists as a tool to potentially keep the bones strong of astronauts after spending some time in the zero-gravity, non-weight-bearing conditions of space. This time spent in space was causing accelerated muscle and bone loss.

The vibrating platform was designed to be used for 10-15 minutes per day and hoped to help regain some of the lost bone and muscle mass. 

Today, there are two types of vibration therapy used to potentially strengthen bones: Whole Body Vibration (WBV) and Low-Intensity Vibration (LIV).

WHOLE-BODY VIBRATION uses a larger platform on which the user stands whilst holding onto handles. The vibration speed and intensity of the vibrations on this machine can be varied - up to high intensities.

Studies have shown mixed results on bone strength. 

Many studies reporting beneficial effects on bone mineral density, muscle strength and falls prevention. [3, 4, 5].

Conversely, some studies also showed that WBV has little effect on bone mineral density and that weight-bearing physical exercise is superior for bone health [6, 7].

Depending on your level of osteoporosis, whole-body vibration, with its increased intensity of vibrations, may cause more harm than good and are not recommended in some cases.

There are also potential contraindications for using whole-body vibration. These include joint implants, retinal detachment, fresh surgical wounds, having a pacemaker or cochlear implants.

LOW-INTENSITY VIBRATION THERAPY, on the other hand, is a smaller platform that looks like digital weight scales and can be used by anyone and is much safer. These platforms are designed for this reason. It is still best to check with your Doctor or Physiotherapist first before using or purchasing a LIV platform.

Again research on both animal and human studies have shown mixed results with the use of LIV therapy, with some animal and human studies showing potential benefits, on bone and muscle mass and falls prevention.

Due to the fact, these platforms have fewer adverse effects than high-intensity vibration devices and have shown beneficial results, low-intensity vibration devices are recommended over whole-body vibration devices.

---

Although vibration therapy is still a relatively new and unexplored medium, and the definite dose of what’s best to stimulate bone growth has not been defined, there is evidence of its effectiveness in improving muscle and bone strength.

If you have difficulty undertaking weight-bearing exercise or are unable to do so, or would just like another way to help keep your bones stronger, you may want to trial vibration therapy. Vibration therapy, however, should not be used as the sole form of treatment for increasing bone and muscle strength.

As with any exercise, ensure you speak to your doctor before using a vibration device.

If your doctor has given you the all-clear to use one of these devices, speak to an appropriate professional who can help you get started and safely progress.

Build up the amount of time gradually (and the intensity of vibrations), and depending on your capabilities. This will allow your body to adapt without causing issues.

IS SWIMMING AND WATER EXERCISE GOOD FOR BONE STRENGTHENING?

A common question I get asked is, “does swimming help with stronger bones?”

Since water-based activities are performed in a low gravity environment (non-weight-bearing), they don’t put much stress on your bones, which means you are not getting the bone-building benefits.

Although with swimming and other water activities (hydrotherapy, aqua aerobics etc.), you are getting less of the forces needed to promote bone strengthening. These activities still make for good cardiovascular training, which is good for overall health.

They also help reduce stress on weight-bearing joints if you have painful joints, can help increase mobility, muscle strength and improve balance and posture. If this is a type of exercise you enjoy doing, it has many health benefits. So keep it up, but if your aim is for stronger bones, make sure to be doing other forms of weight-bearing exercise.

HOW OFTEN TO EXERCISE FOR STRONGER BONES

The goal is to implement more movement into your daily routine and to build this up over time.

An effective exercise program includes a combination of aerobic activity, resistance training, and balance and stretching exercises.

Below are suggested exercises to undertake weekly to help improve bone strength. However, if new to exercise, you should not begin with this much exercise.

Gradually build up the number of sessions you do (and time), and it’s also essential to fuel your body with the correct nutrition (as discussed in Part 2).

• Resistance training - 3x per week (multi-joint exercises)

• Aerobic activity - 2-3x per week - 45 min to 1 hour (E.G. walking, jogging, dancing)

• Balance and stretching - 2 to 3x per week - 30 to 45 min

Ideally, weekly physical activity should include something from all three exercise groups.

EXERCISE PROGRAMS FOR STRONGER BONES/OSTEOPOROSIS

When exercising with osteoporosis (or for stronger bones), you must challenge the areas of your body commonly affected (E.G hips and spine).

Exercises should target both the lower body and the upper body and consist of weight-bearing exercises.

Exercises should be made up of compound movements (squats, lunges, push and pull movements) that load the bones of the legs, hip, spine and arms, target major muscle groups of the whole body and are functional for everyday life.

Below we will go through some exercises you can do to help promote bone strength.

EXERCISES TO PROMOTE BONE AND MUSCLE GROWTH BEGINNER EXERCISES

CHAIR DIPS

EXERCISE DESCRIPTION

• Sitting forward in your chair, shuffle forward to the middle of the chair.

• Place your hands on the side of the chair near your hips or on the armrests.

• Lean slightly forward at the hips keeping your back straight.

• Now press through your hands, straightening your elbows and lifting your buttocks off the chair, if you can.

• Slowly lower your buttocks back to the chair by bending at your elbows.

• Repeat for 10-12 Repetitions.

MUSCLES WORKED

Triceps (back of upper arms), Deltoids (shoulders), Chest

SEATED ROWS - WITH RESISTANCE BANDS

EXERCISE DESCRIPTION

• Place the resistance band underneath your feet, and hold onto it at each end.

• Now sit up tall in your chair and extend your arms out in front of you, at the same angle of the resistance band

• Now pull your elbows back behind you, squeezing your shoulder blades together at the end of the movement.

• Remember to keep your chest up throughout this exercise.

• Return to the start position

• Repeat for 10-12 repetitions.

MUSCLES WORKED

Arms, Shoulders & Back.

SIT TO STAND

EXERCISE DESCRIPTION

• Sitting up tall in your chair, with your feet shoulder-width apart.

• Shuffle forward to the front of your chair.

• From this position, bringing your feet back so your heels are behind your knees.

• With your hands on the chair, on the arm-rests of the chair, or on your thighs, you’re going to lean forward at the hips, so your nose comes over your toes.

• Now stand up, putting equal weight through both feet/legs.

• Make sure you fully extend your legs at the knees and the hips.

• And to sit down, hinging at the hips, reaching for the chair and sitting down.

• Make sure to keep your chest up throughout the exercise.

• Also, make sure that your knees remain in line with your toes, and they don’t move inwards when you sit down and stand up.

  NOTE:

• To further challenge yourself, trying placing your arms across your chest or using a lower chair.

• To make this exercise easier, use a higher chair.

• Repeat for 10-12 repetitions.

MUSCLES WORKED

Buttocks (glutes), thighs (quads), hips, calves, core and back.

PARTIAL LUNGES

EXERCISE DESCRIPTION

• Start by standing up tall, holding onto your chair with one hand.

• Step forward with one foot, and drop the back leg slightly towards the ground.

• Stand up, putting weight through the front lunging leg and return to the starting position.

• Make sure your front knee remains in line with your toes throughout the movement.

• Repeat for 10-12 repetitions, each leg, alternating.

MUSCLES WORKED

Buttocks (glutes), thighs (quads), hips, calves, core and back.

PARTIAL SQUATS

EXERCISE DESCRIPTION

• Standing up tall with your feet shoulder-width apart. Toes can be facing forward or slightly outwards.

• Holding onto your chair with both hands or keep your arms out straight in front for balance.

• Engage your core, hinge (bend) at the hips and sit back as you would if you were to sit on a chair.

• As you sit back, keep your chest up and your core tight and go no lower than 45 degrees.

• As you stand back up, put equal weight through both legs, ensuring your heels remain on the floor throughout.

• Make sure your knees stay in the line of your toes, they don’t go forward past your toes, and they aren’t moving inward throughout the exercise.

• Repeat for 10-12 repetitions.

MUSCLES WORKED

Buttocks (glutes), thighs (quads), hips, calves, core and back.

CALF RAISES

EXERCISE DESCRIPTION

• Standing up tall with your feet about hip-width apart.

• Keeping your knees straight and holding onto the chair with both hands.

• Coming up onto the toes, raising your heels up off the floor, holding briefly and slowly lowering yourself back down.

• Repeat for 10 -12 repetitions.

MUSCLES WORKED

Back of lower legs (Calves).

STOMPS

EXERCISE DESCRIPTION

• Start by standing up tall, holding onto your chair with one hand.

• Bring your knee up and stomp your foot, making sure your whole foot is in contact with the ground.
  Imagine as if you are crushing an insect below your foot

• Repeat for 8 repetitions.

BALANCE - SINGLE LEG STANCE - HOLDING

EXERCISE DESCRIPTION

• Standing next to a chair for safety and stability.

• Stand on one leg.

• Hold this position for 45 seconds on each side. Improving every time you attempt this exercise.

• When you have completed the set time, change feet.

BEGINNER EXERCISE PROGRAM TO PROMOTE BONE STRENGTH (VIDEO)

Beginner Exercise For Stronger Bones

EXERCISES TO PROMOTE BONE AND MUSCLE GROWTH - INTERMEDIATE EXERCISES

CHAIR PUSH UPS

EXERCISE DESCRIPTION

• Stand up tall, facing your chair

• Place both hands on the chair, bringing your feet out about 1-2 feet from the chair.

• Bend forward at the hips keeping your back straight and the core tight.

• With a slight bend in the knees, bend your elbows, bringing your chest towards the chair.

• Now straighten your arms bringing your chest away from the chair.

• Make sure your chair is secure throughout.

• To make the exercise harder, you can bring your feet further away from the chair.

• For an easier variation, do the wall push-up.

• For a more challenging variation, this exercise can be done on the floor. I.E. modified push-up on your knees or standard push-up (dependent on your capabilities).

MUSCLES WORKED

Chest, Arms, Shoulders, and Core

STANDING BENT OVER ROWS - WITH HAND WEIGHTS

EXERCISE DESCRIPTION

• Stand up tall next to your chair, with one hand holding onto a light hand weight and the other hand holding onto the chair.

• Now take a step back from the chair, with a slight bend in the knees, hinge at the hips, bend forward with your back straight and place your arm holding the hand weight by your side, keeping it straight.

• Now bending at the elbow, pull your arm up, leading with the elbow, behind your back, and return to the start position.

• Squeeze your shoulder blades together when lifting your arm up.

• Repeat for the set repetitions and change arms.

MUSCLES WORKED

Back, Arms, Shoulders, and Core

SIT TO STANDS WITH HAND WEIGHTS

EXERCISE DESCRIPTION

• Sitting up tall in your chair, with your feet shoulder-width apart.

• Shuffle forward to the front of your chair.

• From this position, bring your feet back so your heels are behind your knees.

• With your hands by your sides, holding onto the hand weights, you’re going to lean forward at the hips so your nose comes over your toes. Keep your chest up and your back straight.

• Now stand up, putting equal weight through both feet/legs.

• Make sure you fully extend your legs at the knees and the hips.

• Follow this in reverse to sit down, sticking your bum out before sitting down stand back up to the standing position.

• Make sure to keep your chest up throughout the exercise.

• Also, make sure that your knees remain in line with your toes, and they don’t move inwards when you sit down and stand up.

• Repeat for 10-12 repetitions.

MARCHES WITH STOMPS - MORE INTENSITY

EXERCISE DESCRIPTION

• Start by standing up tall, holding onto your chair with one hand.

• Bring your knee up and stomp your foot, making sure your whole foot is in contact with the ground.
  Imagine as if you are crushing an insect below your foot

• Repeat for 10-12 repetitions, alternating legs.

CALF RAISES WITH HAND WEIGHTS

EXERCISE DESCRIPTION

• Standing up tall with your feet about hip-width apart.

• Holding onto some light hand weights with your arms by your side or onto the chair if you are unable to do the exercise with the hand weights.

• Keeping your knees straight and holding onto the chair with both hands.

• Coming up onto the toes, raising your heels up off the floor, holding briefly and slowly lowering yourself back down.

• Repeat for 10 -12 repetitions.

• If you do not have the required balance for this exercise, complete it by holding onto the chair or without the hand weights.

MUSCLES WORKED

Back of lower legs (Calves).

SQUATS WITH HAND WEIGHTS

EXERCISE DESCRIPTION

• Standing up tall with your feet shoulder-width apart. Toes can be facing forward, or slightly outwards.

• Holding onto some light hand weights with your arms by your side.

• Engage your core, hinge (bend) at the hips and sit back as you would if you were to sit on a chair.

• As you sit back, keep your chest up and your core tight and go no lower than 90 degrees.

• As you stand back up, put equal weight through both legs, ensuring your heels remain on the floor throughout.

• Make sure your knees stay in the line of your toes, they don’t go forward past your toes, and they aren’t moving inward throughout the exercise.

• Repeat for 10-12 repetitions.

MUSCLES WORKED

Buttocks (glutes), thighs (quads), hips, calves, core and back.

REVERSE LUNGES

EXERCISE DESCRIPTION

• Standing up tall, holding on to your hand weights

• Take a step forward and gently drop your knee down towards the floor, stopping just before the floor.

• Stand up, putting weight through the front lunging leg and return to the starting position.

• Come back up and repeat for the opposite leg.

• Keep your body upright throughout the exercise, ensuring the knee of your front foot does not come past the line of your toes.

• Make sure your front knee remains in line with your toes throughout the movement.

• Repeat for 5 repetitions each leg.

MUSCLES WORKED

Buttocks (glutes), thighs (quads), hips, calves, core and back.

JUMPS

EXERCISE DESCRIPTION

Standing up tall or holding onto a chair or rail. Do not try and jump too high.

Jump and repeat for 10-12 repetitions.

BALANCE - SINGLE LEG STANCE

EXERCISE DESCRIPTION

• Standing next to a chair for safety and stability.

• Stand on one leg.

• Hold this position for 45 seconds on each side. Improving every time you attempt this exercise.

• When you have completed the set time, change feet.

CAT / COW STRETCH

A gentle stretch for the back

EXERCISE DESCRIPTION

• Kneeling on the floor, legs at 90 degrees to your body and your hands underneath your shoulders.

• Round your back, pulling your abdominals into your spine, gently pushing your midback toward the roof.

• Now move your belly forward and gently arch your back, and gently look up to the ceiling.

• Repeat for 5 repetitions - nice, slow and controlled feeling the stretch.

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INTERMEDIATE EXERCISES FOR IMPROVING BONE STRENGTH (VIDEO)

Intermediate Bone Strengthening Exercises For Seniors

WHAT RESULTS SHOULD I EXPECT BY UNDERTAKING A BONE STRENGTHENING PROGRAM?

Stronger bones are not built in a night. The same goes for other aspects of fitness.

Our body reacts to consistent efforts - the more we exercise, the more our body changes and adapts. With gradual progressions (I.E., continuously challenging yourself as you get stronger and your fitness improves), your body will continue to change and adapt.

Completing one workout session is a step in the right direction, but only after some time staying consistent with the exercise, you start noticing the changes. 

To know exactly what results to expect is difficult. Everyone is different, and as we have covered through this 3-part article, there are many factors that contribute to stronger bones.

Long-term commitment to exercise (combined with what was covered in part 2) is the way to build stronger bones and prevent fractures.

EXERCISES TO AVOID WITH OSTEOPOROSIS

By now, you'd understand the importance of exercise in the pursuit of stronger bones, but it's quite possible that you still hold some reservations toward the idea - and that's understandable. The thought of brittle bones, fractures, and injuries doesn't make it easy to get into exercise with a lot of confidence.

Having fears and apprehensions is normal, especially if exercise has never played a big part in your life, and especially if you have had past fractures.

However, avoiding exercise is not the answer.

Having low bone density, a previously broken bone, or a diagnosis of osteoporosis doesn't mean every move or activity will cause a fracture. 

As touched on earlier, seeing a Physiotherapist can help out with an individualised exercise program, and they can take you through how to do the exercises correctly. They can also let you know when it is time for you to move forward with all your exercises, which allows for continued progress.

It's also imperative that you understand what exercises to avoid if you have osteoporosis which may put you at risk of fractures.

This section is here to guide you through some movements to avoid and some safe alternatives, which will hopefully help alleviate some of the fears and reservations you might have. What you're about to read aren't strict rules and shouldn't be treated as such; consider these words as recommendations.

Hopefully, by the end of this chapter, you'll feel more confident and prepared to tackle whatever comes next.

Increased spinal flexion

BENDING FORWARD

Bending forward (known as spinal flexion), for example - to tie your shoes or pick up a dropped object, is generally a safe movement. However, this action may be putting excess strain on your spine.

One of the most common causes of back issues is bending forward while holding a heavy object; this action puts an uneven weight on the spine and could increase the risk of fractures.

Like with any other movement, it's important to be conscious and aware of this movement and avoid rounding your back as much as possible.

You also want to avoid bending suddenly or repetitively in an uncontrollable manner and twisting in this position. 

Keep your back straight, bend your knees, and do exercises to keep your back and core muscles as strong as possible.

COMMON BENDING FORWARD POSTURE - UNSAFE TOE TOUCH

If you’re flexible, standing toe touches are quite harmless, and you should have no issues. 

However, if you are not flexible with weaker bones, this movement does put extra pressure on the spine and could over-stress the bones and other structures in this area. Avoid this movement where you can.

ALTERNATIVE TO TOE TOUCH

One way to put the stress off your spine when doing toe touches is to bend your knees. This will alleviate the tension not only in your back but in your hamstrings as well. Make sure to keep your back straight and your gaze forward. This will ensure a straight back, and you’ll be able to reach for your toes without compromising your back. 

ALTERNATIVE HAMSTRING STRETCH

For an alternative, safe hamstring stretch, CLICK HERE.

POOR LIFTING TECHNIQUE VS PROPER LIFTING TECHNIQUE

It is very common for people to lift with poor technique, putting excessive strain on the spine, which can lead to fractures or other back injuries. Often, this movement is done many times during the day, which increases the strain on the spine. When weight is added, even more so.

Example- poor lifting technique

The safest way to pick up a load is to stand close to the load, keeping your arms close to your body, bend at the knees and hips, brace the core, look straight ahead and keep a straight back until the weight is off the ground.

Example - good lifting technique

SIT-UPS

One of the most common core-strengthening exercises and my least favourite of all exercises. 

The problem with sit-ups is the repeated lumbar flexion which causes a massive strain on the lower back. Going back and forth and pulling your body against gravity puts a lot of compressive force on the spine, which is especially not good with weaker bones.

Sit-ups also require you to continuously pull on your neck, which can also cause strains. 

And they’re not even that effective for a core exercise. There are better core exercises.

However, if you like sit-ups and have been doing this movement for a long time and can do this exercise without feeling any pain, it should be okay for you to continue.

Otherwise, there are much better exercises you can do that will provide the same results.

ALTERNATIVE EXERCISE - THE PLANK - KEEPING NEUTRAL SPINE

The plank exercise is a much more effective exercise for improving the strength of the core and much safer. It keeps the spine straight (neutral position) without the repeated bending (flexion).

Safer Core Alternative - Plank Exercise

Safer Core Alternative - Plank Exercise

If you find this exercise difficult, you can modify the plank to make it a little easier by resting on your knees, and you also can build up your time as you get stronger over time. Start with a small amount of time.

Seated core exercises can also work that core whilst keeping your spine in that neutral position. 

Also, click HERE for more CORE EXERCISES.

PROLONGED EXERCISE/OVER-EXERCISING

It’s important to maintain a proper balance with exercise. Finding the motivation to start exercising is one thing, but having the patience and the wisdom to know when to take a break is something entirely different. 

Over-exercising can be just as harmful as not exercising at all!

Working out too much or trying to tackle a more challenging exercise too soon can have detrimental effects on your bones and your whole body. Over-exercising can cause muscle fatigue, strains, stress fractures, joint strains, and a general decline in performance.

The best way to prevent over-exercising is to schedule rest days in advance. Make sure to alternate between the muscle groups you’re working with. For instance, if you worked your arms and upper body today, try to exercise your lower body the next day, so your upper body has a chance to recover. 

Also, build up the amount of exercise or activity you are doing. If you have spent a lot of time being inactive, spending a whole day on your feet may cause issues. 

When you’re pushing your postural muscles (the muscles that help you to stand) to their limits, other areas of your body (joints and bones) take on a more strain, which could put you at greater risk of pain, injury or fracture.

Break up your physical activity into smaller sessions (like you do with your exercise) and gradually progress it as you become fitter. 

Finally, listen to our body! If your muscles are too sore, focus on stretching and flexibility exercises rather than strength training. If you feel like the weights are too heavy, switch them for lighter ones. Or take a rest! There’s no shame in taking things slowly and at your own pace.

Your body is constantly talking to you…. so make sure you listen.

PREVENTING FALLS TO AVOID FRACTURES

As we get older, the risk of falling and fracturing something gets significantly higher. 

A nasty fall could easily result in broken bones or other serious injuries, especially when bones are weaker.

Preventing falls is very important, and there are many things you can do right now to help prevent them.

I have written an in-depth article on falls prevention, which will help prevent falls.

For a whole lot more information on Falls Prevention, make sure to read my article: THE ULTIMATE GUIDE TO FALLS PREVENTION FOR SENIORS.

---

So we have now come to the end of the complete guide to stronger bones over 60. 

Implement what’s contained in this 3 part article, and you will be well on your way to improving bone strength.

It will take time and consistent effort to make improvements, but you can do it!

I wish you all the best on your journey to a healthier and stronger body and bones.

Do you have osteopenia and osteoporosis? Have you made improvements by following already what’s contained within this article? What exercise or food have you found to help? Let me know in the comments below.

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SOURCES

CLICK HERE TO VIEW ALL SOURCES USED IN THIS ARTICLE.

The Complete Guide To Strong Bones Over 60 [Part 2]

PART 2: HOW TO EAT FOR STRONGER BONES (AND OTHER FACTORS THAT IMPROVE BONE HEALTH)

We are now into part 2 of The Complete Guide To Strong Bones.

In Part 1, we covered all about healthy bones, osteopenia and osteoporosis. From how our bones work to what comprises strong bones (density and quality), why bones become weaker and how to test bone strength. If you haven't already, make sure to check out Part 1: What You Need To Know To Get Stronger Bones before continuing with this section.

We also established that bones do get weaker and lose density as we get older. However, loss of bone strength is NEVER due to aging alone! There are always other factors beyond age contributing to weaker bones, which you can take control over. Meaning, there are many things you can do to improve your bone strength and prevent fractures. 

In this part (part 2), we will cover factors that may be putting you at risk of weaker bones. What factors to do more of (or start doing) to improve your bone health, and we will cover all about nutrition for stronger bones (including all about the different vitamins and minerals), which, as you'd know, is so important in good bone health.

As with anything health-related, improving your bone strength does take some time and work. However, once you get the hang of what's required, it all becomes much easier.

Take your time going through this part and implement the strategies best you can to improve your bone strength and help prevent any fractures.

Now, let's get into it!

WHAT WE’LL BE COVERING IN PART 2:

WHAT YOU SHOULD CHANGE FOR STRONGER BONES STRENGTH

• CAUSES OF WEAKER BONES

HOW TO GET STRONGER BONES - HOW TO PREVENT BONE LOSS AND FRACTURES NATURALLY

• HEALTHY HABITS FOR STRONGER BONES

NUTRITION: EATING FOR STRONGER BONES

KEY NUTRIENTS FOR STRONGER BONES (MICRONUTRIENTS)

• CALCIUM: ALL ABOUT CALCIUM FOR STRONGER BONES

• VITAMIN D, MAGNESIUM, VITAMIN K, POTASSIUM, ZINC, BORON, COPPER, VITAMIN B, PHOSPHORUS

6 BEST FOODS FOR STRONGER BONES

BEST SUPPLEMENTS FOR STRONGER BONES

THE IMPORTANCE OF GUT HEALTH IN STRONGER BONES

• THE IMPORTANCE OF GUT HEALTH IN STRONGER BONES

• ASPIRIN

WHAT YOU SHOULD CHANGE FOR STRONGER BONES

CAUSES OF WEAKER BONES

The first step towards improving your bone health (and your health) starts with making some necessary lifestyle changes.

Before we cover what healthy habits are beneficial for bones that you should be doing more of, let’s look at some factors that may need to be stopped (or limited) first that are putting your bones at risk.

Some of these factors are more obvious, such as smoking or excessive alcohol consumption, while others are less known, like caffeine, stress, and even certain foods.

Let’s now look at these factors to cut out or limit.

SMOKING (TOBACCO) & EXCESSIVE ALCOHOL CONSUMPTION

I’m sure it’s no surprise that there is a clear link between cigarette smoking and excessive alcohol consumption, and reduced bone density. There is also a clear link between these factors and an increase in fractures. [1 - 4]

If you do smoke or drink in excess, this step should be the first priority to improve your health and your bone strength.

Quitting these habits, especially after some time doing them, can be difficult, but it is not impossible. There are many successful plans out there that can help, which you can speak to your doctor about.

EXCESSIVE CAFFEINE

A daily cup of coffee is something enjoyed by many!  

Coffee contains small amounts of many essential nutrients necessary for a healthy body, including B vitamins, magnesium and potassium.

Ask different doctors or nutritionists, or check the research, and you'll find people and studies on both sides on the "is it healthy?" debate. Some will say it's good for your health, and others will say it's not good.

Like alcohol, issues may arise if consumption is excessive. A study published in The American Journal of Clinical Nutrition claims that caffeine intake in amounts >300 mg/d (roughly three cups of coffee) accelerates bone loss at the spine in elderly postmenopausal women.

If you have an excessive intake of caffeine, or caffeine leaves you anxious and stressed out, or it affects your sleep, I think it's safe to say it's most probably not doing you any favours, and reducing it could improve your health.

STRESS

Another factor that contributes to bone loss is none other than stress.

When it comes to improving health, eating healthily and exercising is usually emphasised. On the other hand, reducing stress is less spoken about, even less for improving bone health.

Reducing stress, however, is just as important as healthy eating and exercising for our health and bone health.

When under stress, our body goes into survival mode. 

In this state, we are in a higher state of arousal and alertness, and energy production is increased to deal with the threat or 'perceived' threat. 

Our body gets this extra energy by promoting a catabolic state (breaking down) of fat, muscles and bones for fuel (energy) to deal with the threat. [5]. This increased fuel consumption highlights the importance of adequate nutrition, along with reducing stress for bone health.

The increased alertness also explains why people have a hard time sleeping when stressed or are worried about something. 

Furthermore, when a stress response is triggered, our hormones change in response to this.

In part 1, we saw that an estrogen deficiency plays a role in osteoporosis, but other hormones, including progesterone, testosterone, dehydroepiandrosterone (DHEA), and estradiol, also play a role in our bone health.

Lack of these essential hormones triggers a decline in bone mineral density, which is often a result of high stress levels. [6, 7, 8]

Another hormone that plays a role in our bone health is one you may have heard the name of before, that being cortisol. 

Cortisol is our body's primary stress hormone. It is a vital hormone that plays a critical role in dealing with threats to our body.

When a threat is detected, our nervous system will signal the adrenal glands to produce cortisol. It will then begin circulating our body (in our blood), doing what it has to do to help return everything to normal.

When the threat is gone, cortisol has done its job and levels in the blood will decrease.

What happens, however, when stress levels are always high? Cortisol levels remain high in your body.

Many studies link high cortisol levels to decreased bone density. [9, 10, 11]

When cortisol levels remain high, the hormones beneficial for strong bones are at lower levels.

Cortisol also blocks calcium, an essential nutrient in bone cell growth, from being absorbed. [11] (More on calcium in the next section of the article).

As you can see, getting your stress under control is a must for good bone health. 

I have noticed that a lot of the time, most people don't even know they're under constant stress when they are. They've become accustomed to the higher stress state. It's usually not until they see the benefit of stress reduction techniques that they then realise the stress they were under. 

We are all under stress in some form or another; even crossing a busy road, switching on the TV or getting on social media these days usually sparks a stress response.

Day-to-day stress is completely normal. The goal here isn't to strive towards an entirely stress-free life, that would be practically impossible! But learning how to manage high-stress situations will benefit your mind, body, and bones. 

Regulating your sleeping habits, practising mindfulness, or taking a stroll in nature are some ways, of many, to reduce stress. It's about finding what works for you. We will touch on this more in the next section.

INFLAMMATION

Another factor that can contribute to weaker bones is inflammation. 

Before we go into how to decrease the inflammation in your body, let’s take a quick look at what inflammation is.

Let’s say you catch a cold or unknowingly eat a peanut you’re allergic to. What happens next is that your body sounds the alarm to make it known that there are unwanted intruders in your system. This is the cue for white blood cells to attack the intruders and defend your body from potential harm. 

So, basically, inflammation is your body fighting infections, toxins, injuries, and similar threats. When we eat certain foods, don’t get enough sleep or exercise, or suffer too much stress for long periods, our bodies become chronically inflamed.

Chronic (long term) inflammation can lead to many health issues, including poor bone health.

Evidence shows that inflammation, especially chronic inflammatory diseases, are closely linked to bone loss. Inflammation can decrease bone formation and increase bone resorption. 

Further studies have found that pro-inflammatory cytokines (molecules in your body that favour inflammation) are implicated in bone remodelling and may play a significant role in the development of osteoporosis.

The good news is the inflammation can be successfully reduced by making a few conscious and healthy lifestyle changes. Introducing a healthy diet and cutting back on inflammatory foods (such as processed foods and trans fats) is a step in the right direction.

Other things you can do to fight inflammation include getting enough sleep, exercising regularly, and reducing stress.

We’ll talk more about proper nutrition, exercise, and stress reduction in the following sections.

POOR FOOD CHOICES

The next factor that plays a role in weakening bones is the type of food we eat.

We all know the 'junk' foods that taste good but are doing our health no favours. However, there are also compounds found in natural foods which you may not be aware of that make some healthy foods not the best choice for strongest bones.

In this section, we'll look at the junk food to avoid and what to be aware of in natural foods so you can make better food choices for better bone strength.

PROCESSED FOODS & REFINED VEGETABLE OILS: THEIR ROLE IN POOR BONE HEALTH

The first foods to avoid are … you probably know what I'm going to say here ... the processed, junk stuff.

Many studies have shown diets high in processed foods (common in western diets) are associated with decreased bone density and osteoporosis. [12-16]

These foods are high in vegetable oil which increases the inflammation in your body. As discussed in the previous section, there is a clear relationship between inflammation and bone degeneration. [17, 18]

Processed foods are full of sodium and other additives harmful to your health and are devoid of much-needed nutrients necessary for healthy bodily processes.

The are also full of refined sugar. Overconsumption of refined sugars potentially increases the risk of osteoporosis. [19].

Processed foods include confectionery, biscuits/cookies, soft drinks (soda), processed meat, french fries, mayonnaise and other condiments, pastries and other highly processed desserts.

Note: There are always healthier alternatives (or versions) of these foods with better ingredients, so it does not mean you have to live without them.

[To read more on processed foods, vegetable oils and choosing healthier alternatives - click here]

On the other hand, diets high in natural nutrient-dense foods improve bone density and are protective against fractures. [20, 21, 22, 23].

Higher adherence to diets comprised mainly of nutrient-dense foods (for example, the Mediterranean Diet) is associated with a lower risk of hip fractures. [22]

By cutting out processed foods from your diet (or limiting them the best you can) and switching to real, natural foods, you make a massive leap towards better bone health. We will discuss nutrition in greater detail in the next section of this article.

However, before we get deep into nutrition, there is something else you should be aware of to help you make better food choices for improved bone health. That is...

ANTI-NUTRIENTS

We’ve seen that a nutrient-rich diet is hugely important for strong bones.

When grown in healthy soil or when eating their natural diet (for animal-based foods) - natural foods are the most nutrient-dense foods you can eat.

However, some foods we eat have a natural built-in defence mechanism, which, when consumed, inhibits the absorption of essential nutrients. These compounds are known as anti-nutrients.

Mother Nature just had to make this all more confusing, didn’t she! :) 

Anti-nutrients are mainly in plant foods (primarily leaves, grains, legumes, vegetables, seeds and nuts). These chemical compounds are a natural way plants defend themselves from predators (animals, insects, and fungi).

There are several anti-nutrients in foods we eat, including:

Phytates (Phytic Acid) - Present in whole grains, seeds, legumes and nuts. Phytates may decrease the absorption of iron, magnesium, zinc and calcium. [24, 25]

Lectins - Present in most plant foods, mainly legumes (beans, soybeans and peanuts) and grains (wheat/gluten) and even animal foods. Lectins may interfere with the absorption of certain minerals and may alter gut function and increase inflammation [26]

We can't avoid lectins because they are present in pretty much all foods. However, it is important to cook and prepare foods to decrease the lectin content.

Goitrogens - Found in cruciferous vegetables (E.G., broccoli, cauliflower and kale etc.). Goitrogens can prevent the absorption of iodine and can interfere with thyroid function. [26]

Oxalates - High in green leafy vegetables and tea. Oxalates can bind with calcium preventing it from being absorbed. [27]

Tannins - Tannins are found in tea, coffee and legumes. Tannins can bind with iron preventing it from being absorbed. [26, 28]

Now, you're probably reading this and are a bit concerned that many of these foods you knew to be healthy might not be the best for your bone health.

So, what's the deal? Should we try to avoid them?

Well, yes and no.

Anti-nutrients aren't inherently bad for us. Let's look at tannins as an example. Tannins are biomolecules found in fruits, legumes, tea, and coffee. They have been shown to have antioxidative properties, antibacterial effects and can protect against heart disease and cancer. [28]

Conversely, tannins are considered anti-nutrients because they can inhibit iron absorption. [28]

In regards to stronger bones, why is this important? Because some foods may not be the best choice to obtain needed nutrients. 

Let's take calcium as an example. We know calcium is an essential nutrient for bone strength. Spinach is a food high in calcium. However, it also has a high oxalate content, inhibiting calcium absorption, making it not a good choice to increase calcium levels. We will discuss calcium in the following sections of this article.

It's good to be aware of (anti)nutrients in our foods, especially if following a restrictive diet, as certain food choices may not be giving you the required nutrients for best bone health (and overall health).

But we definitely shouldn't discard whole food groups, especially when there also proven health benefits. It is a good idea to eat a balanced diet (with all food groups) to ensure you are getting and absorbing adequate nutrients.

Furthermore, when these foods are cooked or prepared in other ways (e.g. fermentation or soaked) and not eaten raw, most anti-nutrients are removed.  

We'll look at nutrition and what to eat for the best bone health in the following sections.

HOW TO GET STRONGER BONES

HEALTHY HABITS FOR STRONGER BONES

We've now gone through what to eliminate for better bone health.

It’s now time to look at what to be doing more of to improve your bone strength and help prevent any fractures.

The first is….

SUNLIGHT

One of the most instrumental things you can do to protect your bones is to.….. go outside! 

Sunlight is the absolute best source of vitamin D, and we all know how vital vitamin D is for our health and strong and healthy bones!

A deficiency in vitamin D is strongly associated with osteoporosis. [31]

Without this crucial vitamin, our bodies wouldn't be able to absorb the calcium we so desperately need to build strong bones.

Do your best to get more sunlight each day, avoiding the hottest part of the day during the summer months. Studies show that sensible sun exposure (even just 5-10 minutes of exposure on the arms and legs or the hands, arms, and face, 2 or 3 times per week) and increased vitamin D in the diet (or through supplements) is a reasonable approach to guarantee adequate vitamin D.

Remember supplements are not to substitute natural sunlight and diet, so if possible, try to use what Mother Nature has provided us.

We'll discuss the importance of vitamin D and other nutrients needed for bone health later in this article.

SLEEP

Lack of sleep can weaken your bones. [30, 31]

One study, published in the Journal of Bone and Mineral Research, found that getting five or fewer hours of sleep at night can cause lower bone mineral density and increase the risk of osteoporosis. 

Other research has shown, any disruption in our circadian rhythm (the process that regulates our sleep-wake cycle) can impair bone formation. It looks like the main culprit behind this is what's often called the sleep hormone - melatonin.

Melatonin is an endogenous hormone produced by the pineal gland and is responsible for controlling our sleep-wake cycle. Our body produces melatonin during the night, alerting our brains that it's time to go to sleep. 

Melatonin has many functions aside from regulating our sleep. Studies show that melatonin is in charge of regulating our bone metabolism and improving bone formation by promoting osteoblast activity (remembering back to part 1 - the cells that build bone up) and decreasing bone resorption.

In simpler terms, melatonin helps develop bone tissue (and teeth), and the less we have of it, the more we are at risk of suffering issues with our bones.

So, start improving your sleep each night. Make it another priority. Click here for some tips on how to get a better night's sleep.

REDUCING STRESS

Reducing stress is one of the best ways to fight inflammation and protect your bones. As I mentioned earlier, avoiding stress altogether is downright impossible; however, finding healthier ways to respond to stressful situations is something you can do!

Making a conscious effort to cut out stress in your life or to make sure to take some time out of your day to reduce your stress, which could be as simple as taking a bath, reading a book, going for a walk in nature or along the beach, will help improve your bone health.

There are also many great techniques, programs and books that can help you get on top of your stress. Some proven and popular techniques are Meditation, Yoga and Tai Chi.

These techniques may not be for you, and that's ok! Decreasing stress is all about finding what feels good to you personally. Explore other avenues and see what works for you.

If you're still stuck, ask yourself, "What makes me happy and relaxed?" Whether it's gardening, baking, journaling, or just basking in the sunlight on your front porch - do what feels right to you, and do more of it!

Another way to reduce stress is through breathing exercises.

Breathing exercises are an easy and quick way to reduce stress. 

There are various breathing techniques available, and you can try different ones until you find one that suits your needs best.

Here is one breathing technique you can use.

• Lie flat on your back with your knees bent (you can lie on a bed or use pillows for more support and comfort). Or sit in a comfortable chair.

• Place your left hand on your chest and your right hand on your belly.

• Start to slowly inhale through your nose, allowing your breath to flow to your belly (you should feel your stomach rise as it fills up with air).

• Hold your breath for a couple of seconds and then pucker your lips and exhale until your belly is flat.

• Practice a few times a day for 5 - 10 minutes.

Additionally, this meditation technique which when done once a day for only ten minutes, can vastly improve your mental health and help you reduce stress.

NUTRITION: EATING FOR STRONGER BONES

GETTING THE RIGHT NUTRITION

What we eat has a significant impact on our body as a whole; healthy food provides energy, fuels our brains, builds DNA, repairs muscles, and keeps our bones healthy. 

Proper nutrition is crucial to improving bone strength and preventing bone diseases.

In this section, we'll discuss the basics of nutrition for better bone health.

We'll focus on how much and what you should be eating. We will also look at the key nutrients for stronger bones in detail. I'll also let you know six foods that I have chosen to add to your diet for better bone health and the best supplements for bone health.

So let's get started with the first step for eating better for stronger bones.

GETTING ENOUGH CALORIES

When it comes to maintaining an ideal weight, the focus is usually on weight loss and the prevention of obesity. This usually includes limiting portion sizes, reducing calorie intake, and being more physically active.

However, when it comes to bone loss, the problem is more so undereating.

Supplying your body with adequate calories from nutrient-dense foods is instrumental for your health and your bones. 

To get through each day, our body needs fuel (energy) for the running of normal bodily processes. Everything your body can do.

If we don't eat enough, we don't supply our body with the nutrients it needs to function at its best.

In Part 1, we established that our bones are constantly being broken down and rebuilt. This process exerts a lot of energy, and it's up to us to refuel our bodies to restore the energy we lost. The bones in our bodies are made up of minerals, and do you know where those minerals come from?

They come from eating high-quality, nutrient-dense foods.

Suppose you are not replenishing your body with adequate energy and nutrients (Eg calcium). In that case, the body will respond by releasing the nutrients from other areas of your body (fat, muscles and bones).

When you are overworking yourself, overexercising, or under stress, the effects are compounded. Your body is burning up more of this fuel.

As you are starting to see, it's imperative to be eating adequate amounts of the right type of food.

Using an example, a meal consisting of some biscuits and soft drink is vastly different from a meal made up of vegetables, rice and some fatty fish in terms of total calories and nutrients.

Which one of these two meals do you think will supply your body with more energy and the proper nutrients to thrive? 

If you chose the latter, then you're right. The most nutrient-dense foods are found in nature and by eating more of the right foods, you're doing a great deal in helping your body thrive.

So, how many calories should you be getting each day?

According to the Dietary Guidelines for Americans, older adults generally have lower calorie needs but similar or even increased nutrient needs compared to younger adults. 

The amount of calories you need differs a bit between men and women and depends on physical activity levels (ranging from sedentary to active.)

• Females older than 60 require about 1600-2200 calories per day depending on the level of physical activity

• Males older than 60 require 2000-2600 calories per day depending on the level of physical activity

The general consensus is to never allow your calories to go below 1400 calories per day.

If you're not sure you're making up the right amount of calories or you're having trouble eating better, let your doctor know or organise to see a nutritionist.

MACRONUTRIENTS (PROTEINS, FATS & CARBS)

When we hear the words protein, fats or carbohydrates, these are macronutrients.

These nutrients are what our bodies use in the largest amounts, and they're responsible for providing us with calories, or in other words - energy.

PROTEIN

When it comes to protein, several studies point to a positive effect of high protein intake on bone mineral density or content. 

Protein makes up about 50% of bone volume, making it a crucial component for bone health. This absolutely makes sense when you consider that bones are mostly made out of collagen, the most abundant protein in our bodies. 

Recent epidemiological data demonstrate reduced bone density and increased rates of bone loss in those who follow a low-protein diet.

Furthermore, a meta-analysis found that in older people with osteoporosis, higher protein intake is associated with higher bone mineral density, a slower rate of bone loss, and a reduced risk of hip fracture.

How much protein should you eat?

In one of my previous articles, we went in-depth about protein, the importance of eating enough protein, and how to add enough protein-rich foods into your diet.

We also mentioned that the Australian Dietary Guidelines recommend that 15-25% of our total energy intake should come from protein.

The recommended daily intake (RDI) of protein for older adults according to Australian Dietary Guidelines is as follows:

• Women over 70 should have at least 57g of protein per day

• Men over 70 should have at least 81g of protein per day

A study conducted by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) suggests an optimal dietary protein intake of 1.0-1.2g/kg body weight with at least 20-25g of high-quality protein at each main meal. 

Furthermore, the European Society for Clinical Nutrition and Metabolism (ESPEN) offers practical guidance for optimal dietary protein intake and exercise for older adults over 65. According to their research, healthy older adults should get at least 1.0 to 1.2g protein/kg body weight/day.

Older adults who have acute or chronic illnesses should aim at 1.2 to 1.5g protein/kg body weight/day, while individuals with severe illness or injury should possibly get even more than that.

Ensure you are getting adequate protein in each meal, each day.

FATS

Fats are an essential part of our diet and not to be feared. But all fats are not created equal!

The best way to ensure you’re choosing the right fats for your health and bones is to learn to differentiate between good fats and bad fats.

I've talked in previous articles about vegetable oils and the dangers they pose to our health and also our bone health.

Refined vegetable oils, including (but not limited to) sunflower, corn, peanut, canola, and grapeseed oil, are made from predominantly polyunsaturated fats. 

There are two main types of polyunsaturated fats: omega-3 fatty acids and omega-6 fatty acids.

To maintain good health, our bodies require an optimal balance of both of these essential fats. According to research, the optimal ratio of omega-6 to omega-3 fats is 4:1 or less. However, Western diets typically contain much more omega-6 fatty acids compared to what our bodies need.

Excess consumption of omega-6 fats leads to an inflammatory state in the body, which we have already discussed is detrimental to overall health and bone health. [32]

The easiest way to restore the disrupted balance is to cut back on omega-6 fatty acids, mainly vegetable oil and processed foods and consume more omega-3 rich foods while.

[To read more on this - CLICK HERE]

There are four types of dietary fats:

1. Saturated fats - beef, lamb, pork, whole milk, cream, butter, cheese

2. Monounsaturated fats - olive oil, nuts (almonds, cashews, pecans etc.), avocados, nut butter, olives.

3. Polyunsaturated fats - walnuts, fish (salmon, mackerel, herring, trout), seeds

4. Trans fats - cakes, cookies, crackers, icings, margarine, and microwave popcorn. The bad fats.

Stay away from trans and make sure to get plenty of healthy unsaturated and saturated fats in your diet and you’ll be improving both your health and your bone health.

CARBOHYDRATES

Just like fats, carbohydrates are often misconstrued as something terrible to be avoided at all cost. This, of course, again is far from the truth.

Carbohydrates are the primary source of energy in our bodies. They're found mostly in plant-based foods in the form of sugar, starches, and dietary fibre. 

The carbohydrates to be limited are again the refined, processed carbohydrates found mainly in processed foods including lollies, soft drinks, cereals and cakes. 

There are many healthy sources of carbohydrates that are an excellent addition to any diet. These being:

• Vegetables. leafy greens, root vegetables and tubers etc

• Fruits. citrus, tropical, berries etc.

• Tubers. Potatoes, sweet potatoes, yams etc.

• Nuts & Seeds. Macadamias, brazil nuts, almonds, pumpkin seeds etc

• Whole grains. Oats, rice, quinoa etc

• Legumes. Beans, lentils etc.

Studies show a positive link between carbohydrates such as fruits and vegetables and bone health.

The Australian Dietary Guidelines recommends 5-6 servings of vegetables a day for people 65+ and 2 servings of fruit.

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As you can see, proteins, fats and carbohydrates make up a healthy, well-balanced diet, and they all play a role in improving our bone health.

The aim is to eat adequate calories filled with good sources of healthy protein, fats and carbohydrates. 

We’ll now look at the key micronutrients important for health, which will give you a better understanding of what foods to add in to your diet.

KEY NUTRIENTS FOR STRONGER BONES (MICRONUTRIENTS)

As the name suggests, micronutrients (in contrast to macronutrients) are the nutrients our body requires in smaller amounts.

Micronutrients refer to the vitamins and minerals we need that are essential to keep our whole body healthy and, yes, of course, our bones.

So, why are vitamins and minerals so essential for our bones?

Any deficiency of certain essential nutrients can cause bone issues.

Multiple studies have confirmed that calcium and vitamin D are vital to fracture prevention. At the same time, further research emphasises the importance of magnesium, potassium, vitamin C, vitamin K for optimal bone health.

Evidence suggests that intake of phosphorus, a component of bones responsible for providing structure, is positively associated with both bone mineral content (BMC) and bone mineral density (BMD,) as well as reduced risks of osteoporosis in adults.

Several other nutrients, namely iron, zinc, and vitamin C, have been known to aid enzymes in regulating optimal bone structure for bone health. Research is clear that vitamin C deficiency is linked to the development of osteoporosis and increased risks of fractures. Similarly, reduced iron intake has been associated with an emerging threat for bone disease, while zinc has been used as a therapeutic agent in bone regeneration.

Micronutrients are crucial for maintaining optimal skeletal health, and their role should not be underestimated. 

Below we will cover the micronutrients required for optimal bone health, their role, and what foods they are contained in.

CALCIUM

The most abundant mineral found in our bodies, calcium, plays the most significant role in bone health.

It is estimated that 99% of the body's calcium is found in the bones and teeth. Unfortunately, our bodies are unable to produce this essential micronutrient on their own, so we need to rely on other sources of calcium to keep our bones strong. 

If you remember from Part 1, bone remodelling is a continuous process heavily influenced by two types of cells: osteoblasts and osteoclasts. 

Once the osteoclasts break down the tissue in bones, the minerals found in those bones, namely calcium, are then released and transferred into the blood. Before the remodelling process is finished, our bones are not the sturdy and rigid structures we expect them to be, and that's where calcium comes in. 

As the osteoblasts rebuild (or mineralise) the bone, calcium phosphates are deposited. This calcium crystallises into what's known as hydroxyapatite. Hydroxyapatite makes up about 65 per cent of bone tissue and is the main component that provides rigidity to the bones.

As you can see, having adequate amounts of calcium in the body is necessary for optimal bone formation. If the body experiences a calcium deficiency, our bones become fragile and more brittle.

One study claims that chronic calcium deficiency resulting from inadequate intake or poor intestinal absorption is one of several important causes of reduced bone mass and osteoporosis. The study concludes that adequate dietary calcium should be consumed in all stages of life. In early life so that genetically programmed peak bone mass can be reached, and in later adulthood so that the skeletal mass can be maintained and age-related bone loss minimised. 

Another article, by The American Journal of Clinical Nutrition, suggests that the average elderly person is in negative calcium balance and accordingly losing bone mass. 

Calcium is readily available in many different foods, including dairy products (milk, cheese, and yogurt) and plant-based foods (leafy greens, edamame, broccoli, Brussel sprouts). However, not all sources are created equally.

To understand this better, we need to look beyond just the calcium content in each food and focus on calcium bioavailability. The bioavailability of calcium refers to the actual amount of calcium that is absorbed by the body and into the areas it is meant to go - in this case, the bones. Basically, not all calcium we ingest gets absorbed by the body!

Even though certain foods might have a higher calcium level, depending on their calcium bioavailability, they might not be a great source of this essential micronutrient. To put things into perspective, cow's milk has a bioavailability of about 30% absorption. One cup (250ml) of cow's milk contains approximately 300 mg of calcium, so by drinking one cup of milk, you'll be getting somewhere around 100 mg of calcium altogether.

Each food item has a different calcium bioavailability.

A big reason affecting the bioavailability of certain foods lies in what we discussed above - anti-nutrients.

Although plant foods are sources of calcium, they also have compounds that will bind themselves to the calcium and prevent it from getting absorbed.

Not to worry though, there are many ways to get your required amounts of calcium.

HOW MUCH CALCIUM SHOULD YOU BE GETTING EACH DAY

According to the National Institutes of Health, the recommended daily intake (RDI) of calcium for men and women over 70 is 1200mg per day.

BEST SOURCES OF CALCIUM:

• Dairy

  • Cheese

    • Parmesan = 330mg calcium per 28.4g (Oz),

    • Swiss Cheese = 225mg calcium per 28.4g (Oz)

  • Cottage cheese 23.5mg per 28.4g (Oz)

  • Milk (305mg Calcium per cup)

  • Yoghurt & Kefir (Yoghurt = 110mg calcium per 100g), Kefir

• Sardines & Canned Salmon (both have soft edible bones)

  • (sardines canned with bones = 325mg calcium per 85g (3 oz) can)

• Leafy greens* and legumes

  • Collard Greens (270mg calcium per cup cooked)

• Bone Broth

• Nuts and Seeds - (almonds, poppy, and sesame seeds)

*Please note: Some greens (e.g. spinach) are high in the anti-nutrient oxalate, which means the calcium is less available and not absorbed by your body.

SHOULD I TAKE A CALCIUM SUPPLEMENT?

It is always best to get your nutrients from food. However, it could be possible you are not getting enough calcium.

If you are having trouble reaching your recommended daily calcium intake, your doctor may recommend taking a calcium supplement to increase your calcium levels.

An effective way to supplement calcium could be eggshell calcium.

TOO MUCH CALCIUM IN YOUR BODY

Another concern is having too much calcium in your body (known as hypercalcemia).

Depending on the severity of the condition, hypercalcemia affects kidney function, digestive health, brain and heart health, and bone and muscle weakness.

Hypercalcemia usually occurs in those who are ingesting a lot of calcium through food and on top of this supplementing calcium.

As we will discuss in the next section, vitamin D deficiency is common. Vitamin D aids the absorption of calcium (and phosphorus). If you're not getting adequate amounts of vitamin D and other minerals (e.g. magnesium), your calcium may not be going to the places where it should, leading to increased calcium levels.

Your doctor will measure your calcium and other vitamin levels on your regular doctor's visits.

VITAMIN D

As touched on briefly above, along with calcium, vitamin D is by far the most important micronutrient for bone health. Even if you're getting enough calcium, it could be going to waste if you're deficient in vitamin D.

Without this essential micronutrient, our bodies wouldn't be able to absorb calcium, magnesium, or phosphate effectively. 

According to research, vitamin D insufficiency and deficiency are now recognised as a major cause of metabolic bone disease in the elderly. 

Further evidence indicates that vitamin D not only improves bone mineral density but also enhances muscle function leading to a decreased number of falls.

So, what are the best sources of vitamin D?

Sunlight is by far the best source of vitamin D, and most people are not getting adequate amounts.

In food and supplements, vitamin D has two main forms, D2 (ergocalciferol) and D3 (cholecalciferol). Vitamin D3 is only found in animal foods.

The best food sources of vitamin D include:

• Fatty fish (salmon, mackerel, herring, sardines) - Vitamin D3

• Egg yolks - Vitamin D3

• Cod liver oil - Vitamin D3

• Mushrooms - Vitamin D2

Certain foods are also fortified with vitamin D.

Vitamin D supplements are a good alternative for those who don't get enough sunlight or can't get it from food.

Aim to get around 15-20 minutes of sun daily, avoiding the hottest parts of the day in the summer months.

If you're following a vegan diet, as vitamin D3 is only found in animal products (which means supplements are derived from animal foods), it's important to get adequate sun exposure.

MAGNESIUM

When it comes to improving bone strength, we usually hear less about magnesium than we do with vitamin D and calcium. It can be argued, however, that magnesium is the most important component for bone health as it aids in the absorption of both calcium and vitamin D. 

Studies show that magnesium deficiency is linked to low-grade inflammation and endothelial dysfunction, which are significant for bone remodelling.

It’s also been shown that lower magnesium intake is associated with lower bone mineral density of the hip and whole body.

Getting adequate magnesium is a must.

The recommended dietary allowance of magnesium is 320mg for women over 51, and for men over 51, it is 420mg. [33]

The best sources of magnesium:

• Fish (salmon, mackerel, pollock, halibut)

• Vegetables (spinach, swiss chard, edamame, okra, potatoes)

• Whole grains (quinoa, wheat germ, bran cereal, buckwheat)

• Nuts and legumes (beans, peas, tofu, flaxseed, peanut butter, cashews, almonds)

• Dark chocolate (woohoo!)

Magnesium can also be safely supplemented, and soaking in a bath of Epsom salts is also an effective way to increase magnesium levels.

VITAMIN K

Vitamin K is another nutrient necessary for bone health.

Several studies have demonstrated that vitamin K deficiency is linked to low bone mineral density or increased fractures.

Human intervention studies have shown that vitamin K can increase bone mineral density in those with osteoporosis and reduce fracture rates. The same studies show that vitamin K may benefit bone health, especially when co-administered with vitamin D.

There are two main forms of vitamin K found in our diet: vitamin K1 and vitamin K2.

Vitamin K1 is mainly found in leafy green vegetables, while K2 is found in fermented foods and animal products.

To get adequate amounts of vitamin K, we must incorporate a mix of foods containing both vitamin K1 and K2 in our diet.

Best sources of vitamin K:

VITAMIN K1 SOURCES

• Leafy greens - kale, mustard and collard greens, swiss chard, spinach

• Vegetables - broccoli, Brussel sprouts, green beans, peas

• Fruits - prunes, kiwi, avocado, dry figs, berries, grapes, pomegranate

VITAMIN K2 SOURCES

• Natto - A Japanese dish made from fermented soybeans

• Dairy - hard and soft cheese, whole milk, butter

• Meat - beef liver, goose liver, chicken liver, chicken, pork

• Egg yolks - Pasture-raised eggs

• Sauerkraut

POTASSIUM

Potassium is responsible for a lot of key processes in our bodies.

Potassium is most notable for its relation to sodium, as the two electrolytes are in charge of maintaining fluid balance in our cells. It is also believed that potassium may have a favourable effect on bone mineral density.

A study investigating the association of potassium intake and BMD among older Korean adults shows that higher dietary potassium levels can improve bone health and reduce the risk of osteoporosis.

A similar study found that dietary potassium intake was positively associated with BMD in postmenopausal women and men over 50. 

Best sources of potassium:

• Fruit and fruit juice (bananas, honeydew, apricots, grapefruit, dried fruit)

• Vegetables (spinach, broccoli, potatoes and sweet potatoes, mushrooms)

• Fat-free dairy products (milk, yogurt)

• Fish (tuna, cod, trout, halibut, rockfish)

• Beans and nuts (pinto, kidney, soybeans, almonds, hazelnuts, Brazil nuts)

ZINC

Zinc is necessary for the development and maintenance of healthy bones by stimulating bone formation and mineralisation. [34]

Best sources of zinc:

• Seafood (oysters, crab, lobster)

• Meat (organ meat, red meat and poultry)

• Beans and nuts (pumpkin seeds, cashews, chickpeas, almonds, peas)

• Dairy products (yogurt and cheese)

Oysters contain more zinc per serve than any other food.

Some breakfast cereals are fortified with zinc.

Some plant foods are good sources of zinc, others not so much as they contain phytates which inhibit its absorption.

An article published by the Laboratory of Endocrinology and Molecular Metabolism in Japan concludes that zinc supplementation has a potent effect in the prevention and therapy for osteoporosis. 

The recommended dietary allowance of zinc is 8-11mg [35]

BORON

Boron is a little known micronutrient that has shown to have some powerful effects on our health. It has shown benefits in improving wound healing, cognitive performance and has demonstrated therapeutic effects in cancer. [36]

Boron has also demonstrated to be essential for healthy bones and joints. [36, 37]

Although the full extent of boron’s mechanisms is widely unexplored, research suggests that its role is most likely to be associated with its interactions with other nutrients such as calcium, magnesium and vitamin D.

Boron is mainly found in plant-based foods such as prunes, raisins, avocados, peaches and apples. Other good sources of boron include peanuts and peanut butter, and broccoli. The World Health Organization estimates that an “acceptable safe range” of boron intakes for adults is 1–13 mg/day [38].

COPPER

Found in almost all body tissues, copper is another essential mineral our body needs to function properly.

Similar to boron, the role of copper in bone health is not fully explored, but findings point to a positive relationship between the micronutrient and bone health.

Studies show that lower serum copper levels are significantly associated with decreased bone mineral density in the total femur and femoral neck.

Different studies on animals and humans have found that rats fed a copper-deficient diet had reduced bone mineral content and reduced bone strength, whilst severe copper deficiency in humans caused various skeletal abnormalities.

Copper is found in various foods such as beef liver, oysters, mushrooms, cashews, potatoes, tofu, sunflower seeds, and dark chocolate.

VITAMIN B

There are different types of B vitamins, and they all play a role in bone health.

Best sources of vitamin B-6

Fish and shellfish, liver, meat, poultry, nuts, green leafy vegetables, whole grains, fruit, legumes, green leafy vegetables.

Best sources of vitamin B-9

Green leafy vegetables (asparagus, brussel sprouts, broccoli), citrus fruits, legumes, seeds, liver, poultry, eggs.

Best sources of vitamin B-12

Organ meats, seafood (shellfish, fish, sardines), meat, dairy, eggs.

Vitamin B-12 is only found in animal foods unless a food has been fortified with it.

PHOSPHORUS

Second to calcium, phosphorus is the most abundant mineral found in our bodies.

When combined with oxygen, the two micronutrients form what is called hydroxyapatite, the main inorganic constituent of tooth enamel and bones. As such, phosphorus plays an essential role in the formation of bones and teeth.

Phosphorus deficiencies are rare unless due to a malabsorption issue or if following a vegan diet.

The problem more so if a high level of phosphorus, which can occur when eating a diet high in processed foods. This mineral is found in a lot of processed foods as an additive. 

As the evidence points out, adverse effects of high dietary phosphorus on bone health have been observed in animal and human studies. This is because excess phosphorus levels cause the body to pull the calcium out of the bones, subsequently weakening them.

One way to limit the intake of dietary phosphorus, and ensure you’re maintaining a good balance of the mineral in your body, is to limit the consumption of processed foods and soft drinks (sodas) that contain phosphates. 

Again, making healthier food choices is the key.

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Micronutrients are essential elements that play a significant role in bone health. I could have covered more of these nutrients, as many play a role in bone health, however, we have covered the main ones involved in bone health and tracking every nutrient in your diet is difficult.

The best way to get the nutrients your body needs for optimal bone health, covering all the nutrient bases, is by eating a diet full of real, nutrient-dense foods from various fruits, vegetables, AND animal foods.

Opt for organic foods when you can, choose grass-fed meat, and wild-caught seafood and pasture-raised eggs over other options.

There are websites that can help you track calories and nutrients. Although they are not completely accurate, they can help give you a better idea of your eating patterns. One such website is cronometer.com.

BONE HEALTH AND PLANT-BASED/VEGAN DIETS

Here are some things to take note of if following a vegan diet:

Eating only plant-based foods makes it more difficult to get all the necessary vitamins and minerals required for optimal bone health.

It is also more difficult to do get the necessary calories and adequate protein and fats to support your body’s needs. Some examples:

• Vitamin B12 is critical for bone health, and it's primarily found in animal products. May need to supplement B12 if following a plant-based diet.

• Vitamin D is essential for calcium absorption, which is crucial for bone health. Again, supplementing may be necessary if following a plant-based diet.

• Calcium can be found in leafy greens like kale, bok choy, and broccoli, but it's more difficult to get enough calcium from plants alone.

Make sure you are not undereating and also getting the recommended amounts of all macronutrients (and micronutrients) in your diet. A nutritionist can help with this.

You may not be absorbing nutrients due to the anti-nutrients in the food. Keep this in mind when choosing food types.

I recommend seeing a nutritionist before jumping into a plant-based diet (or any diet).

BEST FOODS FOR STRONGER BONES

Remember to improve our diet we want to be eating enough calories, but we want to ensure those calories are not foods with limited nutritional value. We want these foods to be nutrient-dense foods.

Below are 6 foods, which I have chosen, as the best foods you can include in your diet to help support bone health (and your health).

1. HARD CHEESES (E.g. Parmesan)

A great source of protein, healthy fats and filled with many healthy nutrients important in bone health. Including calcium, phosphorus, magnesium and vitamin K2.

Hard cheeses are an easier source of dairy to digest for those with dairy intolerances. This is due to the minimal amount of lactose compared to other forms of dairy and the aging/fermentation process the cheese undergoes that helps break down the casein.

2. PASTURE-RAISED EGGS

Pasture-raised eggs are known as nature’s multivitamin and for good reason.

Eggs are abundant in vitamins, minerals and other healthy nutrients. Including, quality protein, omega-3 fatty acids, vitamins A, D, E, K2 and B-12, antioxidants and choline. All essential for health and strong bones.

3. BONE BROTH

Full of essential amino acids and collagen important for strong bones.

Also full of much-needed vitamins and minerals including calcium, phosphorus, magnesium, potassium, zinc, vitamin k2, boron selenium and manganese.

For a healthy bone broth recipe - CLICK HERE.

4. SARDINES

A good source of protein and omega-3 fatty acids. Omega-3 fatty acids are important in decreasing inflammation in the body.

Also a great source of calcium due to their soft, edible bones and a great source of vitamin B-12 and D.

They also contain many minerals important for optimal health, including iron, magnesium, niacin, phosphorus, potassium and zinc.

Ensure you choose sardines packed in a healthy oil (olive oil) or spring water.

5. PRUNES

Several studies have shown eating prunes has been linked to reduced risk of osteoporosis and osteopenia.

Prunes contain several vitamins and minerals that have bone-protective effects, most notably - boron, and also magnesium, phosphorus, vitamin K and potassium.

6. DARK CHOCOLATE

A big reason I chose this was that it tastes great!

But along with the taste, a good quality bar of dark chocolate with a higher percentage of cocoa is packed full of healthy minerals, including magnesium, copper, manganese, potassium, phosphorus, zinc, selenium and iron.

It is said that a chocolate craving is indicative of a magnesium deficiency.

7. SUNLIGHT

Don’t eat the sun, but make sure to get some sun each day. :)

BEST SUPPLEMENTS FOR STRONGER BONES

It's always best to get your nutrients from the food that you eat. 

However, there may be times you're not getting the necessary nutrient requirements for healthy and strong bones. 

Speak to your doctor before supplementing, and your doctor can advise you on what supplements may be a good idea for you to take.

Not all supplements are created equally, so make sure you're buying the best quality ones.

Here are some supplements that may aid in improving your bone health.

A MULTIVITAMIN 

A good quality multivitamin containing magnesium, vitamin D (if required) and other essential nutrients such as B-vitamins, zinc, boron and copper may be beneficial for you.

Make sure to speak to your doctor before choosing a multivitamin.

CALCIUM

If you're low on calcium, your doctor may recommend you take a calcium supplement. 

Eggshell calcium may be a better source of calcium.

WHEY PROTEIN AND MILK BASIC PROTEIN

A protein deficiency is a clear cause of osteoporosis (and muscle loss).

Studies have shown that milk whey protein, especially its basic protein fraction (milk basic protein), contains components capable of promoting bone formation and inhibiting bone resorption.

Additionally, whey protein is filled with other essential nutrients beneficial for healthy bones.

If you have a hard time getting adequate protein and nutrients, this may be something that could assist.

If thinking about supplementing this, make sure to get a high-quality powder. One sourced from grass-fed cows and not filled with harmful additives.

COLLAGEN

I recommend bone broth to help get your collagen needs. However, supplementing collagen may also be beneficial to your bones.

Our bones are comprised largely of collagen (around 25-30% of the dry weight of bone is collagen).

Collagen supplementation has been shown to have a positive therapeutic effect on osteoporosis and osteoarthritis. [39]

One study in particular by the Department of Nutrition, Food and Exercise Sciences links calcium and collagen to a reduced risk of bone loss in osteopenic, postmenopausal women - decreasing the risk of osteoporosis.

Another study on collagen supplementation in 131 women (average age 63 years) was "associated with a favourable shift in bone markers, indicating increased bone formation and reduced bone degradation".

Again, if thinking of supplementing this, make sure to get a high-quality powder. One sourced from grass-fed cows and not filled with harmful additives.

OTHER FACTORS OF NOTE

We have now discussed many factors that can cause bone loss and how you can improve your bone strength through nutrition.

Before we get onto Part 3 (which will be out soon), where we cover exercise for stronger bones, there are two other factors, gut health and aspirin, that have also shown to play a role in bone health and treatment.

THE IMPORTANCE OF GUT HEALTH FOR STRONGER BONES

Having a healthy gut plays a role in improving bone health.

Our body contains millions of tiny living organisms, which, all together, are called the human microbiota. 

The microorganisms live all over our body, including the skin, the nose, the mouth and ... in the gut.

As unsettling as it may sound, it is nothing to be concerned about. Sometimes microorganisms do cause illness, but predominately, they provide essential functions required for human survival.

Our gut is where most of these tiny microbes live. As a result, the gut microbiome, also known as gut microflora, has a vast influence on the whole body. Contrary to popular belief, the microbiome isn't just in charge of digestion; it impacts our immunity, nutrition, diseases, and even behaviour. 

There's been plenty of research on this topic over the years. Evidence shows that an unbalanced gut microbiome is linked to various conditions such as heart disease, diabetes, obesity, asthma, cancer, eczema, and...yes, you've guessed it - bone health.

Research shows that modulation of the gut and its microbiome can affect bone density and strength. 

Emerging evidence suggests that introducing probiotics might have a favourable effect on reducing the risk of osteoporosis. .

This shows that maintaining optimal gut health could significantly help avert bone conditions, and other health conditions.

Optimising these microbes to work in our favour starts with implementing healthy eating habits and boosting our immune system through exercise

ASPIRIN

Aspirin can be found in just about any home. We use it to treat headaches, mild fevers, and inflammation. Aspirin has also found use in the prevention of heart disease due to its blood-thinning properties. However, emerging evidence speculates that aspirin might be a helpful tool in the fight against osteoporosis and fractures too.

An exploratory meta-analysis of observational studies found that aspirin use was associated with 17% lower odds for any fracture and a higher total hip bone mineral density for women. 

Similar results were observed for lumbar spine bone mineral density in women and men. A review on the relationship between aspirin and bone health suggests that aspirin possesses bone protective effects.

Another study confirmed that regular use of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) may have a modest beneficial effect on bone mineral density in postmenopausal women.

Obviously, this doesn’t imply you should start popping aspirin every day. I am simply highlighting that aspirin has shown promising results in improving bone strength and preventing fractures.

Again speak to your doctor to know if this could be something trialled for you and ALWAYS speak to your doctor before taking any medication.

In part 3, we will cover all there is to know about exercise and bone health, including what you should be doing for improved bone health and what movements to avoid with osteoporosis that may be putting you at risk of a fracture. And, we will also go through some exercise programs (with videos) that you can follow to help promote bone strength.

PART 3: EXERCISE AND STRONGER BONES

SOURCES

CLICK HERE TO VIEW ALL SOURCES USED IN THIS ARTICLE.

The Complete Guide To Strong Bones Over 60 [Part 1]

PART 1: WHAT YOU NEED TO KNOW TO GET STRONGER BONES

In early life, keeping our bones strong is something we don’t think too much about!

We know our bones keep us standing.

We know that we can break our bones.

We know it’s important to have strong bones.

But…… that’s all we usually know about our bones most of our life. They just do their thing in the background and we get on with it.

It’s not until later in life that most people start to think more about keeping their bones healthy. This is usually because there is more talk about the effects of weaker bones, or a fracture occurs somewhere in the body, or, after tests, a doctor brings the news that your bones are weaker (which can come as quite a shock).

If you’re reading this article, having strong bones has most probably become important to you. Maybe you’ve been diagnosed with osteopenia or osteoporosis; maybe you’ve had fractures yourself, or maybe you want to make sure you’re doing all that you can to keep your bones at their strongest, which everyone should be doing.

In this article, we are going to be covering everything you need to know for healthiest bones.

In Part 1, we’ll learn about bones and how they work because having a better understanding of your body helps you to be healthier.

We’ll discuss osteopenia and osteoporosis, what is happening in these conditions and why they occur.

We will go through the testing procedures for determining bone strength and how often you should be getting your bone strength tested. We’ll also discuss the factors that contribute to bone strength (which goes beyond bone density).

In Part 2, we will go through all treatment approaches for improving bone strength and preventing fractures, from habits to cut out to nutrition (including vitamins and minerals for bone strength).

And in Part 3, we will cover all about exercise techniques for stronger bones, including some exercise programs (which include videos) that you can do to help promote bone strength.

After reading this article, you’ll have everything you need to make a difference in your bone health.

So read through it all, make the changes required and you’re on your way to better bone health.

Now…. Let’s get into it.

WHAT WE’LL BE COVERING IN PART 1:

ALL ABOUT YOUR BONES & BONE LOSS

• EASING YOUR FEARS AROUND ‘BRITTLE BONES’ AND FRACTURES 

• ABOUT YOUR BONES

• WHAT HAPPENS TO OUR BONES AS WE GET OLDER - WHY DO OUR BONES BECOME WEAKER

• OSTEOPENIA vs OSTEOPOROSIS: WHAT CAN HAPPEN WHEN BONES BECOME WEAKER

• HOW DO I KNOW IF I HAVE BONE LOSS OR OSTEOPOROSIS

• RISK FACTORS FOR OSTEOPOROSIS

TESTING FOR  BONE LOSS

• HOW BONE LOSS IS COMMONLY TESTED

• UNDERSTANDING BONE MINERAL DENSITY (DEXA) SCAN RESULTS

• IS BONE DENSITY THE ONLY FACTOR IN STRONG BONES?: INTRODUCING BONE QUALITY

• HOW CAN I GET MY BONE QUALITY TESTED?

• HOW OFTEN SHOULD I HAVE MY BONE DENSITY TESTED? - WHEN TO GET YOUR BONES TESTED

• CAN BONE STRENGTH BE IMPROVED OVER 60?

OSTEOPOROSIS AND MEDICATIONS

ALL ABOUT BONES AND BONE LOSS

EASING YOUR FEARS AROUND ‘BRITTLE BONES’ AND FRACTURES

To find out the structures of your body that hold you up, help you to move and to go about your daily activities are failing, and potentially going to get progressively worse over time, can be quite unsettling to say the least.

To think that your bones are now what’s commonly described as ‘brittle’ would not give anyone confidence in going about their day in fear of breaking a bone.

There are also some frightening statistics about hip fractures and the outcomes if this was to happen over a certain age that you may have heard (I.E. requiring permanent nursing care or even death not long after the fracture).

It makes the thought of getting older and the possibility of this occurring a terrifying and somewhat helpless situation. 

But let’s look at this all from a different view.

Firstly, (I want to get this out of the way first), in regards to those statistics following a hip fracture, those who die following a hip fracture are usually very frail with serious health conditions prior to the fracture. Full recoveries can be made.

Secondly, it’s important to know that bone health is graded from normal (healthy bone levels) to mild bone loss and to osteoporosis (which has graded levels also).

Whatever your bone health is at this current time, you can prevent bone loss and loss in bone strength and it is possible to get them stronger.

As with many factors that are typically put down to ageing like muscle loss and strength, decreased fitness, and poor balance, weaker bones are also NOT due to ageing alone.

Yes, your bones will not be like they were when you were younger, but there are many other factors that contribute to loss of bone strength beyond ageing that can be changed.

Thirdly, being diagnosed with osteoporosis does not mean you’re definitely going to get fractures. Although osteoporosis does increase fracture risk and fractures are common with osteoporosis, there are many who get diagnosed with this condition that do not get fractures.

And finally, falls, which can lead to fractures, can be prevented.

There are always things you can do to improve your bone health and your situation. 

Let’s focus now on what can be done to improve bone health and decrease fracture risk, starting with learning about our bones.

ABOUT YOUR BONES

Throughout life, the bones of our body are constantly being broken down (by cells known as osteoclasts) and then built up with new bone (by cells known as osteoblasts).

This process is called bone remodelling and it ensures that your body is well-adjusted to the ever-changing mechanical forces placed on it.

Basically, your body is continuously doing renovations to make sure that the whole structure maintains its integrity for the demands of life.

As children, our bones go through rapid periods of growth in both size and density where more bone is added than being taken away.

This increase in bone size and density continues into our late twenties when our skeleton reaches full maturation, and we reach what’s known as peak bone mass. 

From this point, although our skeletal structure has now reached full maturation, bone remodelling continues to take place (now at a slower rate, however, in comparison to childhood).

To put it simply, as long as your body continues to create good quality bone tissue at the same (or similar rate) as it resorbs the old bone, your skeletal system remains strong and healthy.

WHAT HAPPENS TO OUR BONES AS WE GET OLDER - WHY DO OUR BONES GET WEAKER

As our body ages, the rate at which the new bone replaces the old bone slows down.

In other words, the resorption exceeds the formation of new bone tissue, leading to less bone mass.

Additionally, there is deterioration in the structure of the newly laid bone leading to poorer bone quality. [1]

This decline in quantity (density) and quality commonly results in conditions such as osteopenia and osteoporosis, predisposing one to the risk of fractures.

However, as touched on earlier, age-related bone loss is a complex disorder that occurs due to numerous factors and not just ageing alone. These factors include genetics, hormonal changes, as well as biochemical, lifestyle and environmental factors. We will cover this more later in this article.

OSTEOPENIA vs OSTEOPOROSIS: WHAT CAN HAPPEN WHEN BONES BECOME WEAKER

So when the rate of bone breakdown exceeds the rate of new bone formation, our bone mass decreases and becomes less dense (more porous).

When there is a loss in bone density, the first stage is what’s known as osteopenia.

If this loss in bone density was to progress further, we get into the ranges of osteoporosis.

Image: Healthy Hip Bone vs Porous Bone (Osteoporosis)

Osteoporosis is derived from Greek “osteon” (bone) and “poros” (little hole). Osteoporosis meaning ‘porous bone’. [2]

When bones become weaker, it can lead to secondary issues, the most common being fragility fractures.

As osteoporosis can affect any bone in the body, they are all at increased risk of fracture. However, fractures most commonly occur in bones that undertake more strain (such as the spine) or sites most at risk if one was to fall (wrists or hips).

Fractures can be painful and can lead to further problems, such as changes in posture, height loss, decreased quality of life, fear of further fractures, depression and social isolation.

HOW TO KNOW IF YOU HAVE BONE LOSS OR OSTEOPOROSIS

Osteoporosis can be present with no symptoms. Most of the time it usually goes undetected until a fracture occurs. For this reason, osteoporosis has been named the ‘silent disease’.

Osteoporosis can only be diagnosed by certain tests. If you are at risk of osteoporosis, your doctor will recommend and organise bone testing.

Let’s now look at the risk factors for osteoporosis.

RISK FACTORS FOR OSTEOPOROSIS

It’s important for you to be aware of the risk factors for bone loss and osteoporosis to know if you’re at risk and so you can get tested and take action if need be.

The following factors are risk factors for bone loss:

GENDER. Women are generally at higher risk of osteoporosis and osteopenia due to naturally having less bone mass than men.

Bone loss in women is most rapid following menopause with studies showing osteoporosis is related to estrogen deficiency.

By the age of 65-70, both men and women start losing bone at the same rate. [3]

AGE: Your risk for osteoporosis increases with age. Women over 65 and men over 70 are at greater risk.

BONE STRUCTURE & BODY WEIGHT: Thin people usually have a greater risk of developing osteoporosis due to having less bone mass to begin with. Additionally, those that have had major weight loss could also be at risk.

FAMILY HISTORY: Fracture risk secondary to osteoporosis is increased if a parent experiences a hip fracture, particularly if that fracture occurred at a younger age.

NUTRITION: Eating an inadequate amount of calories and consuming a poor diet limited, or devoid, of vital nutrients increases the risk of osteoporosis.

SEDENTARY LIFESTYLE: Lack of exercise and physical activity increases the risk of osteoporosis.

SMOKING AND EXCESSIVE ALCOHOL CONSUMPTION: Smoking decreases bone density and bone quality and increases the risk of fractures [4]. And the same goes for excessive alcohol consumption. [5]

HEALTH CONDITIONS: Certain conditions can put one at risk of developing osteoporosis. The diseases include thyroid disease or an overactive thyroid gland (hyperthyroidism), parathyroid disease or an overactive parathyroid (hyperparathyroidism), chronic kidney and liver disease, and rheumatoid arthritis, plus conditions that affect the body’s ability to absorb nutrients (e.g. Crohn’s disease, coeliac disease, and other inflammatory bowel conditions).

MEDICATIONS: Certain medications (e.g. corticosteroids or thyroid medications) can result in side effects that may damage bone and lead to osteoporosis.

Other possible signs of bone loss or osteoporosis:

• Height Loss: 1/2 inch or more within one year. Or 1½ inches from your original height overall.

• Past history of Fractures: - Fracture after age 50, fragility fracture at any age, or a spinal X-ray showing a fracture or bone loss in your spine

• Pain: Back pain with potential spinal fracture

TESTING FOR BONE LOSS

HOW BONE LOSS IS COMMONLY TESTED

Firstly, a doctor will examine your medical history and ask questions to determine what risk factors (as discussed above) are present that could be putting you at risk of bone loss.

The doctor will also recommend a bone mineral density (BMD) test which is the primary and most commonly used test for bone loss.

Dual-energy X-ray absorptiometry (DEXA or DXA) is considered the gold standard for measuring bone mineral density.

Image: DEXA/DXA machine

The DEXA machine scans your body to measure bone mineral density at the hip and spine.

It measures the amount of minerals, namely calcium, in your bones and is a non-invasive and painless test that usually takes around 10 - 20 minutes.

Lab tests (blood and urine) may also be ordered which can help give more of a picture of what is going on with your bone health.

Lab tests can confirm or eliminate the existence of certain diseases or health problems that could contribute to bone loss or osteoporosis.

UNDERSTANDING BONE MINERAL DENSITY (DEXA) SCAN RESULTS

Once the DEXA scan is completed, the doctor will analyse the results using a T-score. A T-score compares a patient's bone density to the bone density of a healthy, young adult.

The bone density results are typically classified according to the following scores:

• Normal Bone Density: between 1 and -1

• Low Bone Density (Osteopenia): -1 to -2.5

• Osteoporosis: -2.5 or lower 

• Severe Osteoporosis: -2.5 or lower with a history of bone fractures.

The DEXA test provides an important piece of information regarding your bone health. However, one DEXA scan can only give a snapshot of your bone at that point in time. It is not a definitive test to determine if you are losing bone.

IS BONE DENSITY THE ONLY FACTOR IN STRONG BONES?: INTRODUCING BONE QUALITY

Bone mineral density testing (DEXA) is the most widely used clinical tool by doctors to evaluate bone strength and risk of fracture due to its low radiation exposure and ease of use.

While this test is a considerably easy way to give an idea of bone strength and can help in making decisions for treatment and to determine treatment effectiveness, it is limited, however, to only measuring the mineral components of the bone, without any details regarding the structure of the bone.

This is important as bone density alone is not the only factor involved in bone strength and risk of fractures. Yes, lower bone density does correlate to increased fracture risk. [6, 7] However, bone density is only one component of bone strength. [8]

As discussed earlier in this article, as we get older we not only lose bone density (mass), we also get a change in the structure of the bone (or the quality).

A measurement of bone mineral density alone neglects other important contributors to bone strength and fracture risk reduction. Hence additional data is needed for predicting bone strength.

So…… What’s going on here?

As you’re starting to see, BONE DENSITY ALONE DOES NOT EQUAL BONE STRENGTH.

Bone strength is a combination of bone quantity (density and size) and bone quality, consisting of structure (micro and macro architecture), material properties, and bone turnover (remodelling). [9]

In simple terms, bone quality is related to what the bone is made up of and where this material is in regards to its structure, not just how dense the bone is, which is important to uphold the mechanical forces of the body.

BONE STRENGTH = BONE QUANTITY (DENSITY) + BONE QUALITY

This is important as the gold standard and most commonly utilised method for testing bone strength is bone mineral density. However, there is more evidence to show that bone quality is more important in predicting bone strength. [10]

HOW TO GET BONE QUALITY TESTED

At this point, you can see that bone density tests, the most commonly used test to determine bone strength, do not give a complete picture of your overall bone health.

You’re most probably thinking at this stage, “then how do I get my bone quality tested?” And, unfortunately, it’s not that simple.

Although there are methods to measure bone quality that can give a better idea about bone strength and risk of fracture (in comparison to bone density testing), bone quality testing methods are less readily available, invasive, or more expensive than a bone density test. Hence the reason bone density tests are commonly used by doctors over bone quality tests.

Bone density is still an important measurement of bone health. However, we must understand a bone density measurement is only one piece of the puzzle; it is giving you a snapshot of your bone strength at the point in time that test was taken. It is also not telling you if you are losing bone.

You may have a low bone density reading and are not currently losing bone.

Your doctor will require at least two tests over a period of time (and a lab test) to understand if you are losing bone.

HOW OFTEN SHOULD I HAVE MY BONE DENSITY TESTED? - WHEN TO GET YOUR BONES TESTED

If you are a woman over the age of 65 and a man over 70, or if you have any of the risk factors discussed above, it is recommended you get a bone mineral density test. 

A follow-up BMD test is recommended at least every two years.

To improve the accuracy of your testing results, make sure you use the exact same machine for each measurement, as different machines may lead to different results.

If you feel you are at risk for osteoporosis or fractures, do not hesitate to speak to your doctor about getting bone density tested.

CAN BONE DENSITY BE IMPROVED OVER 60?

With bone loss and osteoporosis, the best thing that can be done is to prevent it from occurring in the first place. Or preventing further loss in bone mass and strength, and this most certainly can be done.

The question now is, “is it possible to go beyond this and get the bones stronger rather than just preventing them from getting weaker?”

To answer this question, we look back to the components of bone strength that we discussed earlier, that being: bone strength = bone quantity (density) + bone quality.

Studies have shown that when it comes to exercise, exercise programs either show no benefit or only minor benefit when it comes to improving bone mineral density in those with osteoporosis. [11, 12]

On the other hand, however, osteoporosis treatments and exercise have been shown to have beneficial effects on other determinants of bone strength (more specifically bone quality and bone turnover), which can help to strengthen those bones and reduce fracture risk beyond bone mineral density. [13]

By undertaking the right steps, you can improve your bone strength and decrease your risk of fractures.

It’s important now to switch your focus to improving your bone health and being healthy overall.

This is exactly what we will be doing in Part 2.

Before we get to Part 2, however, which will focus on the natural methods to getting your bones healthier, I wanted to touch on medications.

OSTEOPOROSIS AND MEDICATIONS

I am going to be brief with this section because this is not my area of expertise and something which is best discussed with your doctor.

There are two categories of osteoporosis medications, these being:

• Antiresorptive medications - These stop bone loss by suppressing the action of osteoclasts (the cells which break down bone).

  Antiresorptive medications include bisphosphonates, denosumab (Prolia), estrogen and hormone therapy, and raloxifene.

• Anabolic medications - These increase the rate of bone formation by boosting the activity of osteoblasts (the cells which re-build bone).

  The most commonly used anabolic medication for osteoporosis is teriparatide.

Medications do have a place in the treatment of osteoporosis and it will be determined by your doctor if you require them.

The foundation of any bone-strengthening plan, however, should always be nutrition, exercise and other lifestyle factors (which we will cover in part 2).

With everything medical-related that could potentially have long-term effects, it is ok to get a second doctor’s opinion, or even a third if you want to. This way you can hear different perspectives and get a better idea about what is best for you.

Now, let’s get into what you can do to improve your bone health beyond medication.

PART 2: HOW TO EAT FOR STRONGER BONES (AND OTHER FACTORS THAT IMPROVE BONE HEALTH)

SOURCES

CLICK HERE TO VIEW ALL SOURCES USED IN THIS ARTICLE.

Heart Rate and Weightloss in Seniors

Does the heart rate determine weight loss for seniors?

“I go to my local health club and walk on the treadmill. Is there a certain heart beat rate that I should try to get to in order to lose weight? I have been losing a pound (0.5kg) a week but I think that is more due to eating less. Also anything to help to flatten a stomach?”

There are a few things I want to touch on with Jan's questions.

Number 1) Jan made comment about her weight loss may be from eating less.

My comment: 80% of losing weight is about the food you are putting into your body.
If you’re eating too much food (too many calories), you’re going to find it very, very difficult to lose weight just with exercise.

Make sure you’re eating healthy food and not overeating and, like Jan, you’ll see results.

(In the future I plan on giving information and videos on nutrition for seniors so keep an eye out for this)

Number 2) Jan asked if there is a certain heartbeat rate she should be exercising at to lose weight.

My comment: A great question. Many fitness trainers would say that you want to keep your heart rate in a “FAT BURNING” zone, but I disagree with this. There is no “FAT BURNING” zone you need to stick to when exercising.

However… When exercising we DO want to elevate our heart rate to get the health benefits and burn calories, which will help lose weight.

So what do we elevate our heart rate to?

I recommend exercising in the zone of 60-80% of your max heart rate for the duration of your exercise session.

This may sound complicated, but it actually isn't.

To get your max heart rate, you’re going to put your age into the following formula.

Max Heart Rate = 208 – 0.7(age)

Let take a look at an example: I'm going to pick the age of 70.

Putting Joe's age into the formula: Max Heart Rate = 208 – 0.7(70)

We get 159.

Now when we find 60-80% of this we get the following:

60% = 95 beats per minute
80% = 127 beats per minute

For someone aged 70, they will aim to keep their heart rate between 95 beats to 127 beats per minute for the duration of their exercise session.

When we exercise at 60-80% intensity and combine our exercise with healthy eating we will lose fat and get many health benefits.

Also to touch on the question of flattened stomach's when we lose fat from our body overall, eventually our stomachs will flatten.

As you can see Jan combined her exercising with “eating less” and she is seeing results. Great work Jan!

Now, if you’re like Jan (or me) and like to track and follow numbers when exercising, it’s easy to track if you have a heart rate monitor or you use a treadmill (or other exercise equipment) that tracks your heart rate.

If you don’t have this equipment however, I have created a table known as a Rating of Perceived Exertion (RPE) table which can be printed off and makes it easy for you to track how hard you are exercising.

DOWNLOAD RPE TABLE HERE

From this RPE table you can determine the effort (or exertion) you are putting in when exercising by matching up how you feel during exercise and your % of Max Heart Rate.

This table gives you an easy way to determine how much effort you are putting into the exercise and it is worth printing off, familiarising yourself with, and using during your exercise sessions.

To know if you are at 60% of your max heart rate it basically means you are sweating minimally and can easily hold a conversation. As the effort of the exercise increases your heart rate will begin to climb until you get to 80% max heart rate. At 80% of your max heart rate you'll be sweating, can still hold a conversation but with difficulty.

Anything below 60% is still exercise and it has its place for the health benefits. Anything above 80% is not required for seniors.

Well, I hope the above made sense to you. It can be confusing until you get used to it.

Enter your age into the formula and work out 60-80% of your max heart rate and try to stick to this next time you go for a walk, cycle, etc.

If tracking numbers is not something you are interested in, that’s fine also. Just get moving! Get out there and enjoy it. Be happy and if you’re ready to think about different ways of exercising you can do the above also.

- Mike

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How Heavy Should Weights be For Seniors? (Strength Training)

Choosing the right weights for strength training

You have most probably heard me say before that sooner or later it’s a good idea to add in resistance to your exercises in some form (whether weights or a resistance band). This is so you continue to challenge yourself and get further strength gains. When you’re stronger, you’re going to notice a big difference. 



A question I often get asked is “how heavy should my weights be?”


This is a question I cannot give a direct answer to. Everyone has different capabilities, however, this is what you should do:



Step 1 - Practice First

Once you’re ready to begin using weights, choose a light weight to begin with. A weight that you can still do the exercises with no trouble. Say 1kg. If you don’t have weights, you can also use cans of food to begin with, or water bottles.

Don’t rush this. This is so you can practice the exercise with using weights, which will ensure you avoid any injuries and get the most out of your exercise.

Do this whenever completing a new exercise with weights for the first time.

Only when you feel you are doing the exercise correctly is it time to increase the weight.

Step 2 - Find Your Sweet Spot

Now you've got the exercise down, choose a weight that when completing the exercises it challenges you, yet you are still completing the exercises with correct exercise technique.

You want to feel your muscles being worked.



If you feel it is too easy, that’s ok, continue the workout and next time increase the weight a little. Note this down if you need to.

If you feel you are not able to lift the weight or are losing the correct exercise technique the weight is too heavy, put the weight down. Lower the weight.



For some exercises, you will find the weight too easy, for others too heavy.

 So you'll most probably be using different weights for different exercises.

This is why I recommend a weight set.

Step 3 - Stay Consistent and Progress

By doing the above (step 2) consistently AND ensuring you’re eating adequately, you WILL get stronger, you WILL get fitter.. It’s going to happen. 💪



So now it’s time for you to increase the resistance you’re using.

Use a slightly heavier weight, or a different loop on the resistance band, or double up your band. Or, use a thicker resistance band. If you’re using a resistance machine, you can increase it up a notch. 

Follow again as per step 2.

This is what I'd do (or any trainer would do) If training you. Working out your safe starting strength and over time increasing the resistance (or progressing the exercises in other ways).

And this is how you do it yourself. 🙂

For more on this you can check out my comprehensive article on strength training here: The Strong Senior

If you have any questions, ask them below (Many questions are answered in the article above)! 👇

Easing Peripheral Neuropathy

INCLUDES Exercises for Peripheral NEUROPATHY

Over the years, having helped many patients with peripheral neuropathy experience relief from their symptoms, I have witnessed how uncomfortable this condition can be, and I want to do my bit in helping bring relief to as many as I can.

I have written this in-depth article to help bring you a better understanding of peripheral neuropathy and what you can do to ease the uncomfortable symptoms that come along with it.

I have also included an exercise program in video and pictures that you can follow to help you improve your strength and flexibility, relax your body and muscles and help reduce the symptoms.

So, let’s get into it!

This article covers the following:

• WHAT IS PERIPHERAL NEUROPATHY

• TYPES OF PERIPHERAL NEUROPATHY

• SYMPTOMS OF PERIPHERAL NEUROPATHY

• COMMON CAUSES OF PERIPHERAL NEUROPATHY

• TREATMENTS FOR PERIPHERAL NEUROPATHY

  • MEDICAL TREATMENTS

  • NATURAL TREATMENTS

• EXERCISE TO DO TO IMPROVE PERIPHERAL NEUROPATHY SYMPTOMS

• SPECIFIC EXERCISES FOR PERIPHERAL NEUROPATHY

• MANAGING PERIPHERAL NEUROPATHY

WHAT IS PERIPHERAL NEUROPATHY?

Peripheral neuropathy is a condition that affects and damages the nerves of the peripheral nervous system, causing them to malfunction.

To understand this condition a little better, we’ll need to get a grasp on the function of the nervous system, and more specifically, the peripheral nervous system itself.

The nervous system of our body is made up of two major components, both the central nervous system (CNS) and the peripheral nervous system (PNS).

The central nervous system comprises the brain and the spinal cord. This part of the nervous system is the processing centre of the body.

It controls both our body’s voluntary functions (functions we consciously control) and involuntary functions (automatic functions). The CNS is responsible for interpreting information from the PNS and responding to this information.

The peripheral nervous system on the other hand, is a complex network of nerves that connects your brain and spinal cord to, as you might have guessed from the name, the peripheral areas of your body. It’s the parts of the nervous system outside the brain and spinal cord.

To put it simply, the peripheral nervous system allows your brain and spinal cord (the CNS) to communicate with your body parts (your limbs, skin, muscles, and internal organs). It communicates to your CNS, for example letting your brain know you’ve touched something hot. And it also carries messages from the CNS to different parts of your body (E.G. moving your hand off the hot item).

In the case of peripheral neuropathy, the nerves outside your brain and spinal cord are damaged leading to unpleasant symptoms usually in the lower legs and feet, or the hands.

TYPES OF PERIPHERAL NEUROPATHY

There are different kinds of peripheral neuropathy and they’re generally categorised based on the number of affected nerves. As such, we recognise mononeuropathy and polyneuropathy.

• Mononeuropathy is a type of neuropathy that affects only a single peripheral nerve. The most common cause of mononeuropathy is physical injury to the affected area or prolonged pressure on the specific nerve. Mononeuropathy is often observed in patients who lead an overly sedentary lifestyle or are involved in activities that cause repetitive motions in specific areas of the body.

One such example is carpal tunnel syndrome. This condition is caused by prolonged pressure on the nerve which passes through the wrists and ends in the hands. People who work office jobs or assembly lines in factories are often affected due to the overuse of their wrists. This condition is characterised by numbness, tingling, and pain in the hands, usually in the first three fingers starting from the thumb.

• Polyneuropathy, on the other hand, is a type of neuropathy that affects multiple peripheral nerves at once. Most of the cases of peripheral neuropathy are, in fact, polyneuropathies. The condition results in weakness, numbness, and burning pain, which usually starts in the hands and feet and often progresses throughout the body, affecting other areas as well.

Polyneuropathy occurs due to a multitude of reasons, although the most common form of polyneuropathy is diabetic neuropathy, generally observed in patients suffering from diabetes or those with irregular blood sugar levels.

The condition can be acute or chronic in nature.

Acute polyneuropathy is often a result of an infection or an autoimmune reaction. It occurs suddenly and poses a higher risk with more severe symptoms. Guillain-Barré syndrome is one of the most serious forms of acute polyneuropathy where the immune system attacks the nerves in the body. This disorder spreads quickly and if left untreated, it can lead to permanent damage and even paralysis.

Chronic polyneuropathy is when the neuropathy is longer lasting and is generally difficult to treat. There are different causes of this condition and some are a direct result of underlying disorders such as diabetes.

SYMPTOMS OF PERIPHERAL NEUROPATHY

Symptoms of peripheral neuropathy may range from mild to severe, depending on the type of the affected nerves, as well as the gravity of the damage.

Sometimes, the symptoms occur suddenly, but in most cases, the symptoms develop gradually over a longer period.  

In certain cases, symptoms may go away on their own, without any intervention. Other cases may require medical attention, but it’s important to keep in mind that treatments are available and can greatly alleviate the symptoms of these disorders.

The symptoms of peripheral neuropathy can vary and depend on the type of damaged nerves. These types can be motor, autonomic, and sensory nerves.

• Motor Nerves

Motor nerves are in charge of the muscle movements in the body. They control how we walk, how we talk and when we undertake certain actions, like holding a cup of coffee. When your motor nerves are affected you may experience symptoms such as muscle loss (atrophy), muscle weakness and spasms, coordination loss and falling. Loss of reflexes, difficulty moving your arms and legs or paralysis.

• Autonomic Nerves

These nerves are responsible for bodily functions that people can't control consciously. This includes breathing, digestion, bladder function, as well as heart rate. Damaged autonomic nerves can result in nausea, vomiting, sweating, dizziness, abnormal heartbeat, as well as gastrointestinal issues. 

• Sensory Nerves

When you get a paper cut or burn your mouth with some scolding coffee, it’s your sensory nerves that are alerting the brain of these sensations. If the peripheral neuropathy has damaged your sensory nerves, you may experience either a heightened or a decreased sensitivity to touch. Burning, sharp or throbbing pains. Other symptoms include tingling and numbness, and decreased reflexes. Many people also report a feeling as if they are wearing tight gloves or socks.

Nerves have the responsibility to send signals to your brain. When those nerves are damaged, the signals may be interrupted or misinterpreted.

In some cases, your nerves may alert your brain of pain sensations that aren’t even there; similarly, they might not send the signals when the pain does occur.

Peripheral neuropathy can be caused by several factors and can often be a result of underlying conditions. It’s essential to determine the underlying causes to your neuropathy, as it’s important to treat the root of the problem, rather than just the symptoms.

COMMON CAUSES OF PERIPHERAL NEUROPATHY

Peripheral neuropathy isn’t caused by a single factor and it can be a result of different medical conditions, traumatic injuries, infections, alcoholism, and even certain medicines. By far the most common cause of peripheral neuropathy is diabetes.

• Diabetic polyneuropathy is progressive nerve damage caused by type 1 and type 2 diabetes. Studies show that peripheral neuropathy affects nearly 50% of adults with diabetes. There is no available cure for diabetic neuropathy, but it is possible to slow the progression with certain lifestyle changes.

Aside from diabetes, several other health conditions can cause peripheral neuropathy. These conditions include:

• Inherited disorders

Also called hereditary motor and sensory neuropathy, Charcot–Marie–Tooth disease (CMT) is a type of disorder that causes nerve damage, mostly in the arms and legs. It is known to be one of the most common inherited neurological disorders.

• Bone marrow disorders

Certain conditions characterised by abnormal levels of protein in the blood are also known to cause peripheral neuropathy.

• Autoimmune diseases

Guillain-Barre syndrome is one of the most severe types of peripheral neuropathy caused by an autoimmune disease.

Other medical conditions caused by an abnormal immune system response that are linked to neuropathy are Sjogren’s syndrome, rheumatoid arthritis, lupus, vasculitis, and chronic inflammatory demyelinating polyneuropathy (CIDP).

• Infections

Peripheral neuropathy can also be a result of certain bacterial and viral infections. Lyme disease, leprosy, diphtheria, and HIV are some of the infections known to cause neuropathy.

• Other diseases

Several other diseases such as kidney and liver disease, certain cancers, hypothyroidism, and connective tissue disorders are also linked to potential peripheral neuropathy.

Peripheral neuropathy can also be caused by other factors, such as:

• Traumatic injuries

Physical injuries, including sports injuries, falls, automobile accidents, or complications during surgery are some of the most common causes of mononeuropathy. Such injuries can compress and stretch the nerves, or even cause them to detach from the spinal cord.

• Medications

Peripheral neuropathy sometimes occurs as a side effect of certain medications. Research suggests that drug-induced peripheral neuropathy is commonly observed in chemotherapeutic agents, antimicrobials, cardiovascular drugs, psychotropic, and anticonvulsant drugs.

• Toxins

Prolonged exposure to poisons and toxic substances such as lead, arsenic, thallium, and mercury can also cause neuropathy.

• Vitamin deficiencies

Vitamins play a big role in regulating our nervous system. A deficiency in certain vitamins, (especially B vitamins) have been linked to a higher risk of peripheral neuropathy.

Certain studies show that patients undergoing bariatric surgery should especially pay attention to possible deficiencies in their systems.

• Alcoholism

Excessive alcohol usage is also associated with neuropathy due to several risk factors.

Research shows that thiamin deficiency, malnutrition, and direct alcohol toxicity could be the main reasons behind alcoholic neuropathy.

Sometimes it’s not possible to determine the exact cause of peripheral neuropathy. When this happens, it is called idiopathic neuropathy.

TREATMENT OPTIONS FOR PERIPHERAL NEUROPATHY

Now that we’ve explained what peripheral neuropathy is, how it develops and the way it manifests itself, you’re probably wondering - is it treatable?

Unfortunately, there isn’t an easy answer to this question. Certain types of peripheral neuropathy can be effectively treated and even reversed in some cases.

This is especially true when it comes to neuropathy caused by alcoholism, vitamin deficiency, toxins, and certain medications. Implementing certain lifestyle changes can significantly improve the chances of recovery.

Of course, this isn’t always possible.

The good news is that our nerves (have amazing regenerative abilities, meaning, they are able to heal themselves. However, there is a limit to this power, and sometimes, if the damage is too severe, the nerves aren’t able to fully repair themselves. When this happens, it’s possible to slow down the progression of the disorder, but not completely reverse it.

The earlier you manage to diagnose your condition and seek treatment, the better chance you’ll have at recovery, however, the body is capable of many miraculous things, so always, I repeat…. always, remain hopeful.

Treatments for peripheral neuropathy depends on the cause of the condition. Some types of neuropathy may require medical intervention like surgery or injections, while others can be effectively treated through physical therapy and lifestyle modifications.

MEDICAL TREATMENTS

• Surgery

Peripheral neuropathy caused by physical injury or nerve compression often requires surgical treatments. These procedures are called nerve decompression surgeries and their aim is to relieve the pressure caused by a pinched or entrapped nerve. This type of surgery is not overly invasive and is believed to be successful in 80% to 90% of cases.

• Therapy

Several therapies can help ease the symptoms of neuropathy.

Physical therapy aims at treatments to reduce symptoms and improve muscle strength and mobility issues.

However, other, therapies like transcutaneous electrical nerve stimulation (TENS) plasma exchange (PE) and intravenous immune globulin (IVIg) have also proven to be effective tools for relieving the symptoms and signs of neuropathy.

TENS unit.

TENS therapy relies on electrical currents to stimulate the nerves. Studies show that TENS therapy can significantly decrease pain in patients suffering from neuropathy as well as other painful conditions. These devices are small units that can be self-administered and are not difficult to use. TENS units can be easily purchased online. I recommend you see your Doctor or Physiotherapist to determine if a TENS unit is suitable for you and they can also help show you how to use it appropriately

• Medication

Easing the symptoms of peripheral neuropathy can also be achieved through the use of certain medications. Depending on the severity of the symptoms, your doctor may prescribe pain relievers, anti-seizure medications, and even antidepressants.

NATURAL TREATMENTS

• Quitting Harmful Habits

The first step in improving your health and the symptoms associated with peripheral neuropathy is minimising exposure to, or stopping, substances that can be causing harm to your health.

We all know the damage smoking does to our health and it can limit the blood flow to your nerve cells, impairing your blood circulation in the process.

Additionally, alcohol abuse is linked to nerve damage and can even cause permanent disability in some cases.

The first step towards a successful recovery starts with making small, but effective modifications that can change your life for the better.

If this is an issue for you, speak to your doctor about the options you have available for this.

• Diet

  Get your Diet right! Start eating healthier.

  Move away from processed food and do your best to start eating the best quality natural foods.

  Eat foods that are high in nutrients and decrease or cut out anything that can be detrimental to your health.
  This will help decrease the inflammation in your body and ensure you are getting all nutrients you need to support good health.

  (For more on healthy eating, check out more of my healthy eating articles HERE)

As mentioned earlier, certain types of neuropathy are directly caused by vitamin deficiencies, particularly certain vitamin B deficiency (mainly vitamin B-12).

Meat and dairy products are some of the best sources of B vitamins, which is why those following a plant-based diet are commonly at risk for deficiency.

It is possible to increase the intake of B vitamins through supplements, although it is necessary to consult with your doctor first to determine the right dosage and it is always best to get your nutrients from real food and only supplement if necessary.

• Relaxation Technique

Anxiety, depression, chronic stress and worry all lead to a sensitised nervous system.

When you’re in a state of chronic stress (even mild) you are going to experience more pain and other symptoms.

Make lowering stress a priority in your life. When we are more relaxed, our nervous system is less sensitive, and symptoms will be reduced.

Lowering stress is a very important step towards recovery not only with peripheral neuropathy symptoms but your health in general, which is why it’s crucial to find a suitable way to decrease your stress levels.

Several techniques have proven to be effective in relieving stress and also pain caused by neuropathy.

Most of these methods rely on a body-mind connection, allowing you to ease symptoms of pain, but also help you cope with the condition.

Meditation, is very effective in reducing symptoms in not only peripheral neuropathy but also many other painful conditions.

• Desensitisation Techniques

  When sensation is increased in the hands or feet a light massage with moisturiser or cream of your choice can help reduce the symptoms.

  Not only is massage good for sensitivity it will reduce pain, improve balance and improve range of motion also.

  Another technique that may sound a bit crazy but is used frequently by Physiotherapists (which you can do yourself), is gently moving your hands or feet in a bucket of dry rice or dry beans. The texture of these items stimulates the nervous system and calms down the nerves.

• Acupuncture

  Another type of alternative medicine that relies on stimulating pressure points on the body. Through stimulation of the nervous system, the body releases endorphins, which act as natural painkillers.

  Although not many people believe in the effectiveness of this technique, certain studies have confirmed the successfulness of acupuncture in treating neuropathic pain.

• Exercise

Increasing activity levels can help combat the symptoms of neuropathy.

Regular exercise is beneficial for blood sugar control, as well as stress relief, both of which can greatly improve neuropathic pain.

Multiple studies have confirmed that routine exercise can prevent, and in some cases delay, the onset of neuropathic symptoms.

In the next section, we’ll go through some helpful exercises for peripheral neuropathy in some of the following chapters. 

EXERCISE TO IMPROVE PERIPHERAL NEUROPATHY SYMPTOMS

Dealing with neuropathic pain can be uncomfortable, to say the least. When you’re dealing with these symptoms, exercise may feel like the last thing you feel like doing. And that’s ok. Sometimes you will just have to wait for symptoms to ease. However, maintaining a regular exercise schedule will do a great deal in managing and improving neuropathy symptoms.

It’s necessary to consult with your doctor before starting any type of exercise, and it is highly recommended you see a Physiotherapist to get a full assessment and an individualised exercise plan for you.

When exercising, if you notice that certain activities make your pain and symptoms worse, you should communicate this with your doctor or Physiotherapist.

Easing the symptoms of neuropathy can be achieved through an exercise program including aerobic exercise, exercises for flexibility and joint range of motion, balance and strengthening exercises, and exercises for pain management.

• Aerobic exercises

Walking, swimming or cycling are some examples of great light aerobic exercises that can help you with neuropathic pain.

Undertaking aerobic exercises three times a week will improve your blood flow, work your muscles, and increase your heart and breathing rate. Improved fitness will help with pain and other symptoms.

Aim for 20-30 minutes of aerobic exercise per day. Always work your way up to this amount. Start with a few days per week at a smaller time frame and gradually building your way up.

If you’re able, a great place to go walking is on a beach or on soft grass. Being out in nature combined with the different textures of the sand or grass on your feet will help with symptoms whilst also getting the additional benefits of walking.

• Stretching exercises

Flexibility exercises can help keep your joints flexible, which can, in return, improve your balance and minimise the risk of falls.

These types of exercises are also instrumental in preventing injuries during other activities. Incorporating static and dynamic stretches into your workout routines is the best way to ensure a safe and successful exercise outcome.

• Balance exercises

Muscle weakness and numbness are common symptoms of peripheral neuropathy. This can greatly interfere with everyday life and can cause issues with balance and coordination.

Balancing exercises can help you improve your balance and proprioception and by doing this decrease your falls risk.

SPECIFIC EXERCISES FOR PERIPHERAL NEUROPATHY

The exercises below can help reduce your neuropathy symptoms by moving the area, improving blood flow to the area and relaxing the area.

Additionally, when range of motion/flexibility and strength are improved - pain and other symptoms (numbness/tingling etc.) will be reduced.

In the below exercises, we start with lower repetitions to ensure symptoms are not aggravated. Stay patient, and work your way up to more repetitions and sets over time.

WE START WITH LOWER REPETITIONS TO ENSURE WE DO NOT AGGRAVATE SYMPTOMS. STAY PATIENT.

SEATED PERIPHERAL NEUROPATHY EXERCISES FOR THE LOWER LEGS AND FEET.

TOE RAISES

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Toe Raise Exercise

How To:

Place your feet flat on the floor.

Whilst the balls of your foot remains on the floor throughout, gently lift up your toes.

Hold for a few seconds and lower back to the ground.

Repeat for 5 Repetitions.

TOE SPLAYS

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Toe Splays - Spreading Toes Apart - (I am not a good toe splayer :)

How To:

Place your feet flat on the floor

Now do your best to splay your toes (moving them apart).

Hold for a few seconds and relax your toes again.

Repeat for 5 repetitions.

TOE RAISES

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Toes Raises

How To:

Place your feet flat on the floor.

Whilst only the heels of your foot remain on the floor throughout, gently lift up your toes and the rest of your foot.

Hold for a few seconds and lower back to the ground.

Repeat for 5 Repetitions.

HEEL RAISES

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Heel Raises

ANKLE PUMPS

How To:

Place your feet flat on the floor.

Whilst only the balls of your feet and toes remain on the floor throughout, gently lift up your heels, and the rest of your foot.

Hold for a few seconds and lower back to the ground.

Repeat for 5 Repetitions.

Ankle Pumps

How To:
Sitting in your chair.

Pull your toes up toward you.

Now point your toes away from you.

Repeat for time/set repetitions.

KNEE EXTENSIONS

Knee Extensions

How To:

Sitting up tall with your shoulders back and down. 

Lifting one leg up, extend at the knee.

Hold briefly at the top of the movement, squeezing the muscles at the front of the thigh before lowering your leg back down.

Ensure the movement is slow and controlled.

Repeat for 5 repetitions and repeat on the opposite leg.

SEATED HAMSTRING STRETCH

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Hamstring Stretch

How To:

Shuffle to the front of your chair, place one leg in front of you, and sit up tall.

Now keep your leg straight and point your toes towards the ceiling 

Ensure you remain upright with a straight back and lean slightly forward at the hips until you can feel a stretch in the back of your legs.

Hold for the set time and change legs.

SEATED CALF STRETCH (WiTH TOWEL)

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Seated Calf Stretch

How To:

Shuffle to the front of your chair, place one leg in front of you, and sit up tall.

Now keep your leg straight and point your toes towards the ceiling.

Using a rolled-up towel, wrap the towel around the ball of your foot just below your toes. 

Gently pull the towel towards you, allowing your foot to bend up slowly towards you. Keep your leg straight. You should feel a slight stretching feeling in the back of your lower leg.

Hold for the set time and change legs.

SEATED SOLEUS STRETCH (WITH TOWEL)

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Seated Soleus Stretch

How To:

Shuffle to the front of your chair, place one leg in front of you, and sit up tall.

Now with a bend in your leg, point your toes towards the ceiling.

Using a rolled-up towel, wrap the towel around the ball of your foot just below your toes. 

Gently pull the towel towards you, allowing your foot to bend up slowly towards you. You should feel a slight stretching feeling in the back of your lower leg.

Hold for the set time and change legs.

DESENSITISATION MASSAGE WITH MASSAGE BALL OR TENNIS BALL

Massage Ball

Self Foot Massage

How To:
Place a massage ball (click here to purchase) or a tennis ball on the floor and whilst seated in a chair gently rub the sole of your foot over the ball. Make sure you get all areas.

This will help massage the foot muscles and stimulate the nervous system, calming the nerves.

Do this for 1-5 minutes and you can repeat this during the day.

STANDING PERIPHERAL NEUROPATHY EXERCISES FOR THE LOWER LEGS AND FEET.

CALF RAISES

Calf Raises

How To:

Stand up tall with your feet about hip-width apart.

Keep your knees straight and hold onto the chair with both hands.

Come up onto the toes, raise your heels up off the floor, hold briefly and slowly lower yourself back down.

Repeat for 5 repetitions.

TOE RAISES

Heel Raises

How To:

Stand up tall with your feet about hip-width apart.

Keep your knees straight and hold onto the chair with both hands.

Come up onto the heels, raise your toes up off the floor, hold briefly and slowly lower yourself back down.

Repeat for 5 repetitions.

HIP EXTENSIONS

How To:

Place both hands on your chair and stand up tall.

Keep your legs straight, slowly bring your leg back behind you, hold briefly and then bring your leg back to the start position.

Repeat for 5 repetitions and change legs.

HIP ABDUCTIONS

Hip Abductions

How To:

Stand tall holding on to your chair.

Slowly bring your leg out to the side and in a controlled motion bring your feet back together.

Ensure you keep your toes facing the front throughout this exercise.

Repeat for 5 repetitions and change legs.

KNEE FLEXIONS

Knee Flexion

How To:

Stand up tall, holding onto your chair.

Bend your leg at the knee, lifting your foot up towards your buttocks, to about 90 degrees, hold briefly and return your foot back to the start position.

Repeat for 5 repetitions and do the same on the opposite leg.

STANDING CALF STRETCH

Calf Stretch

How To:

Stand up tall, holding on to your chair with both hands.

Step one foot back, ensuring your toes are facing forward throughout the exercise.

Now bring your front knee towards the chair ensuring that your heels remain in contact with the floor at all times.

Hold this position for 30-60 seconds and change legs.

BALANCE - SEMI TANDEM STANCE, TANDEM STANCE OR SINGLE-LEG STANCE

Single Leg Stance Balance

How To:

Standing next to a chair for safety and stability.

Stand on one leg.

Hold this position for 30-60 seconds.

If you need to you can hold on with one or two hands on the chair.

You can make this exercise a little easier by standing in a semi-tandem or tandem stance position. Click here for balance positions.

Aim to increase your time in this position, without coming out of position, over time.

Relaxation - of the body - 2 Minutes

Spend at least two minutes a day focusing on relaxing your body. Sitting in silence. You can find relaxation videos in the app store on your phone or on YouTube. Also at the end of the video below, we go through a short relaxation sequence.

PERIPHERAL NEUROPATHY EXERCISE VIDEO FOR THE FEET & LEGS

A video you can follow to help with symptoms of peripheral neuropathy.

In this video, we go through seated and standing exercises including range of motion/flexibility/movement for pain relief, strengthening and balance. Plus it also covers self-massage/desensitisation and relaxation.

Exercises for neuropathy in feet and legs

PERIPHERAL NEUROPATHY EXERCISES FOR THE HANDS & ARMS

Exercises for neuropathy in hands and arms

MANAGING PERIPHERAL NEUROPATHY - TAKING PRECAUTIONS AT HOME

Peripheral neuropathy can have a great impact on your everyday life.

If you are suffering from this condition you are at a greater risk of accidents and injuries, when undertaking daily tasks.

There are certain precautions you can take to make your life safer while undergoing possible treatments for your condition.

• Stop smoking and drinking alcohol, cut out unhealthy foods, and reduce stress.

• Stay Active. You might be inclined to limit your activity levels due to muscle weakness and pain, but it’s important to keep active (without overdoing it). Aim to get moving more.

• If symptoms of peripheral neuropathy are affecting your mobility and/or balance make sure you speak to your doctor or see a Physiotherapist so appropriate measures can be taken. You may need a walking aid.

• If your balance is affected when walking, make sure to take your walking aid with you to reduce your risk of falls

• Make sure to clear the paths around your house, to avoid tripping.

• Wear well-fitted shoes at all times to help protect your feet from any injury, and make sure to regularly check your feet for cuts or sores that you may not have felt, especially after walking barefoot.

• Take good care of your feet, trim your nails and see your Podiatrist as needed.

• Avoid prolonged pressure on areas with nerve damage.

• Keep your skin in good condition with a good moisturiser.

• Shower and bath with caution. Avoid slips and falls by installing handrails in your bathroom and adding a non-slip mat on your bathroom floor. If you have a decreased sensitivity to touch, be careful when adjusting the water temperature when showering. Use your elbow to check the bathwater temperature before getting in.

• Cook with caution. Again, if you have decreased sensitivity to touch, be mindful when dealing with hot objects in the kitchen at all times.

• Pain and other symptoms associated with peripheral neuropathy are usually worse in colder climates. Keeping your hands and feet warm with a good set of gloves and socks can help reduce pain symptoms.

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