- Greetings, greetings.
Today, we have a very interesting episode.
We're gonna talk about the 100s or hundreds
of people that we have worked with with broken hips.
Now, I've narrowed it down to the two biggest reasons
for falls causing these hip fractures,
and we will get into those in just a minute.
- So in this video, we're gonna show you
two different balance exercise routines that you can do
at home to help prevent these falls from happening,
and it should only take a few minutes.
- That's right, and if you're interested
in why Mike's head is so suntanned,
he's been workin' on it.
It's been a big topic in the background here recently.
Sorry about that.
I just wanted to say somethin'. (chuckling)
- Goodbye.
(laughing)
(light music)
- All right, now over the decades, Bob, Mike,
and I have all worked with these people with broken hips,
and so many times, we always, I should say this,
we always talk to 'em,
and they're more than happy to share their story
of how their hip was fractured, and it's so repetitive
where what happens is someone is getting out of a chair,
they stumble, or they're getting up,
there's activity in the room,
and they're not paying attention to where their feet are,
or they're walking, and a rug is thrown up, a throw rug,
or their pet is on the floor,
and they're shuffling their feet,
and down they go as a result of that shuffle.
These are all things that are so common,
and we hear 'em time and time again,
and I think we can get onto the next segue, Mike.
- (laughing) So it is important
that necessarily having bad balance is not a good thing,
obviously, but the real problem is when you fall
and then you fracture something
because then you're gonna be weaker,
and your balance has become even worse for a period of time.
So in this video, we're gonna show you
some balance activities that you can do
to help prevent these falls from happening
in the first place.
- Right, and it's gonna happen to all of us.
Our walking, which we call gait,
and our balance gets worse with age,
just like vision or getting gray hair.
(chuckling)
However, the good news is we can show you some things
to correct it and really minimize that risk for falls.
So hold on, we're gonna get right to it.
All right, we're gonna break down
the three most common causes
to these falls in a little more detail
as a therapist looks at it.
Number one...
- Is tight ankles.
Often time, if you can't lift your foot up
and you have a tight ankle, it's harder to walk,
and you probably aren't walking in a nice, correct pattern,
increasing your risk for falling.
- Right, that's where even just a crack
or a lifted sidewalk, a 1/2-inch little lift can catch that
on your toe because you're shuffling,
not dorsiflexing enough, tight ankles, down you go.
The next thing is poor gait habit.
It segues right into that.
That's the shuffling.
When you get old, you ever find yourself shuffling along,
and you think, "What's goin' on?"
You have to pay attention what's going on down there.
Get those feet moving, lifting,
and things will go much better.
- And the third common cause is poor balance
or proprioception deficits.
So that means maybe you have peripheral neuropathy,
or you don't have good sensation in your feet,
and you can't feel the ground, as well.
That's a common cause for falling.
- And that's where a lot of people that are diabetic,
which is more and more common all the time as we age,
that's where that proprioception
and that neuropathy is a big deal.
We want to address that.
All right, one of the big solutions
that can really eliminate falls is simply using
an assisted device, in other words, a cane or a walker
or something of a walking stick.
That's really helpful and eliminates a lot
of the exercises necessary.
However, there are people in that gray area,
where they don't really wanna use an assisted device,
and maybe they don't need it, but they're in that area.
So Mike, do you have anything to say about these devices?
- These devices often will allow you to not shuffle,
like we talked about earlier,
and correct your walking pattern.
So just using one,
even though you may not feel like you need it,
it's better to have one and not fall
than to not have one and take a tumble.
- Right.
Again, cane is one thing.
Walker is a very big difference
because they're more cumbersome to take around
throughout the community.
So that's where these exercises really are advantage
when you do not wanna negotiate a walker.
All right, the first exercise, the routine,
what we're gonna do is address the ankles,
those tight ankles we've already talked about.
Simply, you start out in a seated position,
lift your feet up off the floor so in the air,
and you pull up, dorsiflex, and push down.
Really focus on pulling the toes up.
That's the most important part
because that's where those falls happen,
when you cannot pull the toes up.
You'll feel a stretch.
Do 10 of these.
You can do these throughout today, every now and then.
Just do 10 of 'em at least five times a day.
It's very quick.
Now, the next thing you're gonna do to strengthen
the ankles once you stretch 'em doing this is standing up.
Have something to hold onto to balance,
a chair, a cupboard, something of that nature, and do...
Go ahead.
- You're gonna do some ankle exercises.
So you're gonna go up on your toes,
and then you're gonna rock back on your heels,
and you're gonna do 10 to 20 repetitions each way.
This is gonna work on your balance a little bit.
It's gonna work on your strengthening, and it's gonna work
on your range of motion within your ankles.
So you're getting three positives out of one exercise.
- One word of caution with this is go to the back position
where you're dorsiflexing,
and right at this point is where it's really critical
that you have something solid to hold onto
'cause you may want to fall backwards,
particularly if you already have a balance problem,
and that could result in a broken hip
or something of that nature.
So really make sure something is there solid to hold onto.
Stay safe.
All right, the second routine, this is really critical.
This is to stop that shuffling
that you may not even be aware of
until that trip comes along,
and the first thing we're gonna do is you need
some sort of support for balance and safety.
You may just use a cane or a stick like I have here,
the Booyah Stik, or just a chair but, again, a solid chair,
not one like this.
(chuckling)
It's a studio chair.
- It's fragile.
- Yeah.
So a cupboard, a solid counter base
or a sink where you can put your hands
around the sink is really ideal
'cause it really gives you support in directions,
especially particularly backwards.
So the first thing is simply marching.
- [Mike] So this is gonna work on your balance a little bit.
This is gonna help with the shuffling
because, if you pick your feet up more,
you're less likely to trip.
- Right, and really get those knees up
as high as you feel comfortable
'cause, again, we're gonna do this 10 to 20 repetitions.
The whole idea is to get your mind aware
of what your legs are doing.
If you wanna work your balance,
simply hold it up and go slower
so you're balancing on one leg a little bit.
Again, if you feel like you're really wobbly,
that's too much.
You need to have more support.
It should just feel
like your ankles are working a little more,
and you feel a little wobbly, but you feel safe.
We wanna stay safe with all of these.
Now, we're gonna go on to the next start
as stepping sideways,
which is a really big thing that makes falls.
(laughing)
Okay, now we're gonna go on to sidestepping
because this is a very high or frequent cause of falls.
We're stepping sideways.
We don't pick up the foot, and down you go right on the hip,
and there you got a fracture.
So this works best.
Mike, can you hold onto this?
If you have a rail at home...
No, hold onto it.
There ya go. - Oh.
- (chuckling) So if you have something to hold onto,
like a handrail, do that,
or a countertop that you can hold onto, that works fine.
If your balance is fairly good
and you feel comfortable using a stick or cane,
that's fine, too.
Now, we're gonna work sidestepping, and simply really be...
Actually look down and see what your feet are doing.
Some people are not aware of what's going on down there,
and they're not aware
that their feet are only 1/8 inch off the floor
or maybe even dragging
'cause you can't feel it if you have diabetic neuropathy.
So I want you to really make note on picking those feet up.
Go about four or five steps to the right,
four or five steps to the left,
and repeat that a number of times,
and it's one of those things that,
after you do this a number of days in a row,
your mind, that muscle memory is gonna kick in,
and you'll start doing that without thinking about it,
minimizing your risk for falls, very important part of this.
- And the last option is a little more advanced.
It's gonna help with stairs
and especially lifting those feet up
and prevent the shuffling.
So you're gonna need some type of step
as Brad has here or a staircase.
Make sure you're using rails
or some type of support like Brad is,
and you're going to simply bring one foot up,
tap the step and then bring it down.
Now, you can just work one leg at a time.
Try to do 10 repetitions and then switch.
If this seems easy, you can try alternating.
So you're gonna go right and then left.
This is a little more challenging
because each time you have to shift your weight
to the other side, working on your balance.
What do you have to say, Brad?
- Well, if you do, like we both have an option.
If you feel more advanced
and you wanna get it a little more exercise,
as well as balance challenge,
go up to the next step and do that.
Again, you need to feel stable
and not unsteady when doing those.
So don't overdo it.
Good judgment is absolutely crucial,
so whichever step that you want.
Yeah, this one I really like because, again, it doubles it.
There's a lot of people that do, when you go up a stairway,
you catch your toe because you didn't lift high enough,
and then you have a stumble forward.
So very good work, that one, if it's available.
So Mike, I think you did a really nice job today.
I'm happy you came,
(Mike laughing) and I suggest wearing a hat.
- Oh, I wanted to identify as a tomato for a while,
(Brad laughing) So here I am.
- Actually, I have to tell you this little story.
I never used to wear hats 'cause I had thick hair,
and I thought those hats made me look like a redneck,
which I pretty much am,
(Mike laughing)
but now I wear a hat because my bald spot gets sunburned.
- Oh, my goodness.
- And it's an issue. (laughing)
- Well, my whole head is a bald spot,
so that's probably why.
- You're tougher skinned up there than me
'cause you're not even bothered by it, wow.
- Well, it was a few days ago.
- (laughing) Take care and enjoy.
(light music)