Doctors Explain Why Falls Become More Common With Age — And What You Can Do To Prevent Them

It's a question my doctors ask at every visit because of my autoimmune disease. For the average person in their 30s or 40s, falls might not be top of mind, but they can happen at any age. They're also a major concern for older people. And your risk of injury depends on your daily habits and what you do in those critical seconds before hitting the ground.

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For advice, we talked to two orthopedic surgeons and a doctor of physical therapy about what increases your risk of falling, strategies to reduce injury and fall-prevention tips.

Falls can be caused by a combination of internal and external factors. External factors include tripping on rugs, toys and electrical cords or having to navigate low light, slippery floors or uneven sidewalks. Another cause of falls is improper footwear, including wearing high heels, ill-fitting shoes, very worn shoes and shoes with excessive cushioning, which interfere with your ability to feel the ground. In addition, taking medications, on their own or combined, can increase your risk of falling.

"Internal factors involve the systems that control balance and your musculoskeletal system," Milica McDowell, associate vice president of education at US Physical Therapy and author of "Walk: Rediscover the Most Natural Way to Boost Your Health and Longevity—One Step at a Time," told HuffPost.

Younger people have a lower risk of falling because they tend to have better vision health and vestibular function. Also, their proprioceptive system provides information at faster speeds, helping with balance and coordination, she said.

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Conversely, older adults are at risk of osteopenia (lower bone density), osteoporosis (weakened or brittle bones), muscle weakness, and declines in coordination and reaction time.

"As you get older, you lose muscle mass and have less strength in your lower legs," Dr. Jason Snibbe, a board-certified orthopedic surgeon and sports medicine specialist, told HuffPost. "You also get more arthritis in your lower back, which affects your balance."

Regardless of age, symptoms such as fatigue, dehydration and dizziness can contribute to falls.

Regardless of age, symptoms such as fatigue, dehydration and dizziness can contribute to falls, according to experts. ingwervanille via Getty Images

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Despite these risk factors, you can avoid further injury by learning how to fall correctly and recover safely.

"The most critical area you're trying to protect, if you're about to fall, is your head and face," McDowell said.

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Along with protecting your brain, you're minimizing damage to your airway and the nerves in your neck. If you lose your balance, she recommended tucking your chin into your chest and turning your head toward your armpit. "Think about being as small as possible."

"If you put your arm out to break a fall, you're using one of the smallest bones in your body to manage most of your body weight," McDowell said. Snibbe added that sticking your hands out puts a lot of stress on your wrists and increases the chances of a fracture.

Ideally, you should try to twist your body and land on your side or back. "Your buns are the best place to land, if possible, and will absorb the impact better than your bones," McDowell said. She said to think like a stunt double and try to tuck and roll when you're about to fall.

Women experience 70% of hip fractures. The one-year death rate following a hip fracture is 22%. Deaths tend to occur from complications, such as pneumonia, blood clots and infection from surgery. If you have osteopenia or osteoporosis, both McDowell and Snibbe recommended avoiding landing on your side because your hip is more likely to fracture.

"After a fall, the inclination is to get up right away," Dr. Rahul Shah, board-certified orthopedic spine and neck surgeon, told HuffPost.

He recommended taking a few seconds to check what's hurting and whether you need to call for help. Check that you can move your hands and feet and look for signs of bleeding. McDowell agreed, adding that you should take at least five deep breaths before trying to get up.

"If you try to pop right up, you could pass out, fall, and have a head injury," McDowell said. Check to see if the hazard is still present, whether it's a curb, stairs or an unleashed dog. The goal is to get yourself to a safer environment and avoid further injury. If you're in public, there may be passersby who can assist.

If you're indoors, using sturdy furniture to get back up is smart, especially when you're shaken up and your heart rate is high, she said. Take deep breaths to calm your fight-or-flight response. If you feel OK, you can roll onto your knees, hold onto a chair or table, and gradually get yourself into an upright position, Shah said.

There's a lot of shame associated with falls. "Some people see it as a sign of becoming frail or less independent, and so people will fall and not disclose it to their healthcare providers or family, and that is a big problem," McDowell said. Even if you don't have obvious injuries, Shah recommended seeing a doctor if you can't get up after a fall or have pain that lasts five days or longer.

Strength training is vital to keeping your balance in check and your bones healthy to protect you against fall-related injuries. FG Trade via Getty Images

Waiting until you're a senior to work on fall prevention might be too late. "By then, you've already lost a significant amount of muscle mass," Snibbe said. "It's better to come in with a solid foundation of strength." He emphasized the importance of putting stress on your bones to make them stronger (bone density).

Shah agreed, saying, "I can't think of a time when you shouldn't be improving your balance and strength." He recommended engaging in a variety of activities to improve your overall fitness and build resilience to handle a fall. Here are some fall-prevention strategies to start right now.

"Practicing in a safe environment is a fantastic way to improve your balance," McDowell said. Try standing on one foot and putting your hand on the kitchen counter or standing heel-to-toe. Similarly, Shah recommended single-leg extensions or curls and yoga for improving balance and muscle strength.

In addition to static exercises, try dynamic balance exercises. These include marching in place or walking heel-to-toe like you're on a balance beam. You might feel wobbly at first, but you're training your body not to overreact when your balance is challenged, she said.

"Resistance exercises are critical for everybody," Snibbe said. "Even if you work out three to four times a week, you're still going to lose muscle mass as time goes by." He said 30 minutes on the treadmill doesn't cut it when it comes to fall prevention.

Resistance exercises include weighted squats, weighted lunges and leg presses. "The other thing I love is a weighted vest, not heavy, about 7 to 10 pounds," he said. When you go for a walk, adding a little weight to your frame puts stress on your bones and helps with bone density.

"The more you move and walk, the more you're challenging your neurologic system," Snibbe said. Navigating different terrain activates your nerves. Conversely, being inactive may lead to a loss of neural connections, as well as muscle strength.

For balance issues, he recommended using hiking poles rather than a cane, which makes you lean forward and worsens your posture. "Hiking poles are great because they keep your body upright," he said. Plus, the poles can keep you steady on uneven ground.

"Your core is very important, including your abdominal muscles," Snibbe said. If you lose your balance, a strong core can help keep you stable and prevent falls. He also recommended exercises where you move side to side, walk backward, and work your glute muscles.

"The other thing we recommend commonly is jumping," he said. You don't need to jump high or jump over something. "Just jumping in place for 5 to 10 minutes every day can put a nice load on your bones and increase bone density," he added.

"We're destined to lose muscle mass, so we have to stay ahead of the game," Snibbe said. He recommended supplementing your diet with protein, amino acids and creatine for building muscle mass. Protein sources include yogurt, cottage cheese, chicken, fish, beans and eggs. He suggested adding an amino acid powder to your water, as well as creatine, which helps with muscle mass and cognitive function.

Shah recommended installing grab bars and handrails and removing tripping hazards. He also suggested improving the lighting in and around your home, especially hallways and stairways. Other tips include installing nonslip flooring in your shower, adding nonslip stair treads, securing rugs with nonslip backing and storing frequently used items where you can reach them without a stepladder.

"As physical therapists, we can bring patients into the clinic and teach them how to fall and get up safely," McDowell said. She noted the introduction of the Stopping Addiction and Falls for the Elderly Act, or SAFE Act. "It's a bill that is designed to have physical therapists do fall assessments when Medicare beneficiaries get their yearly checkup."

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