Dear Readers, as regular followers will know I have a habit of crashing to the ground for no obvious reason, so it was with some interest that I found this article in New Scientist that describes a positive epidemic of trips and tumbles. Between 1990 and 2017, the incidence of deadly falls around the world nearly doubled, and although the majority of these were in older people, there has also been a sharp increase in falls among younger people. What light could the article shed on the possible reasons why?
The first is that bipedalism is far from easy: humans are the only animals that walk in the way that we do, with our torsos balanced precariously over our legs. Other bipedal animals, such as the speedy and impressive ostrich, have their bodies balanced in a much more sensible way, and the structure of their legs is different too. The way that a toddler walks, which is in effect a series of stumbles in a particular direction, is basically the way that an adult walks, with a few refinements.
Furthermore, walking is an extremely complicated process: it involves not just our core and leg muscles, but also our sense of balance, our ability to make sense of what we see around us, and our ability to anticipate what’s coming when our foot next hits the ground. Most of the fine tuning takes place in the cerebellum, which acts as a processing unit for all the input from the outside world and from our muscles.
So far, so good. But wasn’t it ever thus? Why are we suddenly falling over so much? One explanation is linked to mental health, and I can testify to the fact that when I’m anxious or depressed, I’m much more likely to take a tumble. My most spectacular trip was on the day that I found out that my Mother was dying, with my second best occurring on the forecourt of the nursing home on the day after Mum and Dad had become residents (a particularly stressful time for all of us). Mental health problems seem to affect the cerebellum’s processing power, and with it our sense of balance. Plus, though this isn’t mentioned in the article, being preoccupied obviously impacts on your ability to notice the raggedy paving stone or the patch of ice in your path.
A standard test for balance is to ask the participant to stand on one leg for thirty seconds, with or without closing the eyes – if you can’t do this, you should probably be looking at improving your balance. But it’s good to start young. We learn a lot about balance as children, and our young people, in the West at least, have never been more sedentary. One recent study showed that children born in 2014 were 20% weaker than their counterparts in 1998. The lack of places for children to play outside, the diminishment of exercise in schools, the way that the outside world is perceived as a dangerous place, all add up to children who are increasingly unfit.
And, as we get older, all that sitting around on our computers (I speak as one who does a lot of this these days) also makes us less fit, less able to balance, and weaker. Dawn Skelton, researcher at Glasgow Caledonian University, UK, describes how things have changed:
“I commonly see people in their mid-40s that have worse balance than 70 or 80-year-olds,”
Fortunately, there are things that you can do to improve your balance at any age.
First of all, do the standing on one leg test, with or without your eyes closed. Make sure you have something to hold on to in case of disaster. Measure how long it takes you to start wobbling – Skelton says that you’ll notice it starting in your feet and ankles, and this is a very interesting point.
One way of improving your balance is from the bottom up – if your feet are stiff and numb, you have less chance of using them effectively. Skelton mentions rocking forward between heels and toes as a good exercise, and picking up a pen or a marble between your toes as a way to increase flexibility. Wearing minimal shoes in the house and going barefoot as often as possible helps to re-train us in the link between the ground, our feet and the rest of our body.
If you are already a gym bunny, you might want to consider swapping the treadmill for walking or running outside, or the stationery bike for a real one. Going out into the real world is much better exercise for your cerebellum, reminding it how to notice what is going on and adjust accordingly.
Interestingly, Skelton isn’t a big fan of yoga or pilates for improving balance on the move, because the poses held are usually stationery, and we need to learn how to keep upright when we’re on the move. For the same reason swimming, though great exercise, doesn’t help with balance on dry land.
The NHS recommend walking sidewise (with or without crossing your legs), step-ups and the heel-to-toe walk, which is surprisingly difficult. You can see a gentlemen in blue Bermuda shorts attempting these tricky manoeuvres here.
So, having read this article I now realise that walking is an inherently unstable activity, exacerbated by when we’re feeling emotionally wobbly. I see some standing on one leg and sideways walking in my future though, how about you? There are few things more embarrassing and potentially dangerous than falling over in the street, so it’s great to know that, however maladroit we are, there are things that we can do.
Photo One By Charles J Sharp – Own work, from Sharp Photography, http://www.sharpphotography.co.uk, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=67715789
Photo Two by Images are generated by Life Science Databases(LSDB)., CC BY-SA 2.1 JP https://creativecommons.org/licenses/by-sa/2.1/jp/deed.en, via Wikimedia Commons
Photo Three from https://www.nhs.uk/live-well/exercise/balance-exercises/