How Can You Prevent Falls in Osteoporosis? 18 Tips From a Physiotherapist

Frighteningly, each year about one-third of all people over the age of 65 will fall. Many of these falls result in broken bones. Preventing falls is really important for men and women with osteoporosis. As falls increase the likelihood of fracturing a bone in the hip, wrist, spine, or other part of the skeleton.

What Is Osteoporosis?

Osteoporosis is a disease of the bones which results in low bone mass and structural deterioration of the bony tissue. This results in the bone becoming more fragile and more susceptible to fractures.

Why Are Falls Bad News as You Get Older?

A study done by Coutinho et al, published in 2012, showed the risk of death in over 60s within a year of a fall was 1 in 4. Of the 250 elderly people who fell and had severe fractures followed through the study for one year, 25.2% died within that year. With the majority of deaths occurring in the first 3 months post-fracture. For hip fractures, the numbers are even more stark. A 2019 study published in the World Journal of Orthopaedics found that previously quoted 30% mortality rates post fracture were likely more in line with the 25% quoted for other fractures. This is likely linked to improvements in surgical techniques and the national registry encouraging higher standards and collaboration.

Falls Prevention Tips for Around Your Home

Here is a list of safety tips to help prevent falls in osteoporosis, both around the home and outdoors:

1. Remove all loose wires, cords and rugs and keep floors clear of clutter.
2. Make sure all carpets are secure.
3. Keep furniture in the place you are familiar with and keep items you use regularly close by.
4. Install handrails by your toilet and in the bath
5. Use a non-stick mat in your shower and bath. If you are unsteady on your feet, purchase a shower chair.
6. If you spill any liquids, clean them up straight away
7. Ensure all lights work
8. Move from lying to sitting to standing slowly to prevent dizziness
9. Install handrails on both sides of the stairs and mark the top and bottom steps with bright tape.

Nine Tips for Outdoors

1. Wear sensible shoes with a low heel and good rubber soles with grip.
2. Look carefully at floor surfaces to ensure there is no obvious ice or wet surfaces which can be slippery.
3. Keep your drive, patio, walkways clear of leaves, snow and clutter.
4. When using stairs or escalators, always use the handrail.
5. Cover your outdoor steps with gritted, non-slip paint, install handrails and ensure the area is well lit with an outdoor light.
6. Use a shoulder bag or rucksack to ensure your hands are free.
7. Use a stick or walking aid as required
8. Stop at curbs and check the height before stepping up and down.
9. As well as cars, be aware of bikes when crossing roads as they can approach quickly.

Exercises to Prevent Falls in Older Adults With Osteoporosis

There are a few things you can work on to reduce the risk of falling as you get older. These are balance, proprioception and strength and endurance.

3 Exercises to Improve Balance

1. Tightrope stance
   Make sure you are standing somewhere that you have something to grab onto if you start to lose your balance. A good place is in the kitchen next to the worktop, or on a landing near a handrail.
   Place your feet one in front of the other like you are going to walk across a tightrope.
   Try and maintain your balance without holding on for 30 seconds.
   Make the exercise more difficult by moving your feet closer together.
   Make it easier by moving your feet further apart.
   You can alternate between left foot at the back and right foot at the back.
2. Single leg balance
   Again, stand somewhere where you can hold on if needed.
   Stand with your feet together, lift one leg off the floor, and maintain your balance for 30 seconds without holding on or touching your raised foot back down to the floor.
   Make it easier by using fingertip touch to the surface nearby you are using as a safety.
   Make it more difficult by moving your arms around in the air to displace your centre of gravity around your base of support.
3. Tightrope walking
   Using a line on the floor, such as the join between tiles or wood flooring, stand with one foot in front of the other, but this time you will step the back foot around the front foot to ‘walk the tightrope’ along the floor. Do this along the length of your worktop or the handrail on your landing.

3 Exercises to Improve Proprioception

1. Toe tap to targets
   Using a tile or regular pattern in your carpet, stand with 3 points within 1 foot of your feet (you can also use stickers on the floor).
   Standing on one leg, move your lifted leg to tap the toe to one of the stickers/pattern points. Then bring it back alongside the standing leg.
   Repeat this for the other 2 remaining points.
   Repeat the process for 30 seconds.
   Try and be as accurate as you can with your big toe tapping the ‘target’.
2. Toe tap on step
   Standing at the bottom of your stairs, lift one foot to tap your toe on the first step, then return it to alongside your standing leg.
   See if you can work up to higher steps.
   Again, try and repeat for 30 seconds.
   Try it tapping either foot.
3. Reaching for objects
   Stand in front of your dining table or worktop surface in the kitchen. Using tins of food or small bottles placed on the surface of the table, stand at arms length from the surface of the table, reach and pick up an object, and then move it as far away from you on the table as possible.
   Repeat this with several other objects again aiming for 30 seconds.
   Try reaching with both hands and alternate hands.

3 Exercises to Improve Strength and Endurance

1. Sit to stand
   A great exercise to improve your strength and endurance. Get into the habit of every time you stand from your bed or a chair (or even the toilet), repeating the process 5 times.
   Try not to use any hands (either pushing up off the surface you are sat on or on your own knees).
   As you get stronger you can start to not sit all the way back down again but just tap your bottom to the seat surface and then stand again.
2. Step ups
   Again, get into the habit of doing this each time you up or down the stairs. When you get to the bottom step, step up and down 12 times on one leg, then 12 times on the other.
   Again, try not to hold on but use the handrail when you first start out if needed.
3. Tiptoes
   Standing behind the back of a chair or kitchen worktop surface, push up onto your tip toes and slowly lower your heels back to the floor.
   Repeat for 30 seconds.

Preventing Falls in Osteoporosis

Now that you understand the importance of preventing falls as you get older, follow these simple exercises to help improve your balance, proprioception, strength and endurance to help reduce your risk of falling.

For further information about Osteoporosis, and how our expert physiotherapists can help you, please see our osteoporosis service.