Do you educate or teach your patients how to fall?

I recently listed to a podcast interview of the founder of MovNat (more on that in a later post), but part of it was about learning how to fall. I realized I practice getting down and getting up with patients for fall recovery, educate and train for fall prevention, and if they ask I’ve talked about not reaching out to fall and stay bent, but I can’t recall practicing how to fall with patients.

General suggestions don’t fit everyone, and a patient who lacks strength, coordination, and quick thinking won’t necessarily remember what you told them. If you can practice some basics you might reinforce concepts specific to them and possibly get them more comfortable so they don’t go rigid when they fall.

We seem to naturally extend our arms trying to self-arrest and prevent further injury (unless you are a child protecting a cookie, or a person with a cell phone), but that increases the risk of a FOOSH fracture. Ditch what is in your hand, tuck your chin/ head, and use your upper extremities to protect your head and face as you start to roll. A common comment/ suggestion in the articles below include not fighting the fall, become loose/ bent in the extremities, and turning it into a roll vs going straight down/ extended and stopping abruptly.

One way you can practice this is to get your patient into tall kneeling in front of a therapy ball. Have them curl over the ball and tuck their chin/ head, then you can control them and the ball as they roll to their side (thanks to Dr. Preeti Oza, a colleague who teaches her patients this way). An option without the ball is shown in the videos in this NYT article about a program in the Netherlands (down toward the bottom), starting from kneeling and going to their side. If you have a surface that can get low enough, you can have them bend their knees to it to initiate from a semi-squat (if anyone knows more details on the program, or where to get a mat like that, please share!).

For backward falling, you could practice on a large mat table while seated, focusing on the chin tuck to protect the head, and then rolling back and to the side, then gradually doing it from a semi-squat position.

What would be great is to find or create a community program with everyone learning prevention/ recovery strategies, and then a range of levels for 1) balance/ strength exercises, and 2) practicing falling from kneeling, from a chair, and from standing to a soft surface (like a gymnastics studio re-purposed during their closed hours). And we should be practicing ourselves, especially those of us who are no longer in our 20’s and aren’t as mobile as we once were!

Articles or interviews about how to fall:

Learning How to Fall Safely (interview with Eric Moen, PT – good ideas for progressions as well) and The Right Way to Fall (NYT article)

How to Fall Without Getting Hurt by Ben Musholt

How to Tumble with Care When it gets Slippery Outside (NPR)

The Art of Falling Safely (AARP)

*****Addendum 6/3: I have cut back on my social media consumption, which means I miss things. I was catching up on podcasts and came across a podcast about this, which included the following link to a FB interview Dustin Jones did with Ben Musholt – check it out, as he’s got good ideas of progressions!

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