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Exercise Now to Protect From Trips and Falls Later

Updated: Oct 28, 2022


Young or old, the exercise you do now will protect you from trips, falls, injuries and accidents in the near future. The skeletal muscle adaptations you build will add resilience to your body, be better able to recover from impact, through to subconsciously helping you miss the accident altogether.

Felled trees representing a fallen person
Will lack of activity fell you?

At one end of the scale, if you did trip and fall you're fortunate to get away with just a spot of embarrassment. Most likely you'll come away with some bruising or grazes, maybe wrist or ankle sprains which though annoying will recover quick enough. However, as we age and our bones become inevitably more brittle (though bone weakness can be delayed with exercise), fractures and broken bones become a real possibility. On the other end of the scale, catastrophising somewhat, a fall may lead to further complications like blood poisoning, nerve damage and under particular circumstances to loss of life.


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Set the scene, you're walking around your city either for work or shopping, loosely looking at the ground whilst trying to avoid pedestrians and gazing at the new pastries advert in Greggs. UK streets being what they are, have uneven slabs also known as trip hazards. You see the slab yet still catch your toe on the corner which causes you to stumble. In this split second moment, your exercise training will play its part in doing more than making you look good naked and saving your heart but also your pride and life.


Avoid the accident

Can you touch your nose with your eyes closed? The phenomenon whereby you just know where your limbs are in space and time is called proprioception or kinesthesia. The nerves in your muscles and joints make a complex interplay to estimate the position of your limbs. It's like plotting a graph, if you know position X and position Y you can make a pretty accurate guess where the point will be without seeing it. The difference is the body also has position Z and monitors velocity through interpreting stimulus from muscle length and joint compression.


In our scenario you have seen the uneven slab so know it's height and distance yet your body's ability to guess where your foot was in comparison was askew. If your proprioception was better you may have been aware enough to know, without looking, that your foot wasn't in the correct position, therefore adjusted and missed the obstacle. Leaving you free to head into Greggs with pride untarnished and zero injuries. Prevention is better than cure right?


Proprioception can be improved in various ways such as balance training but Salles et al (2015) found that even standard resistance training can have a great effect on proprioception accuracy. Therefore, you needn't go looking for anything fancy if you don't want to. Aman et al (2015) found on average a 52% increase in proprioception with training across healthy adults as well as those that had suffered strokes or had Parkinson's disease. Just using your muscles helps with nerve utilisation and accuracy leading to improved perception of joint mobilisation. Keep to your training regime to reap the additional benefits beyond weight management, health and fitness.

Prevent the fall

Balance is one of those things that many people believe is terrible in themselves. The question to ask is how much you practice balancing. Like many facets of human behaviour and adaptation, the more you practice the better you get. Of course, specific balance activities will improve your stability reflex over time but anything that involves being on your feet will help. You could take a machine overhead press to a standing variation as your feet and all connecting muscles, bones, tendons and ligaments through to your hands will need to work together to keep you upright. Another score for just continuing your training regime and avoiding a sedentary lifestyle (usually spent off your feet).

Person on balance beam demonstrating good body balance
Are gymnasts naturally good at balancing or do they practice it a lot more?

How would better balance help prevent a fall? So you stub your toe in our scenario which leads to a delay in the shift of mass in your leg to where it's expected to be. Your body is in a position preempting that leg mass coming to where it needs to be. Without your leg in position the body's own counterbalance works against you to tip you off balance. This is where your muscle reflexes come in. Your brain's levelling device sends signals to muscles to contract which if they are strong enough, will make a powerful movement around your centre of gravity to pull you back into a stable position. The better attuned you are the faster these reflexes kick in too. Taking your potential fall to a near miss stumble and possibly going a little red in the cheeks through some slight embarrassment.


Catch the fall

Perhaps your balance didn't activate in time and some person in the distance is yelling "timmbbeerr" as the world around you moves in slow motion towards your face. All is not lost! No matter how good our balance and proprioception is, we aren't invincible. Now in our scenario, your muscles and strength are about to play a conscious role in being your protection. You're on the way to the floor and you stick out a leg or your hands to decelerate your descent. Heck if you're fast enough and strong enough you may even be able to stop the fall mid-flight. Doing so is hard work. Your mass now has acceleration which multiplies the force you have to overcome or use to eat concrete.


Let's stick with hands coming out to your front. The instinct here is to slow you down, thereby reducing the force and how quickly you hit the floor in order to protect your vital organs and head. Your muscles will now work like airbags in a car to take the impact and slow you down as slowly as possible. Gravity doesn't kill you but the sudden stop does. Your arms are extended when force is applied (the floor) and you'll finish with your arms close to your body. This in fitness terms is called the eccentric phase of a lift, the point where the weight is bearing down on you after reaching full extension and now needs to be returned to the starting position.


Unlike proprioception and balance, eccentric maximal strength is generally only improved with resistance training. That resistance can be body weight, free weight, machines or more alternative methods such as Kettlebell and Steel Mace training. Either way, you need to train with an applied force in order to improve your eccentric loading capability. The NHS reccomends:

"do strengthening activities that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms) on at least 2 days a week"

You can do all the major muscle groups at once or split them into the appropriately named "Splits" as your schedule allows. You can do a Leg day to cover legs/hips, Push day to cover chest/shoulders/arms and Pull day to cover back/arms/abdomen. The Push:Pull:Legs is just one example of a split and there are many more to choose from to suit your availability. You can train more often than twice a week if you wish just make sure you have proper recovery with rest, nutrition and even sports massages. If you're unsure what split would suit you then it may be helpful to inquire about a customised programme plan to be made for you *cough* like this one here *cough*.

Absorb the impact

Your muscles absorbing the impact is a straight forward concept. Say you have more muscle on your chest, that's sort of soft, the shock has to travel through the layers of skin fat and then muscle before it hits the last line of defence being bone. Exercise also improves bone density and health meaning that the last defence is better suited to taking the impact if needed. With the shock absorbed a little more, you reduce the risk of breakage. This doesn't mean you need a chest like a proportioned pigeon but more muscle is good. The muscle itself also elongates the rate of deceleration, albeit by split seconds, to reduce the total force of impact.


Muscle also helps to disperse shock around the body. Pretty much every muscle and ligament is interconnected somehow through a chain of attachments. That way when a shock force hits one muscle, some of that force travels to neighbouring muscles and so on. This is the same principle behind how body armour works, spreading a high point of force around a large area. The energy is total but spread over a large area the energy reduces at each individual point to sum to it's total energy. I said "a straight forward concept" not one paragraph ago.


At this point in our scenario we mustn't think of balance, proprioception and muscle mass as separate. You could have your hands in your pockets eliminating the ability for eccentric deceleration but your proprioception (knowing where you are in space and time) combined with your balance reflex (turning on muscles to invoke a change of position) could work in tandem to help you change your falling position to allow you to land on a squishy part of the body. How many times have you fallen forward but somehow landed on your side? Well that's your balance and proprioception working together subconsciously to land on a more cushioned area of the body.

Analogy that muscle can be armour depicting many types of breast plate armor.
There are many different types of armour just like different types of fitness. They all protect you though.

Recover faster

Perhaps from a combination of having less fall energy and more cushioning, recovery times for exercise trained patients is faster. Likewise, those that are used to training also have a better efficiency with the metabolic breakdown and rebuilding of bodily tissue. On top of that patients also have better hormone levels (such as growth hormone), better blood vessel dilation to carry the needed building blocks to damaged areas and other good training habits like adequate protein and water intake. Added up, those who are trained that experience a like for like injury tend to get back on their feet faster and with less pain.


Rafeeq (2013) did a review of studies comprising 1864 patients and found:

Length of hospital stay, postoperative pneumonia, and atelectasis were also significantly reduced in the preoperative exercise training group across all surgeries. These results are consistent with those of previously published systematic reviews in individual surgical populations

Preoperative exercise resulted in discharge from hospital 2 days earlier than none-trained patients. Thereby, reducing cost and strain on health care systems. The study reviews have implications of comparing like for like patients and injuries as well as training interventions used but on the whole, preoperative training has positive effects and thus for emergency injuries, maintaining a level of fitness and strength is going to help protect you should the worst occur. The exact training isn't defined but training for as little as 1 week or more can have a benefit post surgery. Rafeeq was also clear to say that "Supervised training is clearly superior" when compared to the use of apps or relying on patients to maintain training schedules.


Protect yourself

If you won't protect yourself think of who relies on you to be fit and able so you can at least do it for them. It's not selfish to take time away from your loved ones to improve your quality of life and their biological insurance policy. Exercise will aid with proprioception to avoid the injury in the first place. Better balance reflexes may stop a fall in its tracks whereas strength, especially eccentric strength, would reduce the damage and maybe even stop any damage occurring. More muscle mass will cushion any blow reducing the injury intensity. Good habits from regular exercise will also get you back on your feet faster than you otherwise would.


At no point was there mention of the fall not hurting even with better musculature. Nor was there anything to say you may not pull a muscle in the process (this is where our partner Ani-motions can help more). The point being is that without training, things could be worse. Exercise doesn't make you invincible, sometimes it even causes an injury but it does make you far more resilient to life, gives you better mood, healthier weight and more appealing aesthetics. There is one catch though! You have to consistently maintain your body. A workout today won't help you in 10 years time but the habits you make today might well carry on.

 
Armoured Muscle Personal Training champions beginners to go from under-confident to unstoppable both mentally and physically using proven functional fitness and worthwhile nutrition in as little as 3 weeks.

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References


Aman JE, Elangovan N, Yeh IL, Konczak J. (2015) The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci (Accessed Oct 2022) Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309156/


NHS (2021) Physical activity guidelines for adults aged 19 to 64. Online (Accessed Oct 2022) Available at https://www.nhs.uk/live-well/exercise/exercise-guidelines/physical-activity-guidelines-for-adults-aged-19-to-64/


Rafeeq, Misbahuddin. (2013). EVALUATION OF THE RELA TIONSHIP BETWEEN LUNG FUNCTION AND ANTHROPOMETRIC PARAMETERS IN NORMAL HEALTHY VOLUNTEERS AND SPORT PERSONS. (Accessed Oct 2022) Available at https://www.atsjournals.org/doi/citedby/10.1513/AnnalsATS.202011-1388ED


Salles JI, Velasques B, Cossich V, Nicoliche E, Ribeiro P, Amaral MV, Motta G. (2015) Strength training and shoulder proprioception. J Athl Train (Accessed Oct 2022) Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477923/#:~:text=Improvements%20in%20joint%20position%20sense,resulted%20in%20better%20proprioception%20performance.



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