I'm in my early 50s but I struggled to recover from a recent fall

Our ability to balance diminishes from midlife, increasing the risk of falling. So, instead of exercising in the usual way, we need to introduce multidirectional and unpredictable movement

Fiona Dooley, who tripped on a kerb and suffered serious soft-tissue damage, says she had a slower recovery than would have been the case when she was in her 40s. Picture: Moya Nolan

During the recent cold snap, videos emerged on social media showing us how to stay safe and keep upright when treading on icy ground — by walking like a penguin.

Alas, nasty falls can and do happen and, further still, they are not just the plight of those in advanced years. In 2018, researchers at Trinity College Dublin identified an increase in the number of women over 40 who experienced falls.

Findings from the Irish Longitudinal Study on Ageing suggest middle age is a crucial time to put strategies in place for preventing falls, as fall-related injuries in older people in Ireland cost the economy an estimated €922m in 2020. Projections indicate this could rise to between €1.587bn and €2.043bn by 2030 if preventative measures aren’t implemented.

Physiotherapist Francis Harrigan says several issues can contribute to a fall mid-adulthood, with proprioception decline being just one of them. “This is the sense our body has of the environment around it, and it is regulated by sensors in our joints and tendons along with the central nervous system, which processes this information and can diminish as we age,” he says.

Our overall balance can also become impaired “due to degenerative changes related to ageing as well as visual decline”, he says.

Hormonal changes in women during perimenopause and menopause resulting in a decrease in oestrogen are important to consider “as osteoporosis will predispose an individual to more severe orthopaedic complaints following a fall,” says Harrigan.

He references adverse lifestyle choices such as sedentary behaviour and an increased BMI, giving rise to poorer outcomes following a tumble.

Strength and conditioning classes with resistance training “to increase bone density and lean muscle mass” and a simple balancing exercise “such as standing on one leg with eyes open and then shut to increase difficulty for 30 to 60 seconds” can also aid betterment.

Difficult to bounce back

Kildare-based podiatrist Fiona Dooley attributes distraction as the main reason for her recent fall. Misjudging the height of a kerb, she was “stunned” when it happened. When there was no real improvement afterwards, she was referred for an X-ray and ultrasound. “At first, it was suspected I had sustained a hairline fracture below the knee but it was deep-tissue bruising.”

Normal everyday activities such as driving and using the stairs were doable but uncomfortable. However, her regular 5k walks had to stop.

She says the recovery period isn’t the same as it would have been, even in her late 40s, and her confidence has also been affected. 

“I am definitely more careful and concerned about falling again and, suddenly, I feel a lot older but conflicted too as I’m only in my early 50s.”

Her contemporaries of the same age have also weathered similar experiences.

“We just don’t bounce back as we would have a few short years ago. One friend made the point you know how old you are by people’s reactions to your fall — the younger you are, the funnier your fall seems to be to others. However, at our age, when you fall, people rush to your aid.”

Andrew Dunne, chartered physiotherapist and founder of Personal Health says: “Statistically, women are not more likely than men to fall; rather, the issue is the higher likelihood of secondary complications post-fall. This means falls have a greater impact on women.”

These complications relate to “a higher prevalence of bone mineral density issues, less lean muscle mass, and less strength”.

Keep making smart moves

Dunne says falls are associated with hip fractures, “which are directly linked with premature death, particularly in elderly, frail populations”. He adds: “Falling is, unfortunately, commonplace as we progress in age, for males and females.”

Prevention is always better than cure but Dunne says it’s human nature not to make changes until there has been “a shot across the bow”, resulting in a cohort presenting at his clinic.

He believes agility, coordination, and incorporating dynamic balance in day-to-day life are of great benefit. “The umbrella term for this is neuro-motor activity, and good examples for the 50-65 age group are running, climbing, dancing, and padel tennis.

In general, we tend to restrict our movement towards predictable ‘straight lines’ as we age. So, reintroducing multidirectional, unpredictable movement is a valuable strategy at this stage.

Initially wary of walking her dog during the icy spell, 60-year-old Martina Moylan, from Kildare, tossed a ball in the back garden. Ironically, this was where she fell and broke her wrist. “My foot wedged in the frozen grass and threw me forward. I immediately knew I broke something with the pain.”

Life suddenly looked very different. “Day-to-day life simply stopped. No driving, so straight away, my independence was gone. That is very difficult for someone so active as myself. My confidence took a blow as I became afraid and unsure of walking. I was stunned as I was so careful with my surroundings.”

Moylan is looking at a 12-week recovery period in conjunction with physiotherapy. She acknowledges the episode has left her very careful now when out and about but feels a positive outlook is very important.

“You have to get on and get your life and mindset back to where it was before it happened. Otherwise, you become fearful.”