Falling down on your face is no longer just for the clumsy. Preventing falls, especially among the elderly, is now one of the hottest topics in public health.Chiropractic literature has begun to reflect the role that DCs can play in educating our patients and the public about preventing falling accidents.
As they say on Facebook, "I like this." The chiropractic profession has had a difficult time finding public health issues that fit. Scoliosis and posture have been worthy topics, but not very sexy. We have warned the public about the spine-crushing deformities caused by school backpacks. We have described the new phenomenon of back injuries caused by simulated bowling on the Wii game. We have even joined the voices concerned about the risk of intractable pain in the thumbs caused by phone texting. But nothing has come along in the public health arena for chiropractic as relevant as falling.
After all, there are so many kinds of falls. There is the venerable slip and fall, tripping over stuff like one's own feet, losing one's balance, passing out, being knocked down, diving head first, keeling over. Chiropractors treat injuries from these mishaps every day. So shouldn't we be at the forefront of health professionals assessing risk and promoting caution?
Of course! But this is where I must pause. Falls can be devastating. Dr. Meridel Gatterman reported (DC, Feb. 12, 2011) that falls among those over age 65 account for about 6 percent of all medical expenditures in the U.S. Even 10 years ago, falls among seniors cost $19 billion in 2000 when all associated costs were considered. With this in mind, I believe the act of falling over one's heels deserves grave respect.
When a patient reports injuries from a fall, my reaction is based on the question, "How bad was it?" Take the case of the mother who stepped on a squeaky toy and toppled backward onto the sofa, causing a mild back strain. It elicited only a chuckle from both the patient and myself. But a guy who falls off a roof into a cement mixer? That's a bad fall.
Some patients take too long to tell us about their fall, and use too many details: "I was washing my Doberman in a washtub on the upper deck. This is the puppy that I flew to Vermont to buy, and drove over 1,000 miles back home. Anyway, the dog jumped out of the tub, throwing his whole body weight behind my left knee, which buckled and threw me off the deck into the hedges below. Somehow my head just missed the iron bird bath I bought in Ohio, and my neck twisted..." and on and on. When politely listening to such a long narrative, I literately cannot wait for the end of the story to find out the severity of fall we're dealing with.
One of the more bizarre, but common fall injuries, is not a fall at all. It is the "near" fall, such as when one slips, arms and legs akimbo, but does not actually fall down. Picture Wiley Coyote chasing the Roadrunner when he slips on Acme axle grease. When people slip on ice and stay aloft, I call it the "ice dance." In my career, I have seen almost as many severe injuries from the ice dance as from head-over-heels falls on ice. When this has happened to me, I remember my body twisting and convulsing as if I had just had habanero sauce poured down my throat while at the same time having a colonoscopy. (This is dark humor about black ice.)
Falls can hurt one's pride. I once spotted a man exiting a restroom and tripping over the yellow, fold-out sign warning, "Piso Mojado! Wet Floor!" He sprawled out quickly on the floor, but was not physically hurt. As I helped him up, I couldn't ignore the embarrassing irony of falling over the very sign warning one not to fall.
Here are some humorous (yet realistic) suggestions about how to prevent falling accidents. Be humble, since pride comes before the fall. For women, reduce the height of those 10-inch heels down to at least 9 inches. If you are taking medications, don't take the med that warns "falling is a common side effect." And of course, avoid trip wires.
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