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Why Treat Hip Fractures... Prevent the Falls that Cause Them

One in four falls of an older adult is going to result in a hip fracture, but how common are hip fractures? In the absence of a fall, they are fairly rare. The muscles and bones of the hip joint when healthy are some of the strongest and largest in your body. They are necessary to keep you walking, they are necessary for you to be able to stand and sit, so they are strong enough to lift you up. When it comes to falling, hip fractures are a common issue and one of the most serious for recovery and treatment. Hip fractures from falling account for up to 95% of all hip fractures. Hip fractures from events unrelated to falls are typically due to low bone mineral density as occurs in osteoporosis. And a person who had a hip fracture from a non-falls related event is not in the clear. You will have the same lengthy recovery, and you already had risk factors for falling.  

Why is a Hip Fracture so Dangerous?

Unfortunately, the recovery from a hip fracture can mean surgery and extended immobile bed rest. There are 3 primary considerations when it comes to why a hip fracture is so dangerous for the elderly. These considerations can be framed in periods of recovery. The initial recovery phase includes getting off of the ground, an emergency room visit, and often times surgery. Each of these present their own considerations. Getting up off the ground to see emergency medical assistance could very well mean the difference in life and death. This is why a medical alert device or access to a charged mobile phone is a key tool for any senior. Post-injury surgery is not unlike any other surgical procedure and comes with a variety of potential issues including bleeding, elevated heart rate, and stroke. A trained surgeon is going to minimize these risks, but “an ounce of prevention (in this case falls prevention) is worth a pound of cure (surgery).” The next phase is the long-term recovery, which will likely include a prolonged period of bed rest. This loss of mobility can be devastating. For a senior who has already been slowed, a hip fracture can mean a loss of independence, a loss of socialization, and it can mark the beginning of the end of life if you do not take the steps necessary to heal properly and to regain the strength you lost before you had your first fall. The minimal movement can lead to blood clots in the legs and lungs, bedsores presenting an increased risk of infection, and urinary tract infections. All of these reduce the likelihood of a full and successful recovery that brings you back to your independent lifestyle. Post-recovery comes after you have discharged from the hospital, but it could just as easily be called, long-long-term recovery, because until you have gained the strength back that led you to falling in the first place you are not safe. A previous fall is one of the highest predictors of a future fall and if you haven’t gotten back to where you were before you fell, a second rehab hospitalization is not likely to be more successful than your first. Outpatient physical therapy that focuses on your safety and wellbeing is a key component of your falls prevention plan at this stage. You need a physical therapist who has been trained in all things fall prevention and who can help you through not just the physical well-being, but also the sensory deficits that may be underlying your falls risk.  

What Percentage of Hip Fractures are Caused by Falls? Up to 95% of all hip fractures occur as the direct result of a fall.

How Serious is a Hip fracture?

If you have previously broken a bone, or you know someone who has had a minor fracture like in their finger or toe, you might think that modern medicine has really figured out who to treat a broken bone. You might think that all fractures are the same and that you can recover quickly. But none of this is the case with a broken hip. The recovery is lengthy, often 6 months or more, with a lot of time on bed rest. If you have never had bed rest, you might be thinking a nap sounds good right about now. Let us be clear that bed rest for a broken hip is miserable. You will have little to no mobility, you may end up suffering from bed sores or blood clots, and you will lose muscle even if you are regularly working with a physical therapist.

The goal of physical therapy after a hip fracture is simple, to get you back your function and independence. Unfortunately, that is going to take a lot of work. When your muscles atrophy from lack of use it can take weeks to gain back what took days to lose. If you were unsure and unsteady on your feet before a fall, you are not going to return to that point without some serious work. You will need to be evaluated for your musculoskeletal strength, but your physical therapist will also need to evaluate your balance sensory systems to identify and treat any underlying conditions. Still not convinced of the seriousness of hip fractures? That lengthy recovery can only occur if you are alive, and 21% of seniors who suffer a hip fracture from a fall will die within one year.

Why do Elderly Die from a Hip Fracture?

While an elderly person can die from a hip fracture from internal bleeding, assuming they get medical attention in a timely manner this is not likely to happen. What is likely to happen is infection, health complications like blood clots, and overall health deterioration due to a loss of mobility and independence are the main factors that lead to death following a fall.

What is the Life Expectancy after a Hip Fracture?

Your life expectancy after a fall and hip fracture are fair. Approximately 79% of people with a hip fracture will live beyond a year. But being alive and living are not necessarily the same thing. Being alive at a year likely means you are still in ongoing physical therapy trying to get back to where you were before the fall.

By being proactive and spending the year fighting falls, learning how to strengthen your muscles and bones, and actively participating in a falls prevention program you run the risk of truly living. You will likely come out of that year significantly healthier, and less at risk for falling. You may be alive a year after falling, but you could be living and loving life a year after beginning a falls prevention program.

How Do We Prevent the Elderly from Falling?

While no falls prevention program is fool proof, and there is no magic falls prevention pill. A well-developed falls prevention program can significantly reduce the chances of an older adult from falling. Physical therapists (especially those trained in balance rehabilitation) are experts in strength and movement, making them the ideal partner in developing your targeted falls prevention program. Tailoring a program to your needs will allow you to get the most out of your falls prevention program and allow you to have the lowest likelihood of falling. When if comes to your musculoskeletal system, your physical therapist can assess and prescribe the best course of action to strengthen each of your muscle groups. Health muscles are both strong and flexible. By teaching you how to properly coordinate movements across all three planes of motion and how to strengthen your muscles while eliminating scar tissue or visceral adhesions through manual therapy, your physical therapist can help reduce your pain and gain the strength necessary to keep you on your feet. Your physical therapist can also prescribe the best plan for joint health and mobility. The constant use of our joints throughout our life can create problems as we age. Your physical therapist understands how to strengthen your joints, and she can recommend exercises or modalities to keep your joints free and unrestricted.

One thing your physical therapist may recommend for overall skeletal health is mechanical stimulation and load bearing exercises. Unfortunately, for many elderly individuals already at risk for falling, starting at this very important step is nearly impossible because it is asking you to do an exercise that is going to put you in harms way. If you are at risk for falling because you lack proper muscle and bone health, asking you to walk 3 miles barefoot each day to strengthen your skeleton is like asking you to take 6000 chances with your life. At FYZICAL, we stop falls. So, we have developed or worked with partners to eliminate the risk of falling while working with us, which means you get back to the independent lifestyle you want. Our safety overhead system is a five-point harness that tethers you into rail and trolley system overhead. Each harness is rated for 500 pounds, not sure its strong enough, we’ll let you give it a test ride. Additionally, our Juvent is a micro-impact platform. In 10 minutes you get enough mechanical stimulation to mimic walking 3 miles barefoot. The mechanical stimulation has been shown to improve bone growth, and we routinely hear from our patients that it is also helping to reduce pain. FYZICAL Fights the Falls, and we can help you remain upright and independent. If you still have questions or you want to see the FYZICAL Difference for yourself, give us a call today. 405-400-8909

What is a Falls Prevention Program?

A falls prevention program should be a targeted intervention focused on reducing an individual’s risk of falling. The importance of an individualized falls prevention program comes from the wide array of risk factors that may increase or decrease your risk of falling. Falls risk in the elderly is obviously greater than in young adults, but because of other associated health concerns falls risk in seniors must be very carefully considered. For example, a senior who falls is at high risk for fractures or broken bones (especially if they have osteoporosis or bone loss related to cancer treatment, or use medications that reduce bone mineral density like corticosteroids and diuretics). One in 4 seniors who fall annually will end up with a broken hip, which often means a lengthy hospitalization and a stay in a rehabilitation facility, so the problems with falling do not end when you are able to get up off the ground. The long-term recovery is severe and warrants appropriate and thoughtful prevention, not just intervention after you have been injured.

While there are several considerations for falls prevention (see Risk Factors for Falling), your musculoskeletal system and your bones in particular cannot be overlooked. Your skeleton is the framework over which your muscles lie, to keep your body balanced and moving. When your bones become weakened, as happens when we age due to medication, lack of physical exercise, and related medical conditions (e.g., osteoporosis), your body has a harder time maintaining your balance and posture. You increase your risk of falling, and you increase your risk of serious injury or death from a fall. Your falls prevention program must have a targeted focus on your physical well-being.

 -FYZICAL Therapy & Balance Centers of Oklahoma City

FYZICAL Therapy & Balance Centers have developed a world-class balance rehabilitation program that can be tailored to each patient’s individual needs. As the only Level III balance rehabilitation program in Oklahoma City, the physical therapy provided for patients at FYZICAL Oklahoma City cannot be matched. Our Physical Therapists will conduct an evaluation using state of the art balance assessment technology and provide safety and security throughout your treatment with our safety overhead system. If you are unsure about your balance, or you want to see the FYZICAL Difference for yourself, schedule a free consultation today.