When Falls Happen

Welcome to another edition of the Doctor's Note where we talk about what's on our minds when it comes to your health.

This week I sat down with my long-time friend and fitness expert, Scott Held, for an honest conversation about falls in the elderly—a topic that hits close to home for many of us. Scott shared his personal motivation for focusing on fall prevention, sparked by his grandmother's serious fall and the profound impact it had on his family. As we discussed, a single fall, especially one that results in a broken hip, can completely alter the trajectory not only of the individual’s life but also their loved ones'. The aftermath can often include hospitalization, major surgeries, rehabilitation, and potentially losing one’s independence. This is why, as we both agreed, preventing even one fall can make a real difference for individuals and the families who care for them.

During the episode, Scott and I dug into both the mechanics and the mindset behind falls. We talked about how active older adults sometimes overestimate their abilities, putting themselves at risk, and reviewed simple yet crucial walking techniques—like using a heel-toe motion—to maintain balance and reduce trips. We stressed the importance of proper posture, keeping your eyes about 10 feet ahead, and not looking straight down at your feet, which can actually make things worse. We also covered strategies for getting up safely after a fall, methods to summon help like phone and wearable alerts, and how pride (especially in men) can stop people from using assistive devices that could keep them independent for longer. Finally, we discussed the importance of preparing a plan in advance—whether it’s checking in with a buddy, having accessible phones, or making sure first responders can get in if needed.

PODCAST NOTES 

• One serious fall, especially one leading to a broken hip, sets off a chain reaction impacting not just the individual, but their entire family. This injury often forces major life changes, such as hospitalizations, surgeries, rehabilitation, potential nursing home placement, and loss of independence. The emotional and logistical burden extends to children, grandchildren, and caregivers, sometimes affecting family dynamics for years. As Scott emphasized, keeping just one person from falling can truly change the course for an entire family.

• The most common type of fall results from an improper walking pattern—specifically, shuffling feet or striking with the toes rather than walking heel-to-toe. This "shuffling" increases the chance of tripping on obstacles, uneven ground, or even a rug edge. By walking with an intentional heel-to-toe motion—what Scott calls “four-wheel drive for your feet”—you allow your heel to clear obstacles and your toes to glide safely, helping prevent forward falls.

• Poor posture, with excessive lean forward (often from years of bending or looking down), shifts one’s center of gravity out front and makes it much easier to lose balance and tumble forward. When combined with shuffling or improper gait, this becomes a setup for disaster. Upright posture, addressed through mindful awareness and physical strengthening, is critical for reducing risk.

• Many older adults mistakenly believe that staring down at their feet while walking will help prevent falls. In reality, constantly looking down throws the body further forward and narrows your field of vision, resulting in missed hazards or misjudged steps. Instead, Scott recommends keeping your gaze about 10 feet ahead—scanning for obstacles like a point guard in basketball watching the court—while glancing down only to check a potential hazard.

• If a fall is unavoidable, your instinct should be to protect your head at all costs, even if that means risking a sprained wrist or a bruise. Rolling or twisting slightly to the side rather than landing straight on your hip or back can disperse force, much like athletes and martial artists practice. The head is always a priority—protect it above all else.

• It’s vital to practice getting up safely from the ground in different scenarios. Scott recommends learning how to get onto all fours, use nearby sturdy furniture when available, or brace on your own leg to lift your body if in open space. Regularly testing your ability to stand up after sitting or lying on the floor not only builds confidence but highlights if extra home modifications or support devices are needed.

• Assistive devices such as canes and walking sticks can dramatically improve safety and stability, allowing you to stay independent and enjoy outdoor activity longer. Yet, pride—especially in men—often leads to resistance. Scott and I discussed the importance of reframing these tools: rather than symbols of decline, they are smart choices that protect your quality of life and allow you to remain active, often delaying or preventing bigger setbacks.

• Preparation is everything. Establish a buddy system for daily check-ins, keep your phone or emergency alert device within arm’s reach at all times, and make sure that friends, family, or emergency personnel can get into your house if needed (think: spare keys, garage codes, trusted neighbors). It’s also important to make advance decisions on when to call EMS, especially if you hit your head, suspect a serious injury, or live alone. Wearables like the Apple Watch with fall detection, and medical alert pendants, can be literal lifesavers in these moments.

Falls are not an inevitable part of aging—they are often preventable with knowledge, practice, and thoughtful planning. Whether you’re worried about your own stability or that of a loved one, take the time to implement even just a few of these strategies. Talk to your family, get fit, practice safe walking, and don’t be afraid to use a little help when you need it. 

Most importantly, create a plan now—before a fall ever happens. If you want to keep enjoying the activities and independence you love, prevention is key. Stay tuned for part two, where Scott and I will dig into training techniques for balance and strength as you age!

Stay educated. Stay healthy. 

Till next week.