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The fear falling

By April 16, 2015October 20th, 2020Exercise

Lessons from the Leaning Tower

Galileo was said to have dropped two objects of different weights from the Torre pendente di Pisa—the Leaning Tower of Pisa—to prove his new theory that all objects fall at the same rate regardless of how much they weigh. In 1971, Apollo astronaut David Scott retested this theory from the moon’s surface by dropping a hammer and a feather at the same time. While the moon’s gravity is weaker than that of earth, the objects still fell about the same rate, albeit slower, hitting the lunar ground together.

While Galileo’s use of the Leaning Tower for his research is probably a myth, he did develop the theory of objects falling at the same rate. But the Tower of Pisa is truly leaning because of the weak, shifting soil and the building’s weak structural foundation; and the Apollo astronaut actually performed the gravity experiment, but mostly for NASA publicity.

The seven-story Pisa Tower, whose initial construction began in the twelfth century, began falling at some point during the building of its third story. This was due to a shallow foundation of only about 10 feet of unstable subsoil. For centuries, preventing the building’s fall would be a topic of debate, study and attempts at correcting the cause of the problem—and the focus was directed towards its faulty foundation. By 2008, after hundreds of tons of earth removal and other careful attempts at replacing and reconstructing the groundwork, architects and engineers finally said the Tower’s unstable foundation was safe for the first time in history, at least for the next 200 years. But the Tower still lists at just under four degrees.

The human body can be a lot like the leaning Tower: unstable and with a weak foundation. And the body’s foundation begins with the feet. This means healthy, fit feet that can tolerate the downward pull of gravity, with muscles that are balanced, strong bones, good circulation, proper nerve activity that communicates with the brain, and other attributes including regular movement.

The feet must last a lifetime. The more you understand about the feet, the better you can care for them and even fix them when their function goes astray. The feet are subjected to more wear and tear than any other body part. Just walking a mile, you generate more than sixty tons—that’s over 120,000 pounds—of stress on each foot! Fortunately, and what’s even more amazing, our feet are actually made to handle such natural stress. It’s only when we interfere with nature that problems arise. Almost all foot problems can be prevented, and those that do arise can most often be treated conservatively through self-care.

From birth until death, your feet have a strategically important role in health and fitness. But too often, they become one of the most neglected parts of the body. If the feet lose their support—poor muscle function affecting the arches is a common affliction—the body can lean just like the Pisa, which in turn can lead to knee and hip problems, low back pain, spinal dysfunction, and other physical impairments. And an imbalanced body is more prone to tripping and falling down.

Your feet form the base of the body’s physical structure, and any departure from optimal balance can have significant adverse effects not only locally in the feet but for the entire body. These problems are often transmitted through the ankle, an extension of the upper part of the foot. Anatomists technically consider the foot and ankle as two separate areas, but I consider the ankle as a vital part of the foot for ease of discussion. The ankle is a vulnerable area; approximately 25,000 Americans sprain their ankle each day. And probably many more develop at least one unstable foot and ankle.

Falling is also a common problem. Many people, including seniors, are not the same after a bad fall. It’s often the start of a downward spiral set of related problems—the fall causes a knee bruise and pain, which produces weakness in the leg, and eventually, low back pain shows up, then spinal discomfort in the middle and upper back. It can be exhausting—physically, mentally, and emotionally. Too often, a bone fractures because bone density was poor or pre-existing muscle imbalance was significant.

Poor function in the feet is one of the common causes of falling at any age. When the feet don’t work well, there’s usually associated muscle imbalance, poor posture, and distorted gait—all of which further the risk of a fall. You don’t have to be a daredevil like a rock climber or downhill speed skier to fall. You can trip over a curb that is only several inches high and still get badly injured.

Reduced brain function also predisposes one to the likelihood of someday falling, even in people without severe cognitive or other physical problems. Those most vulnerable are people who have difficulty multitasking. For the distracted brain, the competing chores of thinking about sending an email to a friend, whether one has enough spinach for that favorite fish dinner tonight, and walking down to the basement freezer sometimes is too much to handle, and the risk of stumbling or falling down increases. Or, if you’re working out with a friend or two, and chatting away, your posture may deteriorate, contributing to a fall.

Each year, millions of people fall. The problem is worse in those ages 65 and older, where about a third fall at least once. While about 80 percent of falls occur in this age group, 20 percent occur in those under age 65. About half of those with a history of falling at least once will fall again in the near future. The Centers for Disease Control (CDC) recently reported that, “Falls can lead to moderate to severe injuries, such as hip fractures and head traumas, and can even increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable.”

Prevention of falls is the best treatment. This starts with improved foot function. A well functioning aerobic system improves muscle function, gait, and overall balance. Music can also help the brain with better balance and gait, lowering the risk of falls. In a recent study, Dr. Andrea Trombetti and colleagues of University Hospitals and Faculty of Medicine of Geneva, Switzerland demonstrated that listening to music as a therapy improved the brain’s ability for a better gait and balance, significantly reducing the number of falls. Listening to music stimulates the rhythm centers of the brain, which impact physical movements.

The CDC also notes that:

  • Among those age 65 and older, falls are the leading cause of injury death. They are also the most common cause of nonfatal injuries and hospital admissions for trauma.
  • In 2007, over 18,000 older adults died from unintentional fall injuries.
  • The death rates from falls among older men and women have risen sharply over the past decade.
  • In 2009, 2.2 million nonfatal fall injuries among older adults were treated in emergency departments and more than 581,000 of these patients were hospitalized.
  • In 2000, direct medical costs of falls totaled a little over $19 billion—$179 million for fatal falls and $19 billion for nonfatal fall injuries.
  • Most fractures among older adults are caused by falls—the most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
  • Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, leading to reduced mobility and loss of physical fitness, which in turn increases their actual risk of falling.
  • Statistically, men are about 50 percent more likely than women to die from a fall, and women about 50 percent more likely than men to break a hip.

While the CDC and other healthcare establishments focus on recommendations such as getting an annual eye exam, making the home environment safer by reducing tripping hazards, adding grab bars and railings, and improving lighting, the feet are often responsible for falls. Poor foot-sense and balance, which are intricately linked, can significant increase the risk of falling at any age.

In addition to falling, the feet help prevent many injuries in the knee, hip, low back, spine, and even the neck and shoulders. An important job of the feet is to help balance the whole body. The feet continuously communicate with the brain to regulate the rest of the body’s daily movements, including standing, walking, and running, and even riding a bike. This is accomplished by powerful nerve endings at the bottom of your feet. These nerve endings are developed from infancy and their function is necessary throughout your life. Disturbances of these nerve endings due to trauma, disease, poor footwear, or neglect can lead to further health concerns.

The nerve endings at the bottoms of your feet also become a potential source of powerful therapy when properly and specifically stimulated. This approach can be used both preventatively and after some injury is realized. For example, a simple foot massage, even by an untrained person, can be great for your feet and brain because these nerve endings—also the reason it feels so good—are gently stimulated.

For more information

7 Ways to Grow and Repair Your Brain
Music Therapy
More on Feet and Shoes
Sports Music