Fear of Falling

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AT URBAN EVOLUTION in Alexandria, I fell down about 30 times in a row—forwards and backwards; to the left and then to the right—and felt much better by the end. Early on, I became slightly breathless—not from the exertion but from apprehension—which diminished over the course of my hour-long session.

The main business of Urban Evolution is Parkour, “a free-running acrobatic sport” that involves leaping off obstacles and includes learning how to land.  Geared to ages 35 and over, its “401 PK (Parkour)” classes aim to develop the balance, strength, flexibility and mobility involved in “bailing”—falling in Parkour language.

Parkour emphasizes resilience and flexibility—exactly what tends to decline with age.  Parkour is “strengthening, having fun with movement and adapting to the environment,” Boston Parkour coach Blake Evitt told Mother Nature Network, which cites Parkour as a “workout that emphasizes how to fall safely.”

Whether learning and practicing good ways of falling can help in that split second when you fall, no one knows until it happens to them.  But although practice could help, the more certain achievement of my session was feeling braver.

My fearfulness surprised me, although I’d noticed becoming more apprehensive and cautious with passing years. That’s what drove me to take the $60 private session, rather than a class, with Urban Evolution’s founder and owner, Salil Maniktahla. I wanted to be sure someone watched me all the time.

Fear of falling can restrict activity—and less activity can lead to declining balance and muscle strength, which increases the risk of falling, according to Kathy Cameron, director of the Falls Prevention Resource Center at the National Council on Aging (NCOA).

Incidence of falling is highest among 50- to 60-year olds—“more than older folks,” writes Michael Zimmerman in the AARP magazine. “We’re more active, and that puts us more at risk of falling.”

Falling is the most likely cause of traumatic brain injury (TBI), according to the CDC. And among U.S. residents age 65 and up, “about 20% of those who fall have an injury like TBI or a hip fracture or other broken bones,” Cameron told CNN.

The reason for most falls: people trying to do too much at once “without being attentive,” according to Toulouse University Hospital physician Antoine Piau, lead author on a study that reviewed 371 falls reported over a four-year period.

“Falls happen where people spend most of their time,” said Kaiser Permanente physician Eric Larson in Seattle. They fall when they get up in the night to go to the bathroom—often in bare feet on slippery floors.  In the study, people fell most often at home and often in the bedroom, while only 2% of falls happened on stairways.

Four out of five falls occurred in well-lit areas; almost two-thirds, slips or trips; and almost 90%, because people lost their balance.  Injuries requiring medical attention occurred in 119 of the falls, and 19 resulted in reduced walking ability.

In addition to practice falling, the other element involved in staying safe is prevention. The 15 “Falls Prevention Programs” on NCOA’s list are mostly designed for people unable to practice actual falling because of physical limitations or phobias. In fact, the search for programs that address falling most often directs you to programs for “seniors.” (The NCOA list of Washington, D.C.-area programs begins with Iona Senior Services and Geriatric Care Counselling.)

NCOA programs, such as “A Matter of Balance,” are designed for those not currently participating in regular activity, Sara Pappa, coordinator for Northern Virginia Falls Prevention Alliance, told MyLittleBird.  Many include lectures, for example, on rearranging the environment (notably eliminating area rugs, which are a frequent cause of slipping and forbidden in most senior communities).

At the next level, SAIL (Stay Active and Independent for Life) involves hour-long aerobics classes of evidence-based strength and balance exercises—most done standing, Pappa noted: “Standing on one foot and moving the other forwards, to the side and back; walking toe to heel forwards and backwards; and walking in a circle with arms out to the side.”  Ankle weights can be added.  One goal is “to help you think about where you are in space,” she said.

Although not unlike the balance exercises that began my Parkour session, the repeated practice of actual falling has the benefit of lessening fear, which in turn can help avoid the instinctive reaction of tensing during a fall, the reaction most likely to cause injury.

For safer falling, the key is to lower your center of gravity, Salil explained. Get as close to the ground as possible by bending knees, crouching and curling while falling.

In a “four-point plan for safe crash landing” from stuntwoman Alexa Marcigliano (“Orange is the New Black” and “Blindspot”) cited by Zimmerman, the first rule is stay bent.

The others are protect your head by turning it to the side or tucking your chin; “land on the meat” —thighs and upper arms instead of bony parts like elbows; and keep falling—instead of bracing to stop, continue to roll, which spreads the impact across a larger surface of your body.

Marcigliano talks about “slapping out.” As you fall, extend arms forward, elbows bent, with flat palms—which can absorb a lot of weight—actually slapping the ground.  Practicing this move came early in my session with Salil.

Near the end he addressed my most frequent worry: slipping and falling backwards on uneven downhill surfaces with dry, loose dirt and pebbles in Rock Creek Park.  For me, practicing backwards falling was the scariest but also the most elating.

Salil recommended watching videos of “Parkour ukemi,” loosely translated as “the art of falling” in the context of Parkour.

Parkour ukemi videos portray all levels—from older women in harnesses tripping on uneven or treadmill surfaces to unimaginably acrobatic moves by Parkour experts.

Although I left Urban Evolution pleased with my successful falls, the truth is that I spent most of the time on a very thick, bouncy mat, with a few falls on the next harder surface—but still many levels away from real-life sidewalks or even Rock Creek Park trails.

My “homework” included calf-raises—getting up on tiptoes, first on both feet, then on one at a time; and hops using both feet, forward and backwards, then side to side.

Push-ups to increase strength were also on the list. For people unable—or never able, like me—to do these, Salil recommends slow “push-up negatives” that include only the downward movement and can involve flopping down the last several inches.

When I asked about practice falls on grass, maybe with a towel, Salil looked worried.  Instead he suggested, diplomatically, using a large, thick blanket, but he warned: “Be very careful!”

For the occasions when I still find myself trying to do more than one thing at a time, I know what I should really be practicing is not falling, but strength and balance—and maybe most important, mindfulness.

—Mary Carpenter

Every Tuesday, well-being editor Mary Carpenter reports on health news you can use.