The risk of injury from falls increases as people age. To help prevent falls, physical therapist Bob Cairo recommends people see their doctors about any potential problems with balance.

When I visit with you here in the Coastal Point, I am always focused on talking with you about issues that I believe are important to you. Sometimes I decide to talk with you about an issue that we have talked about before because I am seeing so many patients with a problem that I know it’s time to talk about it some more. An issue often has many sides, and you can’t talk about all of them in just one visit.

In this case, it’s both. We’ve talked about this issue before, but I am seeing so many patients with this problem that I feel it deserves more attention and there is more than one part of this problem to share.

The issue is balance. We’ve talked about some of the sides of this problem before, but I’m seeing a trend that I don’t like, and I’m concerned. I am seeing so many patients with balance problems, and from my conversations with them, there’s a reason why I’m worried. People really don’t seem to understand the factors that together impact balance. The other reason I’m worried is what can happen when you lose your balance and fall.

The Centers for Disease Control & Prevention (CDC) still calls falls the public health epidemic of this decade. Think about what that means, given what we’ve been going through with the COVID epidemic and how many people have paid a terrible price or have seen a serious impact from it, and you understand what I mean here. This is serious business.

Any one of us who is 65 or older needs to understand the components of balance, because from that age on, balance problems become a big problem. The results carry a big price tag in more ways than one, and at the end of the day, the biggest issue is they are preventable.

Falls are preventable, and yet they are the leading cause of fatal and nonfatal injuries among the 65 and older crowd. And the kicker is we don’t really know just how big a problem it is, because a very big number of serious injuries and deaths from falls aren’t reported to the officials keeping all this data. So, when I am telling you it’s the biggest cause of fatal and nonfatal injuries in the 65-and-older crowd, that’s without having all the numbers.

Now, here’s a little local perspective: The last available federal falls data for states is from 2018 and in that year in Delaware, 26.1 percent of folks 65 or older had falls, and health officials know that number has continued to climb in the years that have followed.

Now, one last bit of data for you: By 2030, the expectation is that of the 73 million older folks in the population, 52 million will have falls and 12 million will be dealing with some big issues from them. At the heart of the problem, the biggest cause of falls is balance. That’s why I want to help you understand the key components of balance and how balance problems are treated.

There are three components to balance. There’s the visual system, the vestibular system, which is hearing, and the proprioceptive system, which is feeling.

The visual component involves the receptors in your retina. You’ve probably heard of them. They’re called rods and cones. When light strikes them, these receptors send signals to your brain that tells you about your orientation. Another words, it lets you know if you’re standing upright or lying down and everything in between.

The vestibular system, or hearing system, is made up of three canals that are semicircular and two small sacs, the utricle and the saccule, that are paired together in your inner ear. These two small sacs are the receptors that send signals to your brain tell you about horizontal and vertical orientation, or up and down and side to side. The semicircular canals are the receptors that sense rotation in your movement. Think about when you turn your head from one side to another, for example. They work together in sending impulses to your brain about your different movements.

The last component is the proprioceptive system, which is all about feeling and involves your sensory system including mechanics. This means your skin, your muscles and your joints are all part of this sensory system. They send messages to your brain about movements, so you know whether your leg is bent or straight or whether a hand is open or closed, even when you close your eyes.

Your brain puts together all the information from these three components to help you maintain your balance. When one or more of these components isn’t functioning properly, your balance is going to be impacted. It makes it hard to stand, sit or walk properly.

At the first sign of a problem with your balance, you need to go and see your doctor. Do not wait until you have a fall and really get into trouble. Keep in mind what I always ask you to do. Write down your history, including whether you have ever fallen before and always write down what medicines and vitamins or other supplements you are taking. Has anything changed since your last visit to the doctor? Are you seeing any other doctors? What are those other doctors treating you for?

And when you get to the doctor, be honest. Are you seeing a change in your strength? Has anything troubled you recently that might be keeping you from getting a good night’s sleep? Has your appetite changed? Put it all out there so your doctor gets a complete picture, because that’s how your doctor understands all the factors at work in your particular situation.

There’s a very good chance that your doctor will refer you to a physical therapist. That’s because physical therapists are movement experts, and it’s there where you will get a customized program that is supervised, and that means it keeps you safe. And remember that your physical therapist and your doctor will continue to share information so that everyone stays on the same page and you get the best possible results.

Your physical therapist is going to look at a variety of elements to determine how best to help you. The first visit may include an evaluation of your range of motion, the strength of your legs, how you do with your balance when walking, standing and sitting, and potentially other related issues.

After your first visit, your physical therapist will put together a treatment plan that likely will include balance training to help you become steadier on your feet. It might also include elements designed to build on your core strength and strengthening your legs and your arms. And, yes, arms have to be strong, too, because we use our arms to help us with functions like standing up when we’ve been sitting or getting up from bed. Your program might also have strength training for your spine. Proper posture has a direct impact on your balance, and that means you need a strong back.

I always leave you with something to think about, so here’s the last thought I want to share with you: Whatever you do, at the first sign of a problem with your balance, get help. See your doctor. Do not risk a fall. You want to get the very best out of every day, and having the best quality of life means taking care of yourself before you wind up with a much bigger problem.

Bob Cairo is a licensed physical therapist at Tidewater Physical Therapy. He can be reached by calling (302) 537-7260.