Did you know the fear of falling can increase your risk of falling? The fear of falling largely affects the older adult population, especially during activities with a balance component. The correlation between fear of falling and falling is a vicious cycle. If a person falls then they will become fearful of falling again. Once they become fearful of falling then they have an increased risk of falling. People go around and around this cycle with no way out. You may ask yourself, but why does this happen? It makes sense that if you are fearful of something then you will do your best to make sure it never happens. However, this is not the case. Young and Williams explain that the fear of falling causes ‘stiffening behaviors’ when a person is attempting to maintain their postural stability which increases the risk of falls.
‘Stiffening behaviors’ are strategies people develop in response to fall-related anxiety to help control their posture during dynamic situations. These behaviors include shifting your concentration from outside your body to inside your body when performing a movement (the internal focus of attention) and reducing your visual search for external information. The strategies can potentially be beneficial during simple tasks that require a low cognitive load. However, the strategies can become hazardous during more complex situations that need a great deal of cognitive effort.
Walking is an example of a complex task that we need to accomplish without falling daily. On a flat surface with no obstacles or distractions, walking can be achieved with little attentional focus from the walker and limited challenge to your postural stability. However, most of life does not occur in these ideal conditions. We must walk outside on uneven surfaces and maneuver through crowds. These types of situations are the most demanding of our postural stability and therefore are when we tend to fall. Shifting our focus from what is occurring in the outside world to what is happening in our body causes the loss of the information we need to stabilize ourselves and prevent falls. Hence why the fear of falling and the risk of falling are closely linked and a dangerous cycle for older adults to be in.
You may be wondering how I get out of the cycle. The answer is physical therapy! Physical therapists are movement experts who work with patients to improve their ability to control their posture during dynamic tasks such as walking. Furthermore, physical therapists actively create interventions that will challenge patients in a safe environment to better prepare them for the most complex situations life has to offer. Physical therapists work to build their patient’s confidence in their balance and therefore reduce fear of falling. If you find yourself limiting the activities you love due to balance impairments or fear of falling, then contact us for a free consultation!
Young, William R., and A. Mark Williams. “How Fear of Falling Can Increase Fall-Risk in Older Adults: Applying Psychological Theory to Practical Observations.” Gait & Posture, vol. 41, no. 1, 2015, pp. 7–12., https://doi.org/10.1016/j.gaitpost.2014.09.006.