Fear of Falling
Fear of falling is the most common fear reported in older adults and it causes changes in behavior, as well as four predictable changes in walking pattern.
Many people who fall or feel off balance develop the fear of falling. Some people may develop a fear of falling from hearing about their friends who have fallen.
People who fall often start limiting their outings and social activities due to a fear of falling, which can lead to social isolation and sadness. Interestingly, most falls occur on level surfaces inside the person’s own home.
That fear also then leads to social anxiety where individuals don’t want to leave the home. Sometimes due to falling, individuals can even develop agoraphobic behavioral tendencies.
Eventually, the fear of falling can lead to depression and suicidal ideation, as well as increasing the caregiver burden and reducing the quality of life.
Four Predictable Changes to Walking
A research team at the University of Pittsburgh, lead by a well-known physical therapist named Susan Whitney, has discovered that fear of falling creates four predictable changes in the walking pattern:
- less arm swing
- less trunk rotation
- shorter steps
- less stability from side to side
With less stability from side to side, fear of falling can mean that you’re more likely to tip over to the side. For example, if you’re not swinging your arms, you’re more likely to tip over.
If we can get on top of this by educating our community on fall prevention strategies and providing appropriate care after the very first fall that an individual experiences, then essentially the ripple effect is that our whole community will benefit.
Fear of falling should be reported to the Primary Care Physician, so the physician can make appropriate referrals such as the Vestibular Rehabilitation or other Physical Therapy.
Disclaimer
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
I have recently had two falls in a two month span breaking bones in both. The second fall happened while I was just walking my dog. I fell for no reason, lost my footing went down hard and broke two ribs and my collar bone. It was excruciating. It was the most painful experience of my life. I still have nightmares about it and relive it in my mind daily. I am now terrified of falling. I walk with a walking stick and take very deliberate steps. It’s compromised my whole life… I don’t know how to move on from this.
Hi Diane,
I am sorry to hear of this awful story!
You may need to seek out psychological support through individual counseling or group therapy moderated by a professional.
Some patients can develop trauma related mental health issues after such severe and terrifying falls. You are not alone!
I suggest that you talk to your doctor about how to find a local, qualified mental health provider to support you as you work through this.
This article about PTSD may help.
This article on the link with anxiety may be helpful.
If you have not already engaged in physical therapy to work through any pain and balance issues, I suggest you ask your doctor for a referral to physical therapy also.
I hope you feel better soon!
Sincerely,
Kim Bell, DPT