My wife is a first responder, so we frequently have a scanner on our kitchen counter playing the local radio traffic. On any given day, I’ll hear at least two EMS calls for an elderly person that fell and needs EMS care. Most of these falls are at home and range from people in their 60’s to 90’s.

I’ve known the data for years. According to the CDC, 14 million seniors fall every year. More than 40,000 of these people die. It wasn’t until I started hearing the radio traffic that the data became real to me. We live in a small midwest town, and every single day I am listening to real EMS traffic about seniors in my area falling. For some of them, it’s life altering. Just a regular Tuesday evening at home with their spouse can turn into a nightmare.

Falls are just like anything in life, most people underestimate their risk. I’ve often heard about how relatively fit and active some of these people are. “She loved to garden, swim and walk the dog”. Unfortunately, these aren’t the types of activities that prevent or at least make falls recoverable. Falls happen for a few reasons: poor eye sight, medications, weakness, poor gait mechanics and vestibular dysfunction to name a few. I want to focus on weakness and poor gait mechanics, because these are the two most influential factors that are in our control. We can train these systems, and thankfully they are very responsive to strength training no matter how old you are, but HOW you train them matters immensely.

Let’s start with a very brief overview of muscle physiology. Humans primarily have two different muscle fiber types – type I and type II. The loss of type II muscle fiber size and function is largely responsible for age -related muscle loss, weakness and deterioration of gate mechanics. Type II muscle fibers help us move fast and powerfully. Think tripping and being able to catch yourself before you fall. The question becomes, will you be able to move quickly and with enough power to catch yourself when you get off balance? If you train the systems correctly, you should be able to. The only way to train your type II muscle fibers is by performing exercises with enough intensity that these fibers get recruited. Heavy loads or fast movement is the only way. I wish it was easier. Low intensity strength training will primarily work your type I muscle fiber, and these are already intact in most seniors. This is where the term “old man” or “dad strength” comes from. Old men in particular hold on to their slow squeezing strength, but their ability to move quickly powerfully is largely gone. This is why someone can seem strong, but still be susceptible to a fall.

Now let’s touch on balance. Balance deserves its own article, so I will give you an overview of how to improve your balance. My first advice would be to mostly avoid exercises that look like a balance exercise. They aren’t dangerous, just ineffective in improving your balance. Balance is task specific. Imagine a tight rope walker, as you can imagine they have impressive balance. As long as they are on a tight rope and not a snowboard. Both require balance, but they are two completely different tasks. The best way to improve your balance is to have stronger, more explosive muscles in the hips, knees and ankles.