How Your Podiatrist Can Reduce The Rate Of Elderly Falls By A Proven 36%

Posted 5 Sep '22

While podiatrists aren’t often the first profession that comes to mind when it comes to preventing falls among older adults, our Brisbane-based team of podiatrists have a very strong focus on falls prevention - and with good reason. Falls are currently Australia’s leading cause of injury deaths, with a falls-related death occurring approximately every 2 hours. Looking at the statistics more closely, 40% of all of Australia’s injury-related deaths are caused by a fall, and falls are the cause of 42% of all of our hospitalised injuries. One in three people aged 65 and over have at least one fall every year that will result in a hospitalisation. That is one Australian being admitted to hospital from a falls-related injury every 5 minutes, and more deaths from falls than from car accidents and transport-related fatalities.

So why aren’t we talking about the true impact of falls?

Many people think that there’s nothing left to do outside “being more careful as you get older”. But that’s not a strategy, that’s a fall waiting to happen.

Research shows that over a third of falls are PREVENTABLE.

That’s 8 Australians a day whose lives could be saved. And with these lives, immense heartache and suffering for Australian families that could be avoided. And billions of dollars from our health system. So our team at The Feet People are out to put a stop to preventable falls.

Australians aged over 65 years more falls than all the other age brackets combined, so we know that it’s important to consider an approach to falls prevention that is specific to this group and any age-related changes and challenges.

By staying up-to-date with emerging evidence and studies paired with working with many older adults every day, we’ve seen first hand the difference that can be made when we administer a multifaceted falls prevention program to the elderly. And the research is behind us, showing that a person’s fall risk can be reduced by 36% when working with a podiatrist. 

The only sensible way to treat a serious fall is to stop it from happening, so how can our podiatrists help you prevent a preventable fall? Here are just a few of the approaches to care that we offer.

Footwear Assessment

Footwear is well cited as a strong contributor to a person’s falls risk. This is as shoes influence a person’s comfort, balance and gait by altering the feedback provided to the foot and ankle from the ground while modifying the friction available for stability at the point where the shoe meets the floor. In simple terms, your shoes become the ground you walk on and can either carry you safely throughout your day - or throw you off and make daily movement and balance much more tiresome. Studies have also shown that 72% of older adults may be wearing shoes that do not fit both feet correctly, which also has a notable impact on gait and balance.

Your podiatrist will work with you to assess your current range of footwear both outside and inside the home, as studies have advised that wearing shoes inside the home can help reduce your falls risk compared to walking in bare feet, socks or slippers. Our podiatrists have comprehensive knowledge about a wide range of shoes, including those best suited to older feet that suffer from conditions like bunions, diabetes, claw toes, age-related changes like thin fat pads, and more. We can recommend certain brands and styles, like those with the best traction for a variety of surfaces and conditions, and are also one of few clinics in the area that carry out our own shoe modifications so that you may be able to continue wearing your favourite shoes with some minor adjustments.

Custom Foot Orthotics

Custom foot orthotics are a large contributor to falls risk reduction because of their entirely customisable nature to achieve a wide variety of goals, and the expertise and care that goes into their prescription from our podiatry team. Orthotics can work in multiple ways: they can best support the feet and adjust the way each foot moves through the gait cycle, which changes how muscles are activated, and the feet are loaded with every step. They can promote balance and stability by essentially doubling the proprioceptive feedback to the brain which improves balances. They can also accommodate a wide range of foot shapes and structures and deformities including painful protrusions, corns, calluses, prominent joints and much more, with the goal of making each step less painful and more comfortable and supported. Typically, orthotics will carry out many of these functions to meet each person’s unique needs.

Here at The Feet People, we are well-known for our expertise in our orthotics. Every prescription has years of knowledge and experience behind it, starting with a comprehensive foot assessment with our podiatrists to understand what will best help you to both improve your gait and foot comfort while reducing your risk of falls, and pairing this with a 3D foot scan of your foot to provide the best base for the orthotic that is completely tailored to you - and not some generic foot that doesn’t understand the challenges you face. The use of orthotic insoles has been shown to improve postural stability in studies of older adults.

Treating Or Managing Foot Problems

Foot problems in older people are shown to be associated with falls.^, Specific risk factors include foot pain, stiffness at the ankle, having a bunion, and reduced toe strength. Additionally, toe deformities and the presence of corns and calluses are common contributors to a person’s falls risk that we see in our clinic because of the way that they can alter a person’s gait and therefore stability.

Podiatrists are the best suited health profession to treat and manage these problems, with all the mentioned attributes being in our list of expertise and experience. Podiatrists manage painful foot problems from a wide variety of causes, from activity-related injuries to arthritic pain. We help support stiff ankles and minimise their impact on the foot while offering solutions to better accommodate bunions and improve toe strength (see below). We debride and remove corns and calluses, while also making accommodations for toe deformities. Podiatrists are the go-to for foot pain and problems.

Strength And Balance Exercises

Very recently in June 2022, a study was published that unexpectedly showed that a person’s balance between the ages of 51-75 years was a predictor of death or survival over the following twelve years. Specifically, the researchers evaluated a person’s ability to perform a single-legged balance test where each person needed to stand on only one foot on a flat surface with their hands by their sides while looking forwards. They needed to be able to do this for ten seconds to pass, and each participant had three attempts to pass. At the conclusion of the study, even after adjusting for the age and individual health variables of the participants, they found that those who could not complete this test had a 84% higher risk of death over the length of the study (12 years) compared to those who passed the test.

While the study is not unique in its evidence for the importance of balance for falls prevention, and of strength exercises as a way of supporting and improving balance, both of which are heavily cited throughout the literature, it does powerfully reinforce that a fall isn’t a one-off event for many older adults. Suffering from one fall greatly increases your risk for another, and the injuries sustained in your fall may affect your mobility, pain and quality of life - all of which (alongside many other factors) can compound to influence mortality.

Our podiatrists design exercise programs that work to safely and gradually improve strength and balance. Each program is tailored to a person’s level of mobility and function, meaning that you aren’t lumped with unrealistic exercise plans or expectations. Your podiatrist supports you every step along the way and modifies your program as you progress through and see tangible changes and improvements. One study that found a 36% reduction in falls risk was achieved, when participants carried out an exercise program only three times per week, making it very manageable.

Falls Prevention Education

If you don’t know about it, you can’t take the best steps to manage it or remedy it. That’s why in our falls assessments and treatment sessions with our patients, education is a key component. Numerous studies have shown that tailored education results in increased engagement in falls prevention strategies.^,

Aside from being able to educate you on the various aspects of falls prevention both in your home and when you’re out and about, with various appointments throughout the year, our team also modifies the information to stay relevant to your existing circumstances, living conditions, and in light of medical conditions or injuries. We also offer take-home information for falls prevention and can guide you to additional trusted sources online.

Timely Referrals

Another way that podiatrists play an important role in falls prevention is through the delivery of timely referrals. It is well documented that the best approach to falls prevention involves a multidisciplinary team. During any of your appointments with us, if we detect any changes or concerns that may indicate that you could benefit from the involvement of a health professional that you are not currently working with, such as an occupational therapist, we can refer you promptly. This ensures that new needs and changing aspects of your care are not ‘missed’, and you maintain the best care from a trusted team.

To work with our podiatrists to help you or any of your family members prevent falls and improve your mobility and confidence on your feet:

Book your appointment with our podiatry team online here or call us on (07) 3356 3579.