Falls

When my medication is working my movement is good though a little dysfluent. However, my balance has gradually got worse. My physio gives me exercises eg walking on tip toe etc etc and I also use the Wii fit balance exercises and a big gym ball .

I started tripping over about 18 months ago -mostly just a bruised knee and injured pride but a few days ago I had my second serious fall in 7 months. The first fall I broke my nose but it healed very quickly without visible damage- all family and friends reassured me that it could have happened to anyone - the kerb was too high etc etc. Last Friday I put my foot in a pothole (so I was told by a kind 'rescuer'who saw me fall) and crashed into the ground face first. I spent Sunday having my mouth painstakingly sewn back together again and tooth re construction starts in 3 weeks.

Two major facial injuries in 7 months is not good. I think the falls are occurring because when I trip I can't recover my balance \and for some reason my arms/hands don't reflexively move to break my fall- the experience of seeing the ground coming up to your face and then the awful thud as you hit it, is pretty traumatic and I'd [refer it not to become a habit.

I dont' find a stick helpful as I walk fairly normally so don't need it to lean on. and actually found having a stick very difficult to manage - ironically I kept tripping on the stick itself.

I'm not willing to give up my independence and refuse to let fear of smashing my face up yet again stop me. I know, however, that inevitably I will have more falls but I would love to know if anyone has found a way of teaching themselves how to recover from a trip? Or how to preserve the face? Short of permanently wearing an American footballer's helmet with protective bars over the face, I'm stumped.

Any advice welcome!

31 Replies

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  • Losing capability is inevitable, but we admire your grit!

    I agree that exercise can help delay Parkie. I discuss reasons for this in my reply to another post this morning healthunlocked.com/parkinso...

    Perhaps you will find something helpful. Best Wishes.

  • Thank you so much for your very helpful reply. It makes so much sense. I recognise the feeling you describe of core muscles being unable to support the body - when even sitting on an upright chair is impossible. I shall also show your explanation to my family who don't seem to understand that a muscle can only work properly if the signal from the brain isn't disrupted.

    I shall follow your guidelines - breakfast in bed sounds a fine idea!

    Re admiring my 'grit' - many thanks , I am pretty determined - at the moment trying to stop any more grit being embedded in my face!

  • Nothing like a bit of grit! Though preferably metaphorical rather than embedded in one's mouth and chin!!

  • Find a safe place where you can practice with hazards and uneven terrain. Something like a sandy beach with dunes.

  • I have found having to walk over drift wood at the beach and large rocks crossing a stream really helped my balance. Like @park_bear suggested, find a safe place to practice your balance stepping on and over obstacles.

  • As it happens my daily workout mostly consists of rock scrambling. Great for balance and stretching.

  • Now that's funny! Something else that's funny~~I just fell a couple hours ago. I was just standing & toppled right over thankfully on my left side & not my right where I had a hip replaced a year ago! Also broke my right shoulder in 4 places 3 years ago which still hurts. Yes, I feel the pain!

  • I have the same problem, I think I should have been a professional stuntman. The only thing I have found is exercise ( walking ) is good for you. Of course, this exacerbates the problem. However, I continue to walk between 2-4 miles a day, I refuse to give into it. Do you use a walking stick? I know there is a pride issue using one, but it does help.

    ,

  • Sorry, I should have read your post properly.

  • I used to trip over the stick too, but I am used to using it now. I have been diagnosed 11yrs.

  • Any endeavor requires the support of your family. This is not a solo effort. Next, get a good Physical Trainer.

    We are behind You!

    FJohn1

  • Thanks to everyone for the encouraging replies . I will not give in and allow fear of falling to stop me going out. I will take all the advice here . One change that I hope will help is that I will not try to do anything else while I am walking - eg search in bag for keys etc or do up coat or even look back. If I need to do anything I will stop walkng first .

  • I don't know anyone that can find anything in their handbags quickly, seems like they have eveything needed in life in there:-)

  • Are your falls related to your levodopa levels? If so, increasing the dose and/or frequency may help.

    Have you developed a stoop? If so, correcting this may help. (Easier said than done.)

    You could set up a safe place to practice falling.

    I spend a lot of time standing on one leg. I think this helps my balance.

    Nordic walking/trekking poles may be socially acceptable.

    John

  • Yes by all means use trekking poles.

  • My movements become rather agitated and jerky as leva dopa starts to work and as it wears off. I stoop only when in a bad off period at which point I wouldn't be able to walk around on my own . I'm told that I walk too fast when 'on" so am concentrating on slowing down. An odd aim for a PWP!

  • You might try refining your balance safely by kneeling in front of a couch facing it. Close your eyes and see if you can hold your balance. If it's too easy tip your head backwards as if you were looking up to the ceiling but keeping your eyes close. See if you can do this. It can help you.

  • This sounds useful but sadly brings on my never-very-latent vertigo. .

  • Hi Pen. I sympathize with you and have experienced many falls myself. It is difficult to explain what I have learned to do to overcome this problem and also to avoid the facial injuries. Here goes:

    I assume you have Pd? When we walk normally our movements are controlled subconsciously. That means we are not thinking about our leg and arm movements, they are happening subconsciously. When we have Pd, we have to walk differently to overcome this by concentrating all the time on each movement. It is impossible to concentrate on every movement all the time so I suggest that you go through this routine:

    1. Stand up straight, with your shoulders down and held back and your head held high.

    2. Place your weight on your left leg, so that you are able to lift your right leg off the ground without losing your balance.

    3. Bend the right knee and stick your right leg out in front of you, while moving your body forward, and then straighten the leg and land the heel onto the ground, with the toes pointing up in the air at about 30 degrees.

    4. Lift the left foot off the ground and bend the knee as you bring the left leg past the right leg and stick it out in front of you and then straighten the leg and land the heel onto the ground with the toes pointing up in the air at about 30 degrees.

    You will find that if you concentrate on landing the heels on the ground you will maintain your concentration.

    When you have been concentrating on your heel landings for quite a while until it is happening at a lower level of concentration, then you can start concentrating on pushing up on the toes of the grounded foot so that your body weight is being carried on the toes of the grounded foot and not on the heels. In that way you will be walking very well balanced and in total control. If you are walking over uneven surfaces you will feel very safe and when you trip you will be able to save yourself, because you were balanced properly when you tripped.

    Try practicing falling on a soft surface and as you fall, twist your upper body round so that your body rolls when it hits the ground. Never put your arms out in front of you but roll onto your left arm and shoulder. Get someone to help you with this.

    If you would like to email me at johnpepper@telkomsa.net I will help you with this, at no cost to yourself.

    Good luck!

  • Thanks John This is very similar to an exercise I do already but instead of standing I sit on a giant gym ball. I find it very difficult! Do you think it's possible actually to improve balance or is it slowing progression?

  • Hi Pen. I am not a doctor, I just pass on what works for me.

    I found that with my fast walking, he stronger I got the less I lost my balance.

    I think that loss of balance has at least 2 components.

    1. Lack of muscular strength to rectify the fall, as it is happening.

    2. The brain's lack of ability to tell the muscles that I am falling and my reaction to that message is always too late.

    I have found that I have very little problems with balance these days, so to answer your question I think it can and does come right if I am keeping my self fit.

    I did a 5 kilometre cross-country race this morning against athletes of all ages and both sexes. It was over very uneven surfaces, with potholes and narrow pathways. I tripped and stumbled many times, but never fell to the ground, which tells me that everything is working well. I am 82 years old and not as strong as I would like to be.

    I hope that answers your question.

  • Hi Pen,

    nice to see you again. I have only fallen a couple of times but that slap bang with no ability to break the fall by converting to a stumble or putting an arm out was really weird. I fell like a log all over in one piece. I guess its connected to our balance issues.

    Here is one study with a few interesting observations and suggestions, and it seems to be falls might involve different neronal pathways not just the dopamine one.

    nature.com/articles/npjpark...

    The only advice i have is to remember to lift your feet. I dont think we realise when we are not. Especially on paving stones i have to be focused and sometimes i ask to hold someones arm, like you i dont generally need a stick. People actually like helping in that way i find.

  • Thanks Hikoi and good to be in contact again. This is a very interesting paper and I will try to discuss it with my new neuro team. According to this paper I'm at high risk of falling so I know I must develop strategies to minimise damage -specially to my face.

  • Hi,

    I did that for a year before I had a diagnoses.I am in OT, and PT, Where they work with my balance, etc. Has helped muchly.

  • There is a condition called "dropped foot" involved in a number of conditions. In line with John Pepper's post, you do not realise you are randomly letting our t oe down first instead of y our heel. If exercises don't work, there is an gizmo which uses electrical stimulus to encourage the correct gait. Before diagnosis I tripped over and realised that I had not been able to regain my balance as o ne would normally. This was the worst of a number of "tripping over nothing" incidents but this time resulting in a fractuured wrist. Later I found out what the pr oblem had been - Mr,, P

  • My balance is also getting worse. I had a scare today: I live in a big city, Bangkok, and I walk on crowded sidewalks everyday. Today, I almost fell but luckily was able to regain my balance in time. What was scary is that I almost fell on a young child walking down the street. If I had fallen on him he would most probably have been seriously injured (or even, God forbid, killed.) I weigh 185 pounds.

    This really scared me and got me thinking maybe I'm being selfish thinking it's OK to walk in public.

  • pen1

    My dear friend, falling on your face, breaking your nose and teeth is no small thing!

    Comfort to you!!

    wikihow.com/Fall-Safely

    wikihow.com/Fall-Without-Hu...

    Maybe there will be something in one of these articles that may help.

    Blessings, Eva G :)

  • Hi Pen

    Nice to see your name again, I was diagnosed 11+ years ago and I find my balance is causing me problems. So far I have had a lot of near misses. I also use the Wii Fit a lot and have just started Tai Chi classes as I have heard this can help balance. So far I have managed quite well but it is too early to say that they are helping me. I am also considering joining a Pilates class, but believe this involves some floor work (it would take me too long to get up) so I may have to give these a miss. Do take care/

    Sue_

  • Hi Sue

    Good to hear from you but sorry you're having a pretty rubbish time too. It's so hard when one's children refuse to acknowledge that things have changed and now you need a bit of kindness and to be cut a bit of slack. I'm so sorry to hear about your daughter's problems. My daughter has decide her life is better if she has no contact with me. I wrote a reply to you yesterday but seem to have lost it. If I sent it sorry to duplicate! I've only just woken up so not on full power yet . I'll reply properly in a couple of hours . ( I ve already started getting hot under the collar about this year's PD uk Awareness Campaign! )

    Very best wishes

    Jan

  • Jan

    Please don't get too excited about the Parkinsons Awareness Campaign. I just hope we don't get fed up with all the TV and paper coverage!! We put forward a good few ideas all that time ago, didn't we. Now I do not have the energy or inclination to get involved. I think am getting tired and old age is catching up with me.

    My husband does not cut me any slack and does not understand the apathy and complete tiredness associated with Parkinsons. Mind you he ensures that I keep active. We still look after our three grandchildren. The eldest one, 12, is staying with us at the moment, while her mum is unwell. I have an appointment with my Consultant next Wednesday as my meds are not lasting as long. It maybe that my expectations are too high.

    I am so sorry to learn that things are no better with your children. I cannot offer any advice. Surely, they realise that you could do with some help. After all, I am sure that there are many times in the past when you helped them. I feel like knocking their heads together, mind you they are probably too big for me. Don't give up on them. Family is so important and in the end are all we have got.

    I will be thinking about you when the campaign arrives and will have a little giggle. You take care. No more falls - I know this is easier said than done. My physio advised me to always put my heel down first when walking and I have found that does help .I hope that things work out better for you soon.

    Sue

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