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Falls and Concussions in Older Adults

“Help, I’ve fallen and can’t get up.” Many of us have heard this catchphrase from the Life-Alert commercials, but for some older adults these commercials touch on a very real fear: falling. Falls are the leading cause of fatal and non-fatal injuries in older adults, and according to the CDC one in four Americans over 65 years old fall each year.

For many older adults, falling is associated with stories of friends or family members who suffered a hip, wrist, or ankle fracture. This focus on broken bones, often leads to the under recognition of less visible trauma, like concussions. Just as you would want to check for bruises and broken bones after a fall, it is important to assess for signs of a concussion


What is a concussion?

A concussion is a mild form of traumatic brain injury that causes an alteration in mental status and may or may not involve a loss of consciousness. Now to break down that definition: a concussion is an injury to the brain that causes some type of temporary change in the way we think or feel. These changes may include: memory problems, difficulty concentrating, foggy thinking, anxiety, depression, or mood swings. Other possible symptoms of a concussion include: dizziness, headaches, nausea, balance problems, sensitivity to light or noise, and sleep problems. It’s important to note that no two concussions are the same. Two people, both with concussions, could be experiencing completely different symptoms. Assessing and diagnosing a concussion becomes even more difficult when symptoms like balance problems, difficulty concentrating, and memory problems are considered a part of “normal aging”, when in fact they may be signs something is wrong.

What causes a concussion?

Concussions can be caused by a direct blow to the head, face, neck, or anywhere else on the body. Falls are the most common cause of concussions. Other common causes of concussions include motor vehicle accidents and sports injuries. Keep in mind you do not need to lose consciousness or hit your head to sustain a concussion. So even a hard fall onto your back after slipping on ice could result in a concussion!


can physical therapy help treat concussions?

Physical therapists are movement experts who can work with you to restore balance, build strength, prevent falls, and recover from concussions or dizziness.

Fall Prevention

The best way a physical therapist can treat a fall is to help prevent it from happening in the first place. Physical therapists can help assess a person’s risk for falling. After assessing this risk, a physical therapist can develop an individualized treatment program to focus on fall prevention strategies, improve balance, strength, and mobility.

Post-Concussion Care

Most people recover from a concussion in a few weeks, but for some recovery can take much longer. This longer recovery time may be indicative of persistent post-concussive symptoms. This occurs when symptoms such as headaches, dizziness, and problems with concentration and memory linger longer than expected. A physical therapist can help determine the source of post-concussion headaches and utilize tools like manual therapy to treat this symptom. A physical therapist may also work on balance and stability exercises and incorporate mental challenges to improve symptoms of unsteadiness and concentration problems. A physical therapist will also work with you to slowly increase your strength and endurance without increasing concussion symptoms to allow you to return to all your normal activities.

Dizziness

Dizziness is one of the most common complaints in older adults with at least 25% reporting that they feel unsteady or off balance. Dizziness can have many causes. A physical therapist can determine what is causing the symptoms by performing a thorough history and examination. Sometimes dizziness presents more like a spinning sensation which is called vertigo. If you have ever ridden the tea cup ride at Disney World, then you have likely experienced the sense of vertigo when the ride stopped. The most common cause of this vertigo is a condition known as benign paroxysmal positional vertigo or BPPV. This is caused when crystals in the inner ear become dislodged from their normal position and travel to the semicircular canals. The semicircular canals are the portion of the inner ear responsible for helping us keep our balance when we turn our head. When the crystals fall into the semicircular canals they disrupt our normal sense of balance, making us feel like the room is spinning.  A physical therapist can diagnose and resolve the BPPV by performing maneuvers to reposition the crystals. Symptoms of BPPV can resolve in only a few physical therapy sessions.


The physical therapists at Des Moines University clinic have been trained in concussion management, sports, and vestibular therapy. They collaborate with other health care providers in the Des Moines area for concussion management. If you suspect a concussion or BPPV and need treatment, our exceptional physical therapists at the Des Moines University Clinic can help. We are currently offering in-clinic and virtual appointments for patients. Visit the DMU Clinic website or call 515-271-1717 to learn more.

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Paige Vaden, D.P.T.'21

Paige is from Johnston, Iowa. When she’s not studying, she enjoys spending time with friends and family, staying active, and trying out local restaurants and coffee shops.

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