Friday, March 21, 2014


We have quite a few patients that fit into the frequent faller category... and so it was with my first patient of the morning.     Let me just say from the start that sometimes a therapist needs a little of her own medicine.

Most times, when focusing on balance, I like to start from the bottom up and that means shoes.  I told my long lanky 91 year old that she needed to get out of her cinderella flats and get into sneaker type support shoes.  She looked at me with fear and said: “I just cannot bend down and tie them.”   Okay second defense I began: “I am sure you could find some with velcro straps.”
“Nope, those make me look like too much of an old lady.”  We both laughed and then I took another shot:  “You have fallen 3x in 3 months,  Time to get serious and support your whole body. “  Next, she gets up and as I have done so many times before I follow  her to the closet as she bends down to pick up some red shoes; ones that she says: “have spiders in them because I have not wore them in so long.”

She realizes she can bend over and tie these red  shoes and  also when  She stood up  she   she was picking up her feet and striking her heel down first ;more or less looking like an old woman walking rather than old woman shuffling..
Okay first mission accomplished.
Now let the games begin:
Therapist: “Lets stand up and hold my hands and start rocking from side to side.
Her knees are turned inward, her hips move as if they belonged to a stick figure, a marionettes version of swaying.
“Now lets lunge forward, think of growing roots underneath your feet” I continue as she clings tightly to my hands.  “Soft body” I say, let the tension fall away.” and yes for a second she is moving easily and getting into the swing of it and then I say to pretend that she has a hula hoop and make bigger circles in her hips.
 I tell her this is the beginning of balance.
When the warm up is over, we move to walking outdoors.

Right foot, left foot, right foot,  left foot; onto gravel, then pavement and then watch that pothole and breathe.
She walks and we talk about slowing down.. about how hard it is not to go into automatic pilot and just  "go thru the motions."
Practice feeling each foot hit the pavement, each stride a little longer than the last, keeping your shoulders loose and breathe.. So easy to say isn't it?  All these things we take for granted that fall away when our bodies lose elasticity in muscle, strength,  balance.
 You can call it purposeful walking.  Paying attention to each movement.... in essence that is what our brains have been designed to do.   They get us going...No movement is possible without signals firing up and down from brain to spinal cord to muscle!

In a funny way, I sometimes think of myself as the fairy godmother in The wizard of Oz..  Sure I cannot tell my patients to click their heels together and close their eyes and have them say: "I will walk again:
But I do say: "YOu always had it in you my dear.. you did not just go thru the motions but you once stood triumphant on those two feet and looked up at your mama and said: "I am free, I am free to roam now."
And roam and roam and roam you did   91 years worth...
You now can say to yourself. "Look ma, I am still here, I am still here.. "