Clinically reviewed by What is fall prevention
Falling is not a normal part of getting older. It is a sign that something has changed and can usually be worked on. Roughly one in three people over sixty five falls in any given year, and it becomes more common with each decade after that.
In Urdu the worry is simply girna, and the fear behind it is hadi tootna. That fear is well placed. A broken hip in an older person often ends independence, and the first year afterwards carries a real risk to life.
The useful part: falls are among the most preventable problems in older people.
Symptoms you might have
- Holding the furniture or the wall to cross a room
- Needing both hands on the chair arms to stand up, or two or three attempts
- Steps getting shorter and slower, feet starting to shuffle
- Losing balance when turning, reaching up or bending down
- One near miss, or a fall blamed on a slipper or a step
- Having stopped going out, or stopped going upstairs or on the roof
- Dizziness in the first seconds after standing, or rushing to the toilet at night
Why it happens
- Weak hip and thigh muscles, the biggest single contributor and the most treatable
- Poor balance, and weakness after any long illness or hospital stay
- Medicines, particularly sleeping tablets, sedatives and blood pressure medicines
- Blood pressure dropping on standing, anaemia, low vitamin D
- Numb feet from untreated diabetes, poor vision, and new bifocal glasses
- Knee and hip arthritis, Parkinson's disease, weakness after a stroke
- Loose chappals with no grip, and a shalwar long enough to catch the feet
- Getting up and down from floor sitting when the legs can no longer manage it
When you should see a physiotherapist
Come after the first fall. Most families come after the third, by which time strength and confidence are gone too. A fall assessment covers leg strength, balance, walking, footwear, vision, a medicine list to take to the doctor, and the house itself. Dr. Zahra does home visits, because half the problem is in the house.
After a fall, if the hip or leg cannot take weight, or the leg looks shorter or turned outwards, do not try to walk the person. Go to hospital for an x-ray. Go the same day for any head knock in a person on blood thinners, and for any fall followed by vomiting, drowsiness, sudden confusion, a worsening headache, or any new weakness or change in speech.
Al-Shama Physiotherapy Clinic
Ask about an appointment
اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
Exercise is the treatment that actually reduces falls, and the evidence is specific about what kind. Programmes with a strong balance element, done at least three times a week and kept up, reduce the rate of falls in older people living at home by around a quarter.
- Challenging balance training, progressed until it is genuinely difficult: narrowing the feet, standing on one leg, head turns, reaching and stepping, always with support in reach
- Progressive leg strengthening for hips, thighs and ankles, with resistance added over weeks rather than the same ten repetitions forever
- Sit to stand and floor transfer training, including how to get down to and up from the floor safely, which matters in homes where people sit on the floor
- Walking aid provision and sizing, with training in using it on steps and in the bathroom
- Home hazard assessment with the family, room by room
- Manual therapy, ultrasound or TENS for the painful knee, hip or foot limiting walking
There is no operation that prevents falls. Where arthritis or a cataract is the main driver, treating it helps, and that is a doctor's decision.
Exercises, and what to avoid
What helps
- Sit to stand from a firm dining chair without using the hands, ten times twice a day. The most useful exercise here
- Standing balance at a counter: feet together, then heel to toe, then one leg, thirty seconds each
- Heel raises, side leg raises and step-ups onto a low step, holding the counter
- Walking every day where it is safe, including a short stretch of uneven ground
What to avoid
- Standing on chairs, stools or beds to reach a shelf or clean a fan
- Walking in socks on tile floors, and in loose backless chappals
- Rushing: to the door, the phone, or the toilet at night. Most falls happen in a hurry
- Giving up walking after a fall. Fear leads to weakness, and weakness to the next fall
What you can do at home
Start with the bathroom, where a large share of falls happen. Non-slip rubber mat in the bathing area, floor wiped dry after every use, a grab rail beside the toilet, and a plastic chair for bathing.
Clear the floor: no loose rugs or curled mat edges, no trailing wires, and a clear path to the bathroom.
Fix the light: a switch reachable from the bed, a charged torch for load shedding, and light at the top and bottom of the stairs.
Put a handrail on the stairs, use it on the roof staircase, and never carry things up with both hands full.
Raise the bed to knee height, shorten the shalwar hem so it clears the feet, and swap loose chappals for closed shoes. If getting up from the floor has become a struggle, sit on a firm chair instead.
How long it takes
Strength and balance measurably improve in eight to twelve weeks. Confidence usually follows a few weeks behind that.
The reduction in falls needs the exercise to continue. Stop for two or three months and the benefit largely goes. The programme is written to be done at home three times a week for years, with a review every three to six months.
Home modifications work immediately and permanently, which is why they are done in the first week.
Fear of falling takes longer than the strength does. It improves with graded practice, doing slightly more each week with support nearby, rather than with reassurance.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
گرنا عمر کا لازمی حصہ نہیں ہے، یہ علاج ہونے والی چیز ہے۔ پہلی بار گرنے کے بعد ہی رابطہ کریں۔
فائدہ دو چیزوں سے ہوتا ہے: ٹانگوں کی طاقت، اور توازن کی ورزش۔ ہفتے میں تین بار، اور مسلسل۔ سب سے بہتر ورزش: کرسی سے بغیر ہاتھ لگائے اٹھنا، دس بار، دن میں دو دفعہ۔
گھر میں: غسل خانے میں ربڑ میٹ، فرش خشک، نہانے کے لیے پلاسٹک کرسی، بیت الخلا کے پاس ہینڈل، سیڑھیوں پر ریلنگ اور روشنی، اور بند جوتا۔
اگر گرنے کے بعد کولہے پر وزن نہ آئے، یا ٹانگ چھوٹی یا مڑی لگے، تو چلانے کی کوشش نہ کریں، فوراً ہسپتال لے جائیں۔ سر پر چوٹ، الٹ، غنودگی یا اچانک الجھن ہو تو اسی دن ہسپتال جائیں۔
Roman Urdu
Girna umar ka lazmi hissa nahi hai, ye ilaj hone wali cheez hai. Pehli bar girne ke baad hi rabta karen.
Faida do cheezon se hota hai: taangon ki taqat, aur tawazun ki warzish. Hafte mein teen bar, aur musalsal. Sab se behtar warzish: kursi se bina haath lagaye uthna, das bar, din mein do dafa.
Ghar mein: ghusalkhane mein rubber mat, farsh khushk, nahane ke liye plastic kursi, toilet ke pass handle, seerhiyon par railing aur roshni, aur band joota.
Agar girne ke baad kolhe par wazan na aaye, ya taang chhoti ya muri lage, to chalane ki koshish na karen, foran hospital le jayen. Sar par chot, ult, ghunodgi ya achanak confusion ho to usi din hospital jayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
How can I stop my elderly parent from falling?
Is falling just part of old age?
What is the single best exercise to prevent falls?
My mother fell and now she is afraid to walk. What do we do?
My father fell but he is walking. Do we still need an x-ray?
Related conditions
- Parkinson's disease physiotherapy
- Osteoporosis and weak bones
- Bed sores, prevention and care
- Balance problems in older people
- Difficulty walking