Well with the movie version 'Cats' out, I suppose cats are all the rage at the moment. Watching the movie makes you realise that watching humans overlaid with computer generated images that sort of look like cats and doesn't translate so well when its not on stage. I Think theres a big difference between sticking on a cat costume on stage and actually trying to look like a cat. But enough of being a film critic, what has any of this got to do with Physiotherapy, Sports Therapy or even Sports Science 🤔?
Well actually quite a lot! because it gets you thinking about how cats behave and move and the particularly, how they fall, because last week we started looking at trips and falls. In our previous blog we explored the causes of trips and falls and how we can recognise and manage them.
Why might I hurt myself if I fall?
All this cats stuff got me thinking about the number of people we see who fall for whom the fall results in injury, often in the form of a broken bones, whys do some people fall and get away with bruises but others break bones. Certainly one of our clients who used to fall on a regular basis, would always brake a bone, whereas another always got away with it.
Some of this comes down to the strength of your bones and whether or not osteoporosis (weakening of the bones) is present. Osteoporosis, by the way, is something that can be successfully reversed with loading of the bones and that doesn't need to mean walking, there are many exercises that can be constructed to work even for almost immobile clients that will load the bones effectively.
However, in the case of our two clients, there was a notable difference between the two, one despite their balance issues was quite active and flexible, the other was less active and moved in a very traditional stiff manner.
Does flexibility help to prevent injury?
Cats are very flexible through the spine. As they fall they can rotate to orientate and position themselves it's one of the things that allows them to fall and not hurt themselves. Whilst humans are a little different in how we can rotate our spines, it still holds true that if we are flexible in our spines too, then we can rotate ourselves into a position that can arrest a fall or at least allow us to land in a less harmful position. We lead this rotation of the body with the head, where the head turns the body will follow so at the very least a good dose of yoga, thia chi or a personalised daily exercise programme would help here. 😀 Our client who never broke anything, always says that once they are falling there is nothing the could do to stop the fall but they would twist into a better landing position as they fell and try to relax, the other client would stick out an arm.....stiffly.
Should I relax if I fall?
Cats do! But of course its not really that easy! However, most people know that if we are relaxed in a fall we are less likely to hurt ourselves than when we are tense. When we are flexible this works in the same way as being physically relaxed, simply because the more the bones can move, the more they can dissipate shock and lower the force of hitting the ground during a fall.
Can I improve my balance?
Cats have great balance, this is largely down to their tails. Unfortunately we don't have tails (if we did it could solve all sorts of balance issues, on the other hand it would probably cause all sorts of issues, especially with doors closing to early 😂). Having great balance is something, however, we can gain with a few simple exercises.
Here are some exercises that can improve our balance
1) Walk very very slowly, walking slowly as an exercise in a safe space where you cant fall is extremely effective. In everyday walking we only load the feet for a couple of seconds and we are used to this. However, by slowing down we load our feet for longer and this has the effect of strengthening them, as it is an unfamiliar way of loading the feet.
2) Do a slow walk with and without shoes. The slow walk also works the proprioceptors in the feet. Thats the nerves that allow our brain to work out where our body is in relation to our feet. doing this with shoes, means we develop the proprioception we will use when walking outside and doing without shoes, means we work the proprioception we will use when we first get out of bed but don't have slippers on yet.
3) Tai Chi. One of the main elements of Tia Chi is slow controlled movement and just as highlighted in point 2, this helps both strength and proprioception, But with Tia Chi the movements are wide and varied, so it works strength and balance in unfamiliar positions. Having strength and balance in lots of positions, other than walking and standing straight, means less chance of losing our balance and falling if we find ourselves in an unfamiliar position.
Do I need a Tai Chi class?
Classes are great but they don't suit everybody, your mobility may not allow you to get out of the house or stay on your feet for long enough. Don't worry, There are plenty of home videos and here at The Reinge Clinic we an adapt Tai Chi specifically to your situation and give you an individual home programme to match your needs.
How should I place my feet?
This far into the blog and we are still learning from cats! Cats are very particular about how they place their feet for balance. In our previous blog we hinted that feet are an area that can be worked on to help prevent trips or falls. In particular, we highlighted how bunions, cracked skin, heel spurs etc. affected the way you place your feet. But, as with cats there is also an element of being aware of how you step.
Observe your own walking and ask yourself:
1) Do you drag your feet? This may be due to lack of energy or strength.
2) Do you scuff your feet? This is often associated with reduced ability to lift your legs easily.
3) Do you take very short steps? This can be lack of strength whilst loading the supporting leg or a lack of balance.
4) Do your feet point forward, outwards or do they point in slightly different directions? This is often related to the actual strength of your feet and their ability to support themselves. If your feet point anything other than forward it can be a real trip hazard.
All of the above are of course completely correctable with simple but correctly targeted physiotherapy and exercise interventions.
So what did we learn from cats today?
That cats have great flexibility, great balance and great awareness of how they place their feet and that if we have all of this we drastically reduce our chances of a trip or fall.😀
Ian Reinge is an advanced level Physiotherapist working at The Reinge Clinic in Kenilworth and Portishead.