Winter fall prevention on Indiana ice

Why are falls on ice more serious for older adults?

Because slower balance reactions make a slip more likely to become a fall, and thinner bones make a fall more likely to become a fracture. Wrists break when a hand goes out to catch the body; hips break when people land on their side. The CDC reports that falls cause most hip fracture hospitalizations among older adults.

Ice adds a second problem: it takes away the small corrective steps that normally save a stumble. On a dry sidewalk a trip leads to a quick catch step; on ice the catch step slides too. That is why the advice for ice focuses on not slipping in the first place, through how you walk and what you wear, and on building the strength and balance that buy time when you do slip. If you have osteoporosis, fall prevention matters even more.

How should I walk across an icy parking lot or sidewalk?

Walk like a penguin: short steps, feet slightly turned out, knees a little bent, the whole foot landing flat, and your body leaning slightly forward so your weight stays over the front foot. Long strides with a heel strike are the classic way to slip backward.

• Keep both hands free and out of your pockets; carry bags in a backpack
• Slow down and look a few steps ahead for shiny or dark patches
• Treat anything that looks wet in freezing weather as possible black ice
• Use handrails, a shopping cart or a companion’s arm where you can
• Walk on snow or grass edges rather than smooth ice when they are safer
• Step down from curbs slowly, leading with the stronger leg

Which shoes, cleats and cane tips actually help on ice?

Footwear with a soft, deep-treaded rubber sole grips far better than smooth leather or worn trainers, and slip-on traction cleats grip packed snow and ice better still. Cleats must come off before you walk indoors, because metal studs slide on tile and polished floors.

If you use a cane, an ice tip that flips down for outdoor use and up for indoors adds a point of grip. Check that boots fit well enough that your foot does not move inside them, since a heavy, loose winter boot can make you shuffle and catch your toe. Keep a bag of salt or sand by the door so you can treat your own steps before using them.

How do I get in and out of the car without slipping?

Getting out: swing both legs out, plant both feet flat on the ground, hold the door frame or seat, and stand up straight before you step away. Getting in: back up to the seat, sit down first, then lift your legs in together. Most car-related slips happen when people step out on one foot and twist.

Parking garages and store entrances deserve extra care, because snow melts off cars, runs across the concrete and refreezes into a thin film that is hard to see. Park close to a cleared path where you can, and use cart corrals and railings for support. If you are coming to an appointment at Carmel City Center, the garage is a short walk from the suites, so allow a few extra minutes on icy days; parking for appointments gives details.

How do I keep my own driveway, steps and mailbox path safe?

Clear and treat the routes you use every day before you need them: the front steps, the path to the car and the walk to the mailbox. Spread salt or sand before a freeze where you can, and again after clearing, because refrozen meltwater is the surface most people slip on.

Fix the details that matter on ice: a sturdy handrail on both sides of outside steps if possible, a bright outdoor light on a timer or motion sensor for dark mornings and evenings, and a mat inside the door to dry your soles. Downspouts that empty across a path create a fresh sheet of ice each night, so redirect them in the autumn. If clearing snow yourself is not safe, ask family, a neighbor or a service, and read the snow shoveling guide before picking up a shovel.

What balance and strength work in autumn makes winter safer?

Leg strength and balance training, done regularly for several weeks before the first freeze, is the preparation most likely to help. The CDC recommends exercises that make the legs stronger and improve balance, and gives tai chi as an example.

At home, the sit-to-stand builds the thigh and hip strength that gets you up from a chair and out of a car, and single-leg balance practised beside a counter trains the reactions that recover a slip. The balance exercises for seniors at home guide gives a fuller routine. The CDC also advises asking your doctor or pharmacist to review medicines that cause dizziness or sleepiness, getting your eyes checked every year and making your home safer with grab bars, railings and good lighting.

If you have already fallen, feel unsteady, or are afraid of falling, balance and fall prevention therapy with a physical therapist tests your strength, gait and balance and builds a program around what is found.

What should I do right after a fall on ice?

Stay still for a moment, breathe and check for pain before trying to get up. If you have severe pain, cannot move a leg, hit your head or feel confused, stay put and call 911 or ask someone to call for you.

If you are unhurt, roll onto your side, then onto your hands and knees, crawl to something sturdy such as a car or railing, bring one foot forward and push up slowly. Afterwards, tell your doctor about the fall even if you were not hurt: the CDC notes that less than half of older adults who fall tell their doctor, and a fall is often the first sign that strength, balance, vision or medicines need attention.

To find a physical therapist for balance training, complete the physical therapy questionnaire and choose balance; the matching team proposes an independent therapist in the network.