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Prevent Injury From Falls (Critical Arm Strength Exercises!)

Video Highlights

• Hearing Loss
• Risks of Hearing Loss
• Fall Prevention: Defying Gravity

Hi, I am Dr. Eric Cobb, with Z-Health Performance. And today we’re talking about preventing injury during forward falling. I know that’s a lot of words, but we have a course coming up in June, a live event in here in Las Vegas called Defying Gravity. It’s a brain-based approach to fall prevention. So if you are interested in that, make sure to check out this video and also the last two weeks because when we talk about preventing falls, we have to look at a lot of different systems, the eyes, the inner ear, our proprioceptive systems, how well we balance as we move dynamically, as we’re perturbed, et cetera. But we also can roll this back a little bit and say, you know what? At some point, falling is probably inevitable. So when we think about falling, we have falling forward, falling to the side, falling backwards, and we really have to look at each one of these as a separate problem that needs to be evaluated and solved. So two years ago, a really interesting study came out and it looked at the differences between young adults and older adults in their ability to slow themselves and decreased impact from a forward fall, including the importance of incorporating Critical Arm strength exercises.

Now, why this was a really interesting study was the initial setup. They took the people, they put them onto a board and they had them hold onto the edge of the board and then they put the board at a lean, and then at some point they released it and they would drop them face first onto a mat. And what they were really trying to figure out was what did they do with their hands?

Their hands were here, they started to fall. And as would be typical, what they found was that reflexively people would push their arms out to try and decrease the speed and the amount of impact that they were gonna generate when they hit the mat. Now, what they found in this is really important, and that’s gonna take us to the idea of strength training characteristics that you need to use as a movement professional with your older clients. cause what they found was that regardless of the, the length of the drop, whether it was from a high position or a low position, older adults needed almost between 40 and 60% more elbow flexion to get to come to a stop when compared to young adults. So when you think about that, if I’m falling and my hands automatically go out, I’m not saying this is how we want you to learn to fall.

But it is something that people do, especially if I’m falling to the front. If I am shoving my hands out to prevent my face from smacking into the ground, I’m putting a lot of stress primarily on my triceps, my pecs, deltoid muscles. But really the triceps are going to go into an isometric, hopefully hold, followed by a little bit of an eccentric contraction.

Now, why this is important is that if you are a movement pro, you know that whenever we’re strength training people, there’s no such thing as general strength. Strength is a skill.  we have some things that may generalize across the board, but if we wanna be better at something, we need to have exercises that mimic the muscular characteristics of the movement choirs.

So in this particular case, if I’m thinking about this and I’m falling, I need an isometric stop followed by hopefully a small eccentric contraction of the triceps. So how do we train for that? You have two different easy variations, and this is how I recommend that you program this for your clients. If they are conditioned enough to do pushups, you simply do pushups like this.

We’re gonna begin with a slow eccentric, typically a three second down, 1, 2, 3, a nice hold, maybe two second isometrics, and then a fast concentric. That’s all that I really want you to focus on. Usually for the first four to six, maybe eight weeks, depending on how deconditioned your client is, we want to be working on progressions of that style of pushup that’s going to hopefully increase their skill at eccentric contraction from a fully extended arm position all the way to a full fully elbow position.

You can do it against a wall, do it, you know, up on a a bench, whatever you need to do to begin to build that skill into them. Now the second thing then we need to consider however, is that that may not be enough because we also are gonna have that isometric moment where I fall and I hit the ground and ideally I would be stopping myself.

So now we have to think not just about the isometric hold that we just did in the pushup, but we also have to think about a ballistic isometric. So the way that I normally begin training this with everyone that I work with athletes, elderly, doesn’t matter, is we’re gonna use a stretching strap, alright? It’s got different handholds in it and it’s basically going to go around the back into a pushup position, and then I’m going to adjust where I’m grabbing it based off where I think they may wind up with their hands in a fall. So generally I’m going to try to get them to work in a more extended arm position back to around 90. Anything inside this, we’re gonna have problems already. And in fact, in the study, what they found was that there was only one fall position where the older people actually went inside 90 degrees in general. Incorporating Critical Arm Strength Exercises is essential for improving stability and preventing falls.

Everyone was able to get their hands off the board and get their arms outside 90 degrees.  I like to do my isometric work here. So you’ve done now four to eight weeks of working on eccentrics, isometrics and concentrics, but now we want to change the characteristic. So I’m going to now have my client begin doing one second ballistic isometrics. When you begin doing this with people, ask them to start off around 30% of their actual capacity. ’cause we want them to just work on the speed of the contraction, and as they become more comfortable with this and we’re certain that they’re not gonna hurt themselves, we can begin increasing the intensity. All right? So we’re gonna go from 30% first week, start working our way up to 50, 60, 70.

Eventually, we want them to be doing very hard isometric contractions with virtually no movement in a ballistic manner, somewhere between 30 and 60 repetitions a few times a week. As they begin doing that, their ability to generate force quickly is going to improve because again, this is a skill. When we look at isometrics or we look at speed of contraction in the brain, we actually see differences in different brain areas. Meaning if we look at long distance runners versus strength or power athletes, there are areas of their cerebellum, little brain at the back of the head, that looked very different. So we know that we actually have to train the central nervous system to respond more ballistically, and this is a great way to do it. Last thing I wanna mention here is obviously if I am working with someone and I’m trying to teach them that, hey, if you trip and fall forward and your hands go out and you’re catching yourself, your primary goal here is to make sure that you don’t lose your teeth, break your nose, smack your head into the pavement. So you’re probably naturally also going to want to turn your head. That is something that you can also take advantage of as a brain-based practitioner because we know that whenever we have even an adult turn their head that generates activity in something called the asymmetric tonic neck reflex. Enhance your training with Critical Arm Strength Exercises.

Here’s how this works. If I turn my head to the left, that is going to increase tone in my left side extensor. So my triceps, it’s going to increase tone in my right side flexors. Alright, that’s a left head turn. So since most of our clients are right-handed, when we have them working on this isometric, it is highly likely that they’re going to notice a significant difference in their ability to generate tension.

In most cases, they’re more dominant arm over time, they will feel like they can contract more intensely. So what you’re gonna have them do is set up each repetition this way, they’re in a nice stance, they’re gonna turn their head to lift and then contract, turn head contract, turn head contract. Now we’re taking advantage of a retained reflex, which has been shown in normal healthy people to still be there a little bit to influence their ability to generate tension in that left tricep.

And you can obviously go right and left, but I just want you to make sure that you’re thinking about things like that because we’re again trying to mimic what’s going to happen. If your client turns their head and all of a sudden their ability to generate tension goes down, well that’s a problem because they’re also gonna be turning their head if they’re falling forward.

So two different critical things to think about for injury prevention in a forward fall. From a strength training perspective, make sure that they’re really good at eccentric loading. Make sure over time that you develop their ability to do ballistic isometrics at different elbow flexion positions. Alright, hope you guys enjoyed this. We’re gonna come back next week and we’re gonna talk about something similar, but in relationship to the feet. Alright, have a great week.

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