Dr Cobb de Z-Health Performance. Aujourd'hui, nous allons terminer nos discussions de septembre sur la prévention des chutes en nous penchant sur la peur de tomber. Si vous ne connaissez pas encore Z-Health, sachez que nous sommes une société d'éducation basée sur le cerveau. Nous sommes spécialisés dans la collaboration avec des médecins, des entraîneurs et des thérapeutes qui souhaitent intégrer les neurosciences de pointe dans leurs pratiques de mouvement, qu'il s'agisse de douleurs ou de problèmes de performance. Si c'est votre cas, n'oubliez pas de vous abonner à la chaîne et de consulter notre site web.
Now I spent the last few weeks talking about fall prevention because it’s September in the U.S and we are focused on balance and fall prevention because Falls are a big deal. One of the things that I think is now showing up more and more in the literature is the actual understanding that a fear of falling increases falling risk. What we see in general is that as people become more afraid of falling let’s say they’ve fallen and they had an injury and it took them a while to heal whenever they are challenged in a research environment we actually see them begin to go through what’s called a stiffening process. They start to move and they begin to feel a little bit fearful they get more and more stiff and that is a recipe for disaster because what we need to do in most situations if we’re going to fall is we need to be as relaxed as possible so that we can reduce the amount of impact into the ground and hopefully also be loose enough to recover our balance and not fall.
So whenever you kind of dig more deeply into the science of fall prevention it’s not just about how do their eyes work how’s their hearing how’s their vestibular system can they feel the ground it’s deeper than that. There are cognitive issues there are again emotional issues you want to call fear of falling this is really kind of a deep kind of brain stem issue that we deal with amygdala issue. I want to just give you some basic ideas on how to remedy that. Here’s the deal if you want people to have less fear of falling then you need to teach them to fall. We actually need to get people comfortable with going from standing down to the ground as safely and as comfortably as possible. Obviously, depending on the population that you work with and depending on your skill set as a coach it may need to start with you. You may need to get some training in how do I teach people to fall safely do I know you know different movements do I know how to reduce the amount of impact. There are programs out there. If we get enough interest we’ll make one for you because this is a big idea for me love teaching people how to roll and fall and so there are lots of places you can go you can look at parkour you can look at different martial arts. I do not recommend in the beginning for sure that people get into a gymnastics gym to learn how to roll and fall because gymnastics as a sport is going for an aesthetic that doesn’t translate safely onto concrete and harder surfaces many of the rolls. So you would be better off probably looking like I said at some Parkour as a sport or different forms of martial art. but this is also something that you can explore on your own.
So normally what I do when I have someone that has a fear of falling is we have to get them on the ground we have to do it in a safe way we have to do it slowly but we have to do it. You can’t make an excuse about this.
You will reduce the fear by engaging with the fear but doing that in a very safe way. So I normally will start people on a mat where you know this is a nice thick mat it’s about a three inch mat it’s very very soft and it the softer the better honestly and then we need support. You can do this by a wall for now I just have a chair and I will literally tell people here’s what I want you to do I want you to go down to the floor as slowly comfortably and safely as you can in any way that you want using the support of the chair. So you’ll see people come over and they’ll kind of bend over and they’ll put their hands down on the chair and then usually people will go down to one knee and then they’ll go down to another knee and then they’ll go hands and then they’ll maybe sit back on their butt and down and then I ask them to come back up now nothing wrong with that. Is it ideal to land on your kneecaps? No! Is it ideal to land with your arm outstretched in a locked elbow? No! So what we’re doing in the beginning is we’re starting to see how do they move naturally and what do I need to train them to do.
So we are going to get them doing this to the right and to the left and then I’m going to have them face the chair and I’m going to have them kind of figure out how to fall forward a little bit safely down to the ground and then I’m having face away from the chair and I’m going to have them kind of fall back and catch themselves on the chair and move down. You can do this over and over just getting them comfortable getting up and down. I guarantee you your clients who have a fear of following are going to move very slowly they’re going to get really sweaty really quick because it’s probably something they haven’t done in a long time.
So if that again the ideal way for them to learn to fall no but it is a start remember we reduce fear by confronting that fear in a safe way so a lot of padding use the chair use the wall go slowly and then over time begin helping them understand that the idea of falling safely is to have as much soft tissue make contact with the ground as possible while we are avoiding locking out joints and landing on them because that’s where the big injuries tend to occur.
So there’s again lots of different ways that we can go about teaching that but it all starts here with just the basic simple process of getting people comfortable with their body going down toward the ground and coming back up in a safe way. Now can apply a lot of the principles that we’ve already used in previous videos so sensory reweighting it’s a great thing to do here you can put the earphones on them and have them go through this and they can’t hear and now all of a sudden they’re feeling this differently and then you can go through the visual occlusion using goggles and again go through this approach.
I recommend that you have people do this three or four times a week for five to 15 minutes because it actually takes that much repetition over usually about a month for them to start to get really comfortable with the idea of how am I going to get down to the ground a little bit more comfortably and are they starting to build some mobility that will allow them to again get onto the soft tissues. This again is a very basic starting approach but in working with thousands of professionals around the world it’s something that I see incorporated very rarely into most training programs. When we teach people to get up and down off the ground in a lot of gym settings particularly is kind of in a more formulaic way and we need to understand that most falls that occur will not allow us to get into that deep squat and or whatever it is that we’re teaching people right now we need to make it a little bit more reactive.
This ties in finally to what we know from the scientific literature is that balance is very functionally specific which means that we need you to be good at doing the things that are going to be confronting you in your daily life. Believe it or not one of the most common fall situations around the world is this someone has to walk up to a chair they have to turn away from the chair and then sit down. Depending on their strength their mobility what’s going on with their eyes their inner ear this is one of the most common times to see people lose their balance fall land on the chair and bad things happen from there. So we need to again think specifically about the tasks that people are going to be confronted with and make sure that we’re always incorporating movement forward and backward with rotations because all of these things are what’s going to matter in the real world.
All right so give this a shot again I know it doesn’t seem super formulaic it’s not supposed to be because balance is dynamic and it happens in the real world so we have to add that style of training if we really want the brain to adapt. Good luck with this, hope you enjoy it.