Preventing Falls and Better Balance

The Open Forum in the Villages, Florida podcast features interviews with community leaders and interesting residents of the Villages. The host, Mike Roth, interviews Ed Huston, a retired physical therapist who now teaches a fall prevention class at La Hacienda. Ed's program focuses on improving balance and posture by incorporating Pilates techniques and emphasizing sitting less and moving more. The class is free and held every Monday at 10 am. Ed's program differs from others in the area because it offers different levels of activities and encourages participants to challenge their cerebellum for better balance. Welcome to the Open Forum in the Villages, Florida podcast. In this show we talk to leaders in the community, leaders of clubs and interesting folks who live here in the villages to get perspectives of what is happening here in the villages. We hope to add a new episode most Fridays at 9 a.m. We are a listener-supported podcast. You can become a supporter for as little as $3 per month, or you can choose to pay more. To become a supporter, go to OpenForumInTheVillages.com and click on Support in the black box. There will be shout-outs for supporters in episodes. Hope you enjoy. This is Mike Roth on Open Forum in the Villages. I'm here today with Ed Huston. Ed, thanks for joining me. Thank you. Ed, I wanted to give our listeners a short background on yourself and what you did before you came to the villages. I'm a retired physical therapist. I practiced pretty much exclusively in the Detroit area. I've been pretty lucky all my life. God's been pretty good to me. A fellow I met initially wanted a physical therapist, and I joined him, and he and I became partners. And he was a trainer of the Detroit Lions for several years, so we became known as taking care of sports injuries, and that's kind of what I did throughout my life up there, emphasis on taking care of different types of sports injuries. I moved on to the villages in 2003 and hoped to open up a practice, however, I was unsuccessful, and I worked for the Lake Center Physical Therapy Group until 2018, and then I decided to retire. And now Ed's teaching a course at La Hacienda, fall prevention, and that's an interesting topic. Why did you pick fall prevention, Ed? Well, I got ready to retire, and I talked to doctors around the villages and said, you know, God's been pretty good to me. I want to give back to the community. What can I do? And they knew I was a physical therapist, and they said, well, we have a pandemic here in the villages. And I said, you do what? He said, well, falling and getting hurt. So why don't you teach a fall prevention class? So that's what I did. Since 2008? What I did is I didn't like the classes that they had around here, because I wanted to do something different. So it took me a little while. So I've been teaching it for about three years now. The idea being that my program is a lot different than most programs, basically, because I guess I'm a physical therapist. I look at things a little differently. My program is based on my premise that in order to improve balance, you got to sit less and move more. So that's what I emphasize my program on, and they activated the cerebellum and improved balance with Pilates techniques, as I was a certified Pilates instructor for many, many years, and used Pilates concepts in the practice. What I wanted to do was I wanted to have a program that people could work at home. They didn't have to spend 15, 20 minutes at a time. They could do it throughout the day. Because of my emphasis, sit less, move more, I set up the program so that these activities, I wish I called better balance activities, could be done in three to five minutes. And you could do four to six a day. And ideally, if you incorporate it after you do some daily activities, like brushing your teeth, or watching your coffee brew, or working on the computer and taking a break, or in the evening taking a break with the advertisements. So that's what I decided, how I decided to set it up. The other thing that was important to me is the cerebellum, which is your part of your brain, connects with your vestibular system, and that deals with balance and posture. So I wanted to challenge the vestibular and the cerebellum. So what I did is I have different levels with the activities. You don't go from one level to the next level until you're able to accomplish that level. That makes sense, Ed. Ed, at the Hacienda, where you teach it, is it one class a week, one class a month? How does that work? I teach every Monday at 10 o'clock. It's a weekly class, and it's a free class. That was one of the things I wanted to do, because I didn't want to charge. The other thing that I did was uniquely, I have a health and wellness website called PilatesPlusForBoomers.com. I've had that for many years. I set that up when I was practicing, because I would get patients, and I'd give them exercise. They'd get better, and then they'd call me a couple months later and say, I hurt my back again. What can I do? I said, well, go on my website, because these exercises are what you were doing, and if you don't improve, go to the doctor and come back. Well, most people didn't have to come back. So that was part of the emphasis, too. I wanted to take my fall prevention program and put it on my website so that people could go to the website free and view it and do the activities that are on the website. So how many classes do most people attend before they stop coming? Well, I've been doing it about three years. Initially, I had many more. I'm down to about seven, eight, or ten. The unique thing is that every week, I get new people, and then most of them, they get it from the newspaper, because they can see that, well, I see it in my class. And then, word of mouth, I have people that come and they tell their neighbors about it. And then again, what day of the week and what time is it? It's Monday at 10 o'clock at La Hacienda Rec Center. Every Monday? Every Monday. Well, that's four Mondays or five Mondays. It doesn't matter. I'm there. Okay. So it sounds like most of your classes now are pretty small, only about seven, eight people in them. That's correct. Yeah, they are. Okay. So that gives time for a little bit of personal help. It sure does, yeah. Each class is an hour? Yes. Okay. They're usually over, because some of these people keep asking me other questions that may not be relevant to the fall, but I try to answer them or refer them to somebody that does. So, you said that one of the precepts of your program is to get people to stand up and not sit in the chair. That's right. Get active. Get moving. That's what's important. And then I have three important parts. Posture I have is teach, because that's important, and a small Pilates posture in it, because Bill Pilates was an exercise specialist who worked with dancers, and he had the concept of lengthen and strengthen, and also he's the one that developed the whole idea about core stabilization, because we know that the core muscles are initiated with all this movement, so it's important that you have good core. So I integrate the posture with the activity level, and then I have the activities, and then the strengthening with the bands, elastic bands, and I give them lower extremity exercises, because that's what is needed. Do people have to bring mats or bands to your classes? No, they usually don't. They don't come with anything. I have a handout, which I give everybody, and if people come back, then they will bring the bands, but a lot of people don't come back because of the handout. I don't know if they think they know what to do or if they don't want to do the exercise. I don't know. Okay. You mentioned the name Joe Pilates. Tell us a little bit more about him, because I've heard about Pilates exercises. Yeah. Joe Pilates was a German. He came over here in 1926, opened up a studio in New York, and worked primarily with dancers, and he had these concepts, which we all use today. His concepts are still holding up. His idea was that you want to strengthen and use the core muscles, because everything starts from the center, from your core. The core muscles really are the muscles in the front, side, and back, so you don't isolate. You want everything to work together as one unit, and that's basically how I practiced, and then I still do that. He died in 1964. Sixty-four. Yeah. If you talk to him, you hear all Pilates and everything like that. Pilates is a little different from yoga. Pilates is more for core strengthening, trunk strengthening kind of thing, where Pilates or yoga is more movement. Okay. What is the function of the cerebellum in your programs? The cerebellum is basically, I call it, a computer in your brain. That's the part of your brain that works with your vestibular system in improving balance, so if you have a balance shift, your cerebellum is always regulating this balance, and it helps with posture, and it also helps with movements. For example, if you started to learn, when you were young, you learned to ride a bike, your mother put the wheels on, and that's level one. Level two, your parents would hold the bike as you went, and level three, they'd let you go. So you work to each level, and that's recorded. The same thing if you go out and play pickleball, and you learn how to play pickleball, that's where it's recorded in your cerebellum, and you go back and play pickleball. All these activities are recorded, and the thing that I feel is important that you stimulate the cerebellum, because otherwise it goes into a sleep mode, whereas many programs around here have several exercises, and they all do the same exercise every week, in and out. So that's where mine is pretty well different, because I have three or four different levels at each of the five exercises, and you advance after you're able to accomplish the activity five times, five reps, for five days, you can go up to the next level. So that's where mine is entirely different than most of the others. So you teach your program in different levels? Yes, I show these people the different levels, but most of the people, they all work at the first level. First level is always, you always hold on, and I always emphasize, if people have a chair or a counter or something, you never do it in the middle of your living room floor, because we don't want people to fall. Right. I'm laughing, because I've had several people fall in rec centers when the chair that was on wheels rolled out from under them before they got their rear end down on it to stabilize it. Yeah, that could happen very easily. So in our improv classes, we more or less ban chairs with wheels. Yes. Okay. Joe, can you explain what your five better balance exercises are? Okay, the first one is called just a balance exercise, and you hold on to the chair, and what you do is you work, we work on Pilates posture, you got to maintain your posture throughout the activity, and what you do is you touch your toes forward, touch behind you, touch across your body, and then out to the side together. So that would be the basis on that. So the level one, you would hold on. Level two, you do the same exercise, except you don't hold on. Level three, instead of touching, you point. You do the same exercise. You point with your toes forward, back, side, and across to do four exercises. And then on that level. To do that, you're standing on one foot, then. That's right. So on that level, that level three, you hold on to the chair until you're able to do it for five days, because that's what we want to make sure that it's established in your cerebellum, in your brain. And then the next level, you do the same thing, except you don't hold on. And that's when the trouble starts. Mostly everybody, everybody seems to have, everybody has problems. So if they're able to, so they work at the level that they can work at, so they don't jump up to the top level right away until they can accomplish the other levels. And then the top level would be, you would do the same exercise, except you would hold it in each position for five seconds. Okay. So that would really increase your deep balance. Yeah. That's the one, one balance. The other one is I have people put one foot in front of the other and talk on the telephone. And what you do is you talk about five minutes on the telephone. And every 25 seconds, you change a foot, put it behind. I'm trying these, as you say. Okay. So in level one, you hold on. Okay. Level two, you don't hold on. Okay. And then level three is what you do is you're just going to walk, holding on to the counter, you walk forward and back. And then holding on in level four, you do the same walking forward and back, except you don't, you don't hold on. And then that's just walking in a regular step. And then when it gets advanced, you hold on and then you do the heel toe walking forward and back. And that's level five is when you let go of the, you don't have to hold on and you walk forward and back. And then the other level is the top level is you do the heel toe touching, walking forward and walking back. But you hold on. I don't have people not hold on because nine out of 10 people would probably fall. So that's... As you're doing these classes in the rec center, anyone haven't fallen? Yes, I've had a few people, but they were never injured. So... Never injured. Okay. That's okay. And that's the second activity that we do. This is Mike Roth with Dr. Craig Curtis for today's Alzheimer's tip. Dr. Curtis, can you tell our listeners something they can do to improve the nourishment that they give to their brains? Absolutely. Our brain only weighs about 2% of our overall body weight, yet it receives about 20% of our blood supply. So it's very important that we essentially nourish our blood vessels. As we nourish our blood vessels, we'll essentially then nourish our brain. So lowering the amounts of sugars, red meat that's high in cholesterol, can go a long way to nourishing our brain by making our blood vessels more compliant. With over 20 years of experience studying brain health, Dr. Curtis's goal is to educate the villages community on how to live a longer, healthier life. To learn more, visit his website, craigcurtismd.com or call 352-500-5252 to attend a free seminar. My favorite activity is I have a ball. You sit in your ball and throw your ball back and forth and catch it when you're sitting. And in five days, you're able to stand up because you developed a program and you do the same activity, standing up there five times. I guess, how big is the ball that you throw? Oh, I'm sorry. It's a tennis ball. Okay. It's just a regular tennis ball. And then the next level is you walk forward and back. And then the following level is you bounce the ball to the left and to the right and you sidestep right and left, that type of thing. So the whole idea is that when these people, when they walk, the idea is that people aren't used to shifting. And so what we're trying to do is get that cerebellum so then it shifts around. And then the next one we do is what we call the tightrope walking. And usually in your home, you have wood slats going forward. You walk, keep your feet on two of the wood slats, holding on, walking forward. And then the next level will be after five days, you go to level two, you don't hold on and you go to the next level where you hold on and you step forward, but you turn to the left and turn to the right as you walk. And again, they do five of these back and forth. And when they're able to do that for five days, five times without problems, they go to the next level. And then that next level, they wouldn't hold on. And so they progress. How long does it take someone to get to these level fives? Just several months. Several months. Some people will never get there. They just don't have that ability, a cerebellum. I think the more advanced somebody is in an athletic position, if they worked in activities where their body or cerebellum is used to that type of activity, the chances are that they can get to that level. And then the fun one is dancing with a pillow. And I recommend that people do this in the evening when the ads come on. You do one ad and what it is, it's a modified waltz is what it is. But the emphasis is having people when they walk forward and then when they turn around, they step and turn around. So that's when a lot of people fall, when they go to turn, they fall. Then you rotate your body like 40 degrees. Yeah. And you move your foot. When you move, you're moving your foot back, too. A lot of people don't move. So what we're training that cerebellum to do is that when you go that way, your cerebellum is going to say, move your foot back. And that's and that works because people have told me that they've stumbled in everything like that. So since you've talked about stumbling, let's talk a little bit about what you call the art of falling. Believe it or not, there is an art to falling. Problem is that in order to do that, you have to relax. That's the number one criteria. So if you're going to fall, you have to relax and just relax. But you don't practice it. You'll never learn to relax. So what I have people do is they get up back up against the chair. And the whole idea is when you when you do this, what you want to do is you want to put your head down, get your chin to your head, your chin, your chin to your chest and look down and squat as fast as you can and then relax because you want to land up on your butt is where you want to end up. So you're not there. And you have to keep and keep your arms in front so that you don't get your arms out because that's what happens when people fall. They put their arms out. Next thing you know, they have problems. So the biggest thing, biggest thing is practicing. And I don't I don't guarantee that it'll work. But I've had several people follow me in my class and said that works. I didn't fall. I didn't stumble. Well, it's not the stumbling, but if someone is going to fall, that part about pulling your arms in is really important. That's right. We have a lady in our improv class who fell once and broke an arm. Yes. OK. And then she went to get out of her car to get her mail, tripped on the curb and broke the other arm within a week of the first arm. So, you see, that would be hard to try to relax in that situation. But sometimes if you do stumble, you can recover. I've done that several times because I do practice this in my garage because everything in my garage is like everyone else's garage. It's kind of tight. So it's hard to get around some things. I thought you were going to say you paved your garage. No, no. So are there any pads on the floor so people can practice? No, because the goal is that we don't want you to fall. OK. But you are going to fall. Hold your arms in front of you. That's right. And try to relax. And try to land on your... And drop down to a squat position and chin to the chest because you don't want your head back. Right. And drop down as fast as you can. You may be able to stop the fall. So that's something you have to learn to do in milliseconds. That's right. That's why you need to practice it. OK. And then in conjunction to that is getting up from a fall. OK. So let's pretend you've just fallen. OK. And you landed in a good position on your rear end. OK. And hopefully somebody's there or if they're there, they want to make sure that you're not injured. That's the number one thing. You want to make sure you're not injured. If you are, you should call 911. That's what you do. Hopefully somebody is there. And then what you do is you roll on your side and roll over and get on your hands and knees. And then you can crawl to a chair and then you put both hands on that chair and put one leg up. OK. And stand up. Now, if you have somebody at home, they can bring the chair to you so you don't have to go. Right. Right. So you don't stand up where you fall, but stand up next to an object or a chair that you can use as a brace to pull your body up with. Yeah. So I mean, I have a video that I show is because some people, you know, fall and it shows you how to scoot and everything on your butt and everything. If you want to scoot and find your phone, come through that. But I recommend you try to get to a chair is the best way. Or keep your phone with you. Yes. No, we don't. I don't know anybody does that all the time. I can see you. It's right here on my hip. All the time. Even when you get out of bed at night? It's next to the bed. Oh, is it? Okay. Okay. But if I get out of bed at night, you're right. I don't have a belt on. So the phone is still on the night table. That's when a lot of people do fall, as you know. Yeah. So how does that relate to people who have cases of vertigo? That makes it very difficult to do that. So they just I have them just stay at lower levels instead of trying to advance to the higher levels until they, you know, until they can do it. But that's basically it. Don't worry about going to higher levels, just stay down to the lower levels. And some of these people, I have them, they continue to hold on. So now what I do before we start any of these, I tell people, how do you know you have a problem? You don't unless you test yourself. So I have them do three tests. Three tests. And one is a single leg test, which we do. Stand on one leg. Stand on one leg. And get your posture and stand on one leg for 30 seconds. Okay. And then what you want to do is, if you want to be able to do that, then you won't have to do it as often. I recommend if you have trouble doing it, there's a standard. And I have on my hand that I give out standard based off your age, how many seconds you should be able to stand. Really? So if you're 60 years old, you should be able to stand at least 30 seconds. If you're 90, just 10 seconds. Okay. So you want to be able to stand what your age group is. And then basically practice that maybe three days a week. If you can't do it, I want you to do this, practice it five days a week. Okay. So that's test one. Test one. Test two is a 30-second test, and that's where you put your heel-toe together and hold it for 30 seconds. There you go. Heel-toe. Right. For 30 seconds. Okay. And then the third test is a sit-to-stand test, 30 seconds. That's where you sit down, stand up, sit down, stand up, 30 seconds. How many times you can do that? In 30 seconds. How many times? And there are standards based off your age group. So what you do is you find your age group, and the younger you are, the more you should be able to do. If you're 90 years old, you should be able to do about 16 of these in 30 seconds. Ninety? Yeah. Sixteen of them in 30 seconds? Yeah. Now, is there a specification for the type of chair that you're getting up on? Well, I want to make sure the chair is always against the wall, and you can put some pillows down on your chair so that when you fall down, you know, or if you have trouble getting up, you put the pillows down, and then as you get stronger, take the pillows out because you want to get all the way down. So a lot of people can't get out of a chair. I have a woman right now that's been coming. She can't get out of a chair, so she's using about three pillows to practice this every day. So she's trying to get her legs stronger. And as she gets stronger, she'll take one pillow out all the way until she finally gets down. You're talking about a 90-degree chair. That's right. Okay. A chair that has about the length of a mat like I have in my kitchen. No, you don't need that. You don't want that. Like a 110-degree chair. Yeah. Or the... It's a kitchen chair, so to speak. A kitchen chair. Or the recliner. Yeah. Even in worse shape. Yeah. You don't want that. They can't move. That's the important thing that you don't want that because the whole goal is we don't want you to fall. Right. So that's why I'm overly cautious about people making certain that they don't fall, doing it safely. And then the third part is I have them do some leg exercises, standing and then sitting, using bands around their ankles and around their knee and around their feet. Tell our listeners a little bit more about that because I just can't see that in my mind's eye right now. Okay. So you take the band. Basically, what you do is take the heaviest band you have and put it under your table. And then you can do three exercises, standing tall. And this is where I emphasize Pilates posture. You tighten your tummy for five seconds as you take the leg out to the side and you start out doing six or eight and add a couple every week until you get up to about a dozen. So explain to our listeners that where is the band? The band's around your ankle. The band's around your ankle. Yeah. Okay. And then so you're going to do sideways. You're holding the band on the other hand. No. What you do is you hold it. Put your hand on the table. The table. Yeah. Keep the hand on the table and just move the leg. I always want you to hold on. So where is the band getting resistance from? The band's around both legs or around the table leg. So the resistance is at the table leg. Oh, okay. So it's around the table leg, then around your ankle. And so you're moving your leg out against the resistance of the band against the table leg. Right. And what you do is you move it out. Think of your pelvis as a bucket. You want to pull up on your pelvis, on your bucket. So you breathe out for five seconds, keep it out there, and then breathe in as you bring it back in. So you go sideways and then you do one across the body and then the third one would be behind your body. So you do three of them. Okay. So you have to turn your body to get those angles. Right. Right. Correct. Do you practice those in your class at the Hacienda? Yes, I do. Okay. Well, I demonstrate that because we don't have a lot of tables. Only one table at the Hacienda. Well, they got lots of tables. You'll have to bring in more tables. Two or three. You'll have to bring in more tables. Two or three. That's maybe not. I don't want to do that. So, and then the other exercise I have sitting and there what they do is they do put the band under one foot and then put it over the other foot and then do a straight leg raise with the band. Again, I can't see that. You're sitting. You're sitting. And you got a band under one foot. What part of the band? The other part of the band on your other foot and then you raise one leg up. You want to get it all the way up. Straighten it. Hold it for five seconds again with you. So, you're putting your foot on the band. Yeah, one's on the band and the other foot holds the band. Sit down. So, let me see if I got this straight. Put my foot on one end of the band. Yeah. Okay. But you're sitting. I'm sitting. And then the other is around the toes of the other foot. Around the toes. Okay. And then what you do is you take your, put your hands under your knee, raise your leg up and then straighten your leg out. As far as it'll go. As far as it'll go. Yeah. Yeah. Okay. And you hold it for five seconds, tightening your abdominals. So, you're working your core muscles. I'm working my glottis muscle. Okay. So, this is very good. These are things that you don't need to join a gym to do. No, that's right. And the third exercise, you put the band around your ankles and you push your ankles out to the side. Take them apart. They're on each of the ankles. Both ankles. You're running the band around your ankles. Well, if you have a small... The band is tied together. Oh. So, it's a small band. Yeah. They're small bands. Okay. I'm thinking it's a four-foot band. No. No. Just a small one. Then it'd be a lot of slack. Yeah. And you push your feet out. Yeah. Okay. We got that. Good. So, if people are interested in taking your course at La Hacienda, do they have to make a reservation? No. They show up at 10 o'clock on Mondays. Okay. Have you ever had overfull? No. What's the most you ever had? Probably about 15. 15. Okay. So, it's still a small class exercise. Yeah. But it sounds like it's going to be a really good exercise. Yeah. I got most of those people after the paper did an article on it. So, I got most people for a couple of weeks and then it goes on. Yeah. Off of the course. Right. Good. Ed, thanks for being along with us. Anything you want to add? Less thoughts? Just remember, sit less, move more. Hey, I like that expression. The theme song. Thanks a lot for joining us, Ed. Sure. Thank you. Remember, our next episode will be released next Friday at 9 a.m. Should you want to become a major supporter of the show or have questions, please contact us at mike at rothvoice.com. This is a shout-out for supporters of the show. If you have any questions, please contact us at mike at rothvoice.com. Thanks. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye.