When new clients come through my door, we put them through our FMS (Functional Movement Screening) screening. Many times during the screening, they realize that they've lost some balance over the years, balance they didn’t realize they had lost until the screening. All of a sudden the client has a mindset shift. The loss of balance sparks the fear of falling. Now balance becomes one of their fitness goals. Which is good, but is it their balance that they're looking to improve?
You can have great balance and still fall. Don’t get me wrong, balance is important and needs to be trained, but there is much more to fall prevention. Preventing the fall once you lose your balance or when an accident occurs is key to injury prevention.
There are times when we fall, and it has nothing to do with our balance. For example, you are standing at the edge of a curb and someone knocks into you from behind. Boom, the next thing you know you're falling.
That fall had nothing to do with your balance. All your balance systems, the sensory information from your eyes (visual system), muscles, tendons, and joints (proprioceptive input), and the balance organs in the inner ear (vestibular system) proprioception were giving your brain the correct information to stand there. The push from behind came as a surprise. Because accidents are unplanned, they just happen you need to train your body for them.
You need to train your body to move quickly and be strong enough to accept and produce forces. For example, if you trip you need to be able to move your leg quick enough to get your foot or your arm to get your hand into a position to prevent the fall. Next, the body needs to be strong enough to accept the forces placed upon it from the fall. Finally, the body needs to have enough strength to push you back up to a standing position.
No matter what population, the body’s ability to react quickly, accept, and generate force for overall function and safety. You need to train reactive power. Reactive power training should be a part of everyone’s exercise program. Train the body’s ability to react and move quickly. To react quickly, with powerful movements involves eccentric contractions (a reduction in force, deceleration) and concentric contractions (an increase in force, acceleration).
For example, when you perform a step forward lunge the stepping leg has to accept the forces of the body when the foot strikes the ground. As the body lowers it is decelerating. Once the body stops descending it creates a force to accelerate back to a standing position.
Forward lunges are a great exercise to strengthen the body to prevent falls. Agility ladder drills are also great to work on foot speed. But, that is only part of it. You know the drill. Your brain tells your muscles what to do. In reactive power training, the sense of surprise is introduced. It is the nervous system that needs to be trained to react.
Reactive power training incorporates the stretching capabilities of muscle tissues to store the energy during eccentric concentration, the deceleration phase as potential energy, and then utilize energy as kinetic energy or energy of motion to be able to generate those forces efficiently to be able to stop the fall and pop yourself back up (the concentric phase or acceleration). Reactive power training teaches the mechanisms of our nervous system to recruit muscles quickly, thus enhancing the rate at which the muscle generates force.
Functionally applicable to a task at hand, and our nervous system will only recruit muscles at the speed at which is it trained. So if you don't train your nervous system to recruit muscles quickly when it comes time to meet the demands of that activity, the fall, the nervous system will not prevent the fall. If you only train slow and always know what action is to be performed, your nervous system will not have the capacity to recruit the muscles quickly, bang you fall!
Imagine you're driving your car and you see a tree up down across the road ahead. You're going to push on the brakes at an appropriate force to slow down to a stop before hitting the fallen tree. But if you're driving along and a deer jumps out right out in front of your car you’re going to quickly slam on the breaks to avoid the deer. Those are the two different reactions. The second one is reactive power.
The first example of the tree equates to a step forward lunge, jump squat, or agility ladder drills. You know what is going to happen. In the case of the deer, you didn’t know what was going to happen so is reactive.
The key to fall prevention is performing reactive training in your program, so the nervous system is being trained.
What does that look like? There are multiple levels to reactive power training. But, for example, the first level would be similar to the voice reactive. You shuffle left until a coach tells you to stop.
One thing it's important to know this, you don't just start off doing reactive training, You can get injured. Start once you have developed enough overall body and core strength to decelerate and accelerate, along with mobility, stability, and flexibility to move correctly and balance.
You need to be able to react quickly both when you lose your balance and when an accident occurs. Training your reactive power is a must for all fall prevention programs.
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