Taking a Fall

It’s that time of year and with the transition from summer to fall/winter running coming, we often hear about more trips and falls when out running right now. Soon trees will drop their leaves, it gets darker and wetter and tripping hazards are even more pronounced. Falling when out for a run can happen at any time of the year. And no, you don’t even have to be out for a run!

A Fall Waiting to Happen

Particularly in Seattle, our sidewalks and streets can leave a lot to be desired. Tripping hazards abound. If you are new to a route, pay extra attention to those tripping hazards. Distractions like fussing with your phone or chatting with a run partner, for instance, can all take your attention away from placing your feet. It’s not that we don’t want you to have fun, but be mindful of your surroundings and your distractions.

Fatigue

As you get tired on a run, you may be more prone to tripping. Your turnover slows, some muscles may tighten up creating a change (often unnoticeable to you) in your gait pattern, you tend to drag a bit and you are slower to pick up your feet. This is a great time to remind yourself about form cues like running lighter on your feet, proper posture and arm swing. If you happen to get caught at a stoplight doing some hip swings or stretches can help re-set things too.
 
Your brain also may be lagging a bit as glycogen gets low and you physically get tired. Here is where a gel or other sport fuel might just be the pick me up you need. Many confuse the idea that fuel when out on a run (or bike ride for that matter) is only for when you feel hungry. The signs of glycogen depletion are evident first in brain and then muscle function long before you will actually feel hungry.

Strength and Balance

Looking at research on falls within the elderly population, it appears that those who have better core and lower body strength have a better chance of not falling. Wouldn’t it stand to reason that overall strength would help any one at any age as well? Some key things to think about are even strength. Is one side much stronger than the other? Generally everyone does have a “better” side and it’s important to continue working to build strength evenly through lower body, glutes, core and upper body. As a muscle fatigues our bodies are designed and do a good job of other muscles jumping in to help out. This keeps us going but over time can create tightness and imbalances that lead to a change in gait or set us up for a potential injury.
 
Also, as running is a series of hops from one leg to the other, having better balance and proprioception can only help. Balance training is a simple way to help mitigate the risks of falls. Some simple exercises include standing on one leg for 30 to 45 seconds. Try bringing your non-standing leg through the motion of running and try not to flail too much. When this becomes easier, try closing your eyes but make sure you are near something you can hang on to when you start to fall over! This can be done randomly and subtlety throughout the day as when you brush your teeth, wait for an elevator or in line. As you get better, add more challenging exercises into your regular strength routine.
 

• Single leg standing on a foam pad, bosu or other stability-challenging tool.
• Single leg reach - stand on left leg with knee slightly bent and right leg behind you. Slowly bend left leg while reaching down towards the ground in front of you. Come up. Then reach to the right. Come up and then reach to the left. Keep your knee directly over your ankle and only go as far as is comfortable for you. Switch legs.  
  

Going Down!

Still, falls happens. Try and roll with a fall and hope you are landing on something soft and not in front of traffic! Sometimes trying to save yourself from a fall can even cause it’s own issues as in a pulled hamstring or other muscle. Been there, done that! When you are going down, protect your head and face but let the inevitable happen. We sadly have a lot of experience with falls and find that if you fall on trails, it can be a lot softer as long as there aren’t any big rocks. Hopefully, you aren’t right next to a big cliff! 

Triage and Treatment

After you hit the ground, the natural tendency is to pop back up (after turning off your Garmin!) and pretend all is well. Is it? We really recommend sitting back down to assess damage. That ol’ Vasovagal syncope reaction can be triggered by a fall and cause you to faint. Sitting down is the best way to control this reaction and wait for it to pass. This reaction is a natural reaction to trauma or stress and caused by a drop in blood pressure.
 
Carefully check yourself over and access the damage. Hopefully a few scrapes and bruises and annoyance are all that you’ve acquired. Should you finish the run? Walk about carefully for a bit and you’ll have a better sense of if it’s best to call it a done day. Keep walking and then gradually ease into a run. If something still feels very painful, you are limping, dizzy or if bleeding is an issue, it’s time to stop!
 
Carefully clean out any scrapes. We hate to tell you but that may involve a scrub brush in the shower to get all the dirt out. Ouch! You do not want any dirt to be in any open wounds. Depending on how extensive a scrape or cut is, scrapes can heel more comfortably if they are kept dressed and covered with bandages.
 
And unfortunately there are times when you will need to see a doctor or have emergency services respond. Sometimes that twisted ankle can be broken, that sore hand may need assessment or you may need stitches if a wound won’t stay closed. If you hit your head, please be assessed for concussion. Bicycle falls typically involve higher speeds and are more likely to cause damage but you can also cause serious damage when out running or walking and take a fall. Please take this damage seriously and get medical treatment as needed.

Recovery

With the jarring that happens when you hit the ground, you can be sore later in the day or the next few days after a fall in unexpected areas. Even after a seemingly minor fall it can feel like you got hit by a truck and it’s surprising! Some gentle movement such as walking can help ease soreness. Try resuming your normal run schedule but if you feel that your gait is off or something is too sore, it’s a good idea to take a couple days off. With any open wound, do not go swimming even if you have it covered.
 
Scrapes typically heal within a week and bruises take a couple weeks to fully heal but you may still be nervous about falling soon after a bad fall. This is a pretty typical reaction. Remind yourself about proper lighting (headlamp or flashlight) and try to stick to better-lit routes and routes with fewer tripping hazards to help minimize falls. And do your homework! We are always proponents of more strength and balance work and even falling practice. No really!
 
Link to "The Right Way to Fall"