Overcoming the fear of falling Fear can be a helpful signal; it can bring your attention to problems—such as a balance disorder, reduced vision, or muscle weakness—that keep you from moving confidently. But fear can also undermine you. Persistent worrying about a fall, if it's unwarranted, may cause you to limit your range of motion unnecessarily and avoid activities that you're capable of. It's estimated that one-third to one-half of older adults are concerned enough about potential falls that they have begun to restrict or avoid activities that would be beneficial for their health. Get your copy of Mobility and Independence   Mobility and Independence, a Special Health Report from Harvard Medical School, will help you maintain your mobility and safeguard your independence. It will give you recommendations for exercise, diet, preventive care, and lifestyle choices that will keep you stronger and steadier with fewer aches and more stamina. Plus, you’ll get advice for aging in place, adapting and fall-proofing your home, choosing services, and more. How can you build your confidence? If you don't trust yourself when walking, it's important to talk with your doctor to understand the cause of the fear. Is it a sign of a health problem — perhaps a vision problem or arthritis pain — that you need to address? Do you need a hip replacement or a new pair of glasses? Or are you worried about your sense of balance? Exercise is essential for helping to maintain strength in your legs, buttocks, and core, all of which are important for balance. Certain types of exercise, such as Pilates, yoga, and tai chi are particularly helpful for balance.  Measures like these can help build your confidence—and prevent devastating falls. If you've already had a fall, think about building confidence back gradually as you recover. Depending on how badly you've been injured, you may need to work with a physical therapist to regain your strength and range of motion. One type of therapy you can do with a physical therapist is called gait training. In this therapy, you work not just on strengthening muscles, but also improving posture and developing good walking form, so that you move more fluidly. Once people recover 90% of their normal strength, they start to regain their confidence. If you've been prescribed a cane or walker, don't hesitate to rely on it for balance and support. If strong relatives can accompany you on walks, so much the better. Stick to walking in familiar places that you know well, and avoid walking at night or in wet or icy conditions. If you're afraid of falling, try exercises that don't carry a risk of falling, like riding an exercise bike, swimming, or doing pool aerobics, so the water supports you. For more on how to preserve your mobility so you can stay active, check out Mobility and Independence, a Special Health Report from Harvard Medical School. Image: monkeybusinessimages/Getty Images Share this story:

What type of mattress is best for people with low back pain? Back pain is one of the top reasons that people begin to lose mobility in middle age. Pain can keep people from engaging in physical activity, making it more difficult for them to maintain a healthy weight and keep up their strength, stamina, and balance as they age. So treating and managing back pain that results from injuries or health problems is crucial for staying on the path of a healthy and active life. Considering that most people spend roughly a third of their lives lying in bed, choosing the right mattress is essential for managing low back pain. It can make the difference in whether you can sleep at night and function the next day. In the past, doctors often recommended very firm mattresses. But one survey of 268 people with low back pain found that those who slept on very hard mattresses had the poorest sleep quality. There was no difference in sleep quality between those who used medium-firm and firm mattresses. Soft mattresses, on the other hand, can also be problematic. While a soft mattress that conforms to your body's natural curves may help the joints align favorably, you might also sink in so deeply that your joints twist and become painful during the night. If you want to find out whether a firmer mattress would feel better than the one you're currently using, try putting a plywood board under your mattress to dampen the movement from the bedsprings, or try placing your mattress on the floor. Of course, you can also go to a mattress showroom and test a variety of models. But keep in mind that what feels comfortable for a few minutes in a store might not translate into a good night's sleep. A more reliable test is to observe how you feel after sleeping on different types of mattresses while away from home — for example, at a hotel or a friend or relative's house. For more on how to preserve your mobility so you can stay active, check out Mobility and Independence, a Special Health Report from Harvard Medical School. Image: AndreyPopov/Getty Images Share this story:

Featured in this issue

Mobility and Independence Featured content: • Mobility and quality of life     • Prime movers: Knees and hips • A good foundation: Feet and ankles        • A stable support: Your back and posture • Masterful muscles        • Balancing act    • The mind and senses: Staying sharp Click here to read more »