Slips, trips, and falls are common occurrences many of us encounter within our home and work environments. They can range from the ones we simply laugh off to serious injury-inducing ones that require medical attention. Reducing slips, trips, and falls is dependent on several factors that we will break down in this article. Learn about the most common causes of slips, trips, and falls, how balance works, and gain helpful safety tips that you can apply to common winter tasks.
Part 1: How Balance Works
Balance is an important part of how our body maintains stability and equilibrium. It is an integration of the following 3 input systems:
- Somatosensation: what we feel from touch (proprioception, force sense, kinesthesia)
- Vision: what we see (orientation of our eyes and head in relation to our surroundings)
- Vestibular: what movement we sense (gravitational, linear, and angular accelerations of the our head in relation to space)
These three input systems work together to provide the information that the brain then processes, followed by the muscles in the body that then coordinate a response to initiate a balance response. If we have deficiencies in one of the input systems (for example, individuals who experience vertigo which affects the vestibular system, or when we are temporarily blindfolded and can’t use our vision to process information), the other two systems can compensate to help out.
Our body coordinates 3 different strategies to maintain our balance: ankle, hip, and stepping strategies. Each of these strategies aim to recentre our body’s centre of gravity (COG) over our limits of support (LOS). In this case, our limits of support are our feet when we are standing and walking. When too much of our body weight travels beyond our LOS we are more likely to lose our balance and fall. For example when our feet are positioned close together our LOS is very tight and we only have a small area to keep our COG within. When we widen our stance shoulder or hip width apart we increase our LOS which gives us more wiggle room and makes it easier to keep our COG within our LOS.
If you’ve followed our resources, hopefully you recognize that establishing a Stable Base is one of our ‘Big 3’ Movement Fundamentals. With any dynamic movements, we want to adopt stances that will encourage good movement opportunities further up the chain that allow us to use the different balance strategies. It is important to have all these strategies available to utilize for the best chance of minimizing slips and falls. It can be harder to use these strategies as we age and our muscle coordination decreases, or even if we’ve recently injured any of our lower body joints.
Our feet are the first parts of our body that make contact with the ground. Our foot and ankle muscles adjust in order to keep our centre of gravity stabilized over our feet (in this case, our limits of support). This is the most commonly utilized strategy, which works best with slower movements. As we walk and stand, our ankle muscles are constantly working to fine tune our balance.
Does The Shoe Fit?
A critical consideration when it comes to our ankle strategy is our footwear! How our shoes are built and how they fit to our feet can make balance easier or harder for us. Shoes that fit too loose can result in a more delayed balance response because there is simply more slack in the system and less feedback telling us we may need to adjust our balance. Shoes with too narrow of a toe box can reduce the muscle response in the toes needed to quickly adjust. Shoes with a higher neck are not just for puddles, but will tend to provide more ankle support as well as more balance feedback.
Ensure the soles of your shoes have adequate grip for your activity needs. Dress shoes or high heels can often result in a slippery trek during winter conditions so consider adding grip stickers to the soles (you can purchase these from most shoe retailers) or having a change of outdoor shoes you can change in and out of for commutes. For work boots or winter boots, remember to check your soles for any signs of wear and tear that may indicate it’s time for an upgrade. We can also consider adding traction-aids such as cramp-ons to our footwear as well. Overall, look to find well-fitted shoes that will accurately fit your personal needs and ensure they continue to stay in good condition.
Our body’s centre of gravity is situated around the hips (similar to the centre of gravity of a seesaw being the middle point). In this strategy, our hips and torso shift in various directions to help us maintain balance. This allows us to make adjustments in our centre of gravity. We typically use this strategy when the ankle is unable to control our balance (gets tired or weakens), when there is a sensory interruption/loss, or we’re exposed to slippery surfaces. The hip strategy helps to control our bodies during quicker movements and also helps to stabilize in situations where we may have a narrower base of support.
Using a neutral spine posture with the hips able to easily hinge can unlock more power muscles in the lower body that help to provide better control and quicker response times. A slouched posture with the common posterior pelvic tilt (aka butt tuck) locks up some of our much needed power muscles in the hip that adjust for balance and power. Think of yourself when you were just learning how to skate – lightly bending the knees and sticking your butt out a bit just happened to help you become more stable! Also think of why athletes often adopt the “power position” before explosive movements, for example, the ready position in American football.
Sometimes we may have barriers such as tool belts or layers of clothing that may restrict us from utilizing the hip strategy as well. Look for alternative strategies to carry your tools and items as well as movement-friendly attire if possible. If we are carrying a very heavy load with our upper body, that can also prevent us from using the hip strategy. Consider taking a slower approach with careful steps or use an alternative method to lift/transfer the load.
Our last strategy is taking a step or adjusting our foot position to maintain our balance. We use this strategy when our centre of gravity is outside the base(s) of support. This can happen if someone bumps into us, we trip, or our hip and ankle strategy becomes fatigued. We’ll often either take a step to widen our base of support, or in cases where our feet get pulled away from us (think unexpected splits on ice) we may also step inwards to bring our base of support back to neutral. This strategy uses all of our lower body and core muscles.
Our lower body and core muscles coordinate to respond quickly to a change in the system. The faster the response, the better, as too slow of a response can result in a fall or injury. Many studies over the years have shown improvements of reaction time in adults, and subsequently a reduction in losing balance and falling when they incorporate balance and exercise components into their lifestyle. This can be especially important as we age, and the old adage of “if you don’t use it, you lose it” certainly applies here. The key is that our muscle coordination can be improved upon with simple practice! From standing on one leg while you brush your teeth, to more complex lower body and core stability exercises, we can all benefit from improving our balance throughout life!
For a few basic balance and core exercises to help you get started, take a look at our MoveSafe video below:
Part 2: A Few Slip/Trip Tips for Winter Tasks
Winter conditions increase the risk of slips and trips due to the addition of slippery surfaces and deep snow. Try incorporating the following tips if you haven’t already!
Tips When Exiting Vehicles
- Slips and falls can happen when we don’t anticipate the conditions or hazards outside our vehicles. It may be dark, slippery, or uneven so make sure to fully check your surroundings before exiting your vehicle. It can be helpful to test the ground with one foot before fully committing with our body weight.
- When exiting, consider your body mechanics! Align the knee and foot (this is where lots of people have twisted their knees) by making sure your hips are moving the same direction your toes are pointing.
- Adopt the MoveSafe ‘Big 3’ principles and hinge at the hips, maintaining a neutral spine posture when bending forward to get in and out of the vehicle. If exiting a taller vehicle or descending from a truck bed, avoid jumping off and opt for a more controlled movement option to minimize stress to the joints.
- Use 3 points of contact when exiting, or at the very least, ensure you have an extra hand available for additional support. That means not exiting your vehicle with a mug of coffee in one hand and your work bag in the other if you don’t need to. We have had too many coffee casualties doing this!
Walking, Deep Snow Hiking, Snowshoeing Tips
- When walking, consider the three balance strategies highlighted above in this post. We ideally want to have the ability to use all three options if we need to, in order to minimize our fall risks as much as possible! With deep snow hiking and snowshoeing, we typically use less of our ankle strategy by taking larger steps that employ our power muscles in the hip to push us forward. It may be beneficial to incorporate warm-up exercises that wake up the power muscles in the hips as well as some recovery stretches afterwards.
- Remember, vision is a main input we require for balance, so keep your line of sight visible at all times! Consider doing outdoor winter tasks during daylight periods or ensure you have proper lighting with you. Headlamps can also work as a great hands-free option for those pesky outdoor winter tasks!
- Consider fatigue effects if you will be exposed to long periods of walking or trekking. Even more so with adverse conditions, difficult terrain, or wearing additional gear on your feet such as snow shoes or large footwear. Incorporate a warm-up prior to the activity, break up long durations with short breaks in between, and focus on recovery activities afterwards to keep the body physically fit. In addition, you may want to consider other fatigue mitigation strategies that incorporate good nutrition, hydration, and sleep habits as well.
- Additional equipment and gear may benefit us as well, such as the use of hiking poles, traction aids, boot liners, etc. Boot liners can not only help to keep our feet warmer and dryer, they can also fill space gaps that we have in larger footwear, providing a more snug fit overall. Traction aids can come in many different options. We commonly see people utilize the rubberized versions that wrap around the soles of the shoes, or the simpler elastic bands that fill the centre of the sole. The first is often a better option for consistent outdoor walking with better overall grip, the latter is more flexible for those moving between indoor and outdoor environments but less grip. Snowshoes have a lifter that angles the snowshoe, making it much easier on the ankles when hiking uphill.
We hope you enjoyed this blog article on preventing slips, trips and falls this season! Slips and trips aren’t the only hazard for the musculoskeletal system in winter. Check out our Snow Shoveling Safety Tips article to learn how to take care of your back while clearing snow. As always, we’d love to hear more from you on how you’ve applied these tips personally or if you have any requests for future topics!