woman falling off of ladder

According to the National Safety Council, “Falls are one of the leading causes of unintentional injuries in the U.S.”  In 2020 over 42,000 people died in falls at home and at work and more than 6.8 million people were treated in emergency rooms for fall-related injuries. 

Slips, trips and fall accidents can happen at any stage of life. For babies and toddlers, it may be a tumble from a crib or from learning to walk; for children, it may be from roughhousing on the playground or falling from a bicycle. Sports are a common field for falls for people of all ages and we also find slips and falls a common cause of personal injuries at home and in public domains.

During our careers (and depending on vocation), workplace slips and falls are common cause of injury, lost work time and workers’ compensation issues. In the golden years, fall risks become even more significant. For senior citizens, (those 65 and older), fall risks increase substantially and can pose much higher risks of morbidity and mortality as a result. It is estimated that millions (one in four) of older individuals will suffer a fall each year. Out of those that fall, it is sadly reported that less than half will even tell their doctor.

Many falls that people endure are ‘light’ and do not cause significant injuries, however, one of every five falls is said to cause a serious injury such as harm to the head or a broken bone. A big danger lies in-between these extremes in that injury may exist but symptoms from a fall injury or mild concussion may not manifest right away. These types of ‘temporarily hidden’ injuries are a cause for concern. Don’t wait for a deep bruise or dizziness to manifest days after injury to realize you were hurt. Because concussion and musculoskeletal symptoms may show up later, it is extremely pertinent that people seek care and monitoring after any slip and fall incident to avoid complications and optimize a swift and safe healing process.

When preparing for an assessment it is very helpful to try to remember the mechanism of the fall and your positioning such as: ‘What caused it?,’ ‘How did you land?,’ ‘Did you hit your head?,’ ‘Did any joints of the back or extremities bend abnormally?,’ ‘What type of surface did you land on?,’ ‘Were there any abrasions or bleeding?’ These types of details provide many important clues about the injuries that you may have sustained.

A Dangerous Reality

In the case of severe falls, 911 and emergency care should happen immediately. For other falls, it’s still critical to seek consultation and care as soon after a fall as possible. It is imperative to understand that individuals may or may not feel the effects right away. For some people pain, strain/sprain, lack of motion, bleeding, a bump on the head, blurred vision or other telltale signs of injury will be present. For others, the effects and symptoms may be delayed many days after the fact.

Neglecting timely management can prolong the inflammatory process and healing time which in turn can cause people to unwittingly cause further injury. A delayed response to seeking evaluation after a fall can lead to complications. Concussion is one of the most serious. If the fall causes a jerk or hitting of the head, the effect can be like that of a whiplash injury and a concussion may be present along with injury to the cervical spine (neck). 

If symptoms show up later, the dangerous reality is that people may not realize that they suffered a concussion. Healing and rest is needed for the brain. When an individual opts to jump back into activities or sports it can create risk for a potential second incident that could cause much more significant harm. After a fall, and especially if you jerk or hit your head, have your doctor of chiropractic (DC) evaluate you right away.

No matter when they occur, symptoms such as passing out, blurred or tunnel vision, nausea/vomiting dizziness, amnesia, fluid drainage from the nose or ears, ongoing paleness, slurred speech, weakness in the arms or legs, seizures, inability to balance and walk would all warrant an immediate assessment.

Latent symptoms

Mild concussions may have symptoms that manifest later. Neck stiffness with injury to soft tissues, headache, dizziness, abnormal sensations or paresthesias (burning, prickling or numbness), shoulder or back pain, extremity pain or loss of motion, memory loss, concentration issues, nervousness, irritability, sleep disturbances, fatigue or depression should all be watched for after a fall. New headaches that do not remit or get worse over time should be paid special attention to as they may represent a building of pressure in the brain and would require immediate attention.

In the case of neuromusculoskeletal injuries, like sprain/strain, pain symptoms, limited motion and outward signs like bruising may take time to appear. Waiting days for symptoms to arrive is losing precious time to optimize joint function, care for inflammation and support the healing process. Having an assessment right after a fall occurs allows your DC to examine the involved joints and maximize your healing process. 

After a fall the individual should cease activity and engage in R.I.C.E. protocols to minimize inflammation. Rest-Ice-Compression-Elevation takes the pressure off of the joints, works to control inflammation and start the healing process in a healthy way.

Without management of the injury site, some patients, for example, may opt to use a heating pad because it sounds relaxing. In reality, they will be increasing inflammation in the joints that can swiftly lead to more pain and disrupt the body’s healing process.

Prompt chiropractic care also decreases the risks of doing something too quickly that will result in further harm to the area of injury (like a heating pad or initiating exercise prematurely), DCs deliver care that includes:

  • Utilizing protocols for monitoring concussion.
  • Stabilizing the spine or joints when needed with braces or splints.
  • Managing acute injuries with R.I.C.E and changing protocols as healing occurs.
  • Restricting the movement of joints that need to rest to heal.
  • Recognizing the risk of mini-fractures that may not show up on X-rays right away. If fractures are not obvious and go untreated they may become unstable when people try to use the injured area normally. A care team will watch for fractures that may appear later and ensure they have time to heal effectively and not become worse.
  • Adjusting all affected joints to maximize function and alignment that help ensure that surrounding soft tissues will heal in balance with the attached bones.

Doctors of chiropractic (DCs) are an invaluable part of the health care team for slips and falls and may be a more accessible option for those cases that don’t require immediate emergency services. DCs are trained to examine the spine and extremities after injuries and are well-versed in the guidelines for concussion and management. Many offices also are equipped with X-ray capabilities for diagnosis and physiotherapy modalities that can be incorporated in recovery plans.

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