Showing posts with label falling. Show all posts
Showing posts with label falling. Show all posts

Sunday, March 5, 2023

Stories of the falls

Nope. The Brad Pitt movie is "Legends of the Fall" not "Stories of the Falls.". This blog is a follow up to my last blog about falling down. I'll be recounting a few of my more spectacular crashes and talk about what I did wrong and what I did right.

And I'll start with the one I illustrated last time.

This one was strange in that I had no sensation of falling. In other words, I was stepping up onto pavement and then I was face down on concrete with no feeling of anything between. That's why I'm pretty sure my feet got tangled up. I had recently bought a pair of walking shoes and, although they were very comfortable, the heels flared widely and tended to catch on things, including each other.

                      The very place

I was about to step up onto the concrete island when I suddenly found myself face down on it. My face had that sting that signals deep damage. My first thought was, "I've broken my cheek bone." After a couple of loooong seconds, the sting subsided and I decided that my face was not, in fact, broken. I lay there and went over the checklist.

Am I dizzy? No.
Has my vision changed? Yes, but it's because my glasses have been gouged.
My spine...any loss of feeling or movement? Nope.
Fingers, arms, toes, legs. All wiggle like they're supposed to, but it feels like I scraped my right knee. Hmmm, feels like my palms are scuffed, too. I must have tried to catch myself.
My torso...ugh, I might have broke a rib...or at least dislocated it. It's the same one I injured about 27 years ago. That's going to give me trouble.

It seemed okay to move...carefully, so I rolled slowly to my left side and, then, sat up cross legged on the concrete island...then stopped. 

By that time, two men had pulled over and were out of their vehicles. They made all the standard warnings, "Don't move. Take your time. Are you okay?"

I was bleeding from my face so one of the guys produced a towel and some medicated wipes. I assured them that there was no serious damage, thanked them profusely for stopping and helping (I want to encourage neighborly behavior whenever I can,) and told them that I was going to sit there for another minute and recuperate. 

The whole thing might have taken ten minutes. Then I got up, brushed myself off, and walked to the shops I was headed for in the first place.

This was a strange fall since I had no sensation of falling. It taught me that my new, comfortable walking shoes had a dark and dangerous side. I didn't throw them away, but I did change my gait slightly and haven't had any problems with them since then. One more incident and they would have gone into the trash. Your shoes definitely shouldn't be a walking hazard!

Since I didn't realize that I was falling until I was already down, I couldn't choose my "method of decent" so my part in the drama started with my checklist. There were no obvious hazards around. I was on the sidewalk, not in the street, so I had some time to evaluate my situation. I lay on my face until I was fairly sure I wouldn't do more damage by moving.

That rib worried me so I moved slowly, paying attention to it and my joints as I sat up. Then I stopped again. I checked myself again and rested. There were two good Samaritans there so I accepted their help and complimented their citizenship.

By the time I stood up, yes, I was hurting some, but I knew I could get on with my life without doing anything more extreme (calling an ambulance, yelling for help, fighting off a cougar.)

Over the next few days, I did my regular household chores but generally took it easy. In three days, I could resume my regular schedule, but I added the rib to my collection of "sports injuries".

As a kid, I was very active, so I kept scabs on my hands, elbows, and knees. That extended into the rest of my life. Working offshore on a lay barge as a welder helper, I found myself on one side of an empty pipe conveyor that I wanted to be on the other side of. They stored junk between the rollers and so, instead of taking the time to just walk around (we were down for an approaching storm), I decided to go across and started calculating my path...up on my side, over to that big piece of sheet metal, over to that box, up on the other side, voilá!

The sheet metal had grease on it.

Why is it the first reaction of people after a fall to look around to see if anyone noticed?

The Southeast Howl, oh, I guess spring of 2003, I walked the mile and a half to the showers with a couple of the other Howlers. It had been a rainy March and the wide trail they called a "service road" was all mud. We got to the ranger station pretty late at night without incident, showered, and started back.

At one place, the whole trail was a mud puddle with a thin shoulder of mud. My companions got across but half way, the shoulder gave out under me and I went over. Twisting to the side, I spread out so that I could get as much traction on the slope as possible and maybe I could catch on something with my outstretched arms.

But there was no slope. There was nothing under me and I ended up hanging off the side of the bank by my arms. It was so quick that, to my friends, it seemed that I had just disappeared. They heard me fall but there I wasn't. When they called to me, I didn't want them to try pulling me up and all of us going...somewhere, so I grunted, "I'm okay. I can climb up."

Of course, the fall sorta made my shower moot. 

I wasn't injured. I could have been...badly. The next day by light I looked over where I fell. The creek was swollen from the rains and was crashing through a lot of big boulders and, sure enough, it was a vertical drop to the creek.

My twist to the side and extending my arms is what saved me. I was already in form to catch myself.

I had integrated most of the tips from the last blog as motor memory. A couple of years before, I was hiking with a friend from Highlands, North Carolina to Franklin. It's a breathtaking hike. The first ten miles, the Cullasaja River crashes over one fall after another and then it blasts out over the 200 foot Cullasaja Falls, and the river settles into a beautiful, peaceful valley that looks just like a post card from the Swiss Alps.

Just before the river goes over that last ledge, it goes through a meat grinder. The broad stream flows into a narrow slot between two rock walls. I wanted a photo of that and there was a rock face on the mountain between the road and the stream that I had to traverse. I usually crabwalk down those. A crabwalk is a flipped crawl, moving on hands and feet facing up. That gives you four points of contact with the ground but you can see where you're going better.

About halfway down, I hit a slick spot and started sliding. I came down quickly on my back to get more friction, which stopped me from sliding about two feet from the edge.

No longer in danger, I scooted over to a better vantage point and took the picture.

Had I panicked, I probably wouldn't be here today. But had I been paying more attention, I would have seen the slick spot and I wouldn't have been in that predicament.

My last fall was embarrassingly funny. Well, I can laugh now.

I was rolling our garbage bin from the patio out to the curb. It was particularly heavy that night, and top heavy at that. It normally resides on our patio so I have to roll it down three steps into and through the garage, down the driveway to park it on the curb in front of the house.

This night, I rolled it down two of the steps,and when I let it down off the last step, that was a little too far...we all went down. Pulling back on the handle and putting my weight against the top of the garbage bin slowed our decent and saved me from some serious injury.

Unfortunately, pulling back on the handle also ensured that my fingers on both hands were between the handle and a step with my upper body weight on top. I was firmly pinned and pushing myself up just shifted my weight onto my fingers, which were already being crushed.

My strategy? Growl, snarl, make a lot of noise.

I couldn't lift myself straight up off my fingers but I decided that I could lay to the side between the garbage bin and the steps. That got most of the weight off my hands and, by the time the others in the house heard my racket and came to check, I had my fingers free and was crammed into the space on the steps.

They knew not to move anything before I finished my damage check. Afterwards, Coyote pulled the garbage bin off me and Fox got it on down to the street. I ended up with a minor cut on one knee and no broken fingers. There was some crushing of the soft tissues. I'll be feeling that for awhile.

So, what did I do wrong? I was very tired that night and I thought I could manage the weight of the heavy garbage bin down all three steps but the last one pulled our centers of gravity too far apart. We became a class 2 lever with no force pulling the arms together.

What did I do right? First, I knew that I was going down so I had time to prepare for the impact. I had also played around with levers enough to know how they work. Who says physics labs aren't useful?

I knew that the further the force pulling  arms of the lever together was from the pivot, the slower they would slide apart and the slower I would fall. I could only pull as hard as my strength allowed, so I shifted my weight from the handle of the bin up to the lid, as high on the bin as I could.

Every fall is a survival situation. It's unexpected and will cause some injury, if only a shock to the system. In more extreme cases, it can result in death. The goal of the person falling is to minimize injury.

The Teaching Company has a course presented by professor Nancy Zarse entitled Survival Mentality: The Psychology of Staying Alive. It won't give you what you need to survive critical events....that also requires practice, but it will tell you what you need.

There are 12 chapters and I can illustrate them with my falls.

Chapter 2 is about locus of control. A person with an external locus of control feels that the world happens to them. A person with an internal locus of control feels that they happen to the world. There will be a day when the world overwhelms me, but there will only be one and until then, I have plenty of control to get through any emergency I have to face. In a fall and after, I keep track of what's happening, what resources I have, and how to use them to my benefit.

Instincts: my body is equipped to deal with emergencies. My senses of balance and location of body parts (including my center of gravity) are powerful tools and I pay attention to them.

Intuitions are learned. I'm a lifelong learner and have a broad base of knowledge. I never know when an obscure fact might come in handy, for instance, how a class 2 lever works, so I enjoy learning as much as I can about as much as I can. And I train my body to move in emergencies and to sustain injuries. The endurance hikes I've written about push me to my limits so I can learn to manage myself at my limits. In an emergency, you have to think but you don't usually have time to deliberate. Most of what you do needs to be ingrained behavior, programmed through prior practice.

Surviving a critical event requires the ability to manage emotions under pressure. Emotions happen. You can't stop them but you can control them. When something catches you by surprise, your startle reflex causes you to pull in to yourself to present a smaller target. That is usually the exact opposite of how you should handle a fall. When I fell off the bank of Sauty Creek, my outstretched arms caught on the bank. Fear paralyzes. In an emergency, you need to monitor, evaluate, think constantly. You can only do that by compartmentalizing your emotions so that they don't interfere with your reasoning.

A lot of everyday experience prepares you for emergencies. If you pay attention to your body as you walk down the street, you will develop a sense of body position, what is termed "proprioception". If you focus on your smartphone, you won't...at least, you won't develop that conscious sense of how your body moves in different situations 

In a fall, you don't have to just manage your own body, you have to be aware of what's going on around you. Situational awareness is important in any critical event, but you have to develop the habit of taking stock of what's going on around you.

A fall happens quickly, but the follow-up might be long and grueling. A survival situation often requires perseverance under pressure. When I fell at Sauty Creek, I had to hang there a minute to figure out why there was nothing under me. I also had to understand the danger to two other persons. I determined that I could probably climb to safety without putting them in danger so I told them that I was okay (something I was not absolutely sure of!). 

When I fell with my garbage bin, I was trapped. I could have done a lot more damage to my hands but I calmed down and realized that I didn't have to pull my fingers straight out from under the handle that was pinning them. I could shift my weight to the side and then free them. 

Certain mental qualities act as protective factors to help you in the face of danger. Confidence is a big one. I'm currently 69 years old and I have gotten out of a lot of scrapes. Some could have cost me my life. But with each one, my feeling that I can survive any emergency increases.

Not only do we have to live through emergencies but we also have to heal and to heal well required physical health, perseverance, and, just as important, a positive outlook.

The last factor of survival discussed by Ms. Zarse is community. I might be able to drag myself out of the wilderness after horrific injury like Hugh Glass sustained and was left for dead as portrayed in the movie The Revenant but I don't know because every injury I've had, in town or out, someone has come to my aid. I didn't always need them, but I never let them know that. Community is important to prepare for emergencies, to survive emergencies, and to heal after emergencies.

If it's falls, car crashes, or any other emergencies, great or small, learn through them. They will happen sooner or later, and the more adventurous you are the more frequent they will be. If you have to put up with them anyway, collect all the benefit you can. Be aware, learn, and remember.

Saturday, February 18, 2023

Falling down




I'm not talking about the movie with Michael Douglas. This is about surviving a fall.

I sorta liked the cosmetic effects of the fall-before-last, especially with a cap. It looked really sinester and gothy...like a super-villain, but that isn't eye shadow in the picture above.

If you hike long enough, you're going to take some falls. There are five points to keep in mind.

1) Stay healthy. You come through specific injuries and illnesses better if you're generally healthy.

2) It's better not to fall, than to have ever fallen at all. Learn how to prevent falls.

3) Like I said, if you hang around long enough you're going to fall. That's a result of the precarious, two-legged stance our ancestors adopted. Learn how to fall right...that is, learn how to minimize the damage when you fall.

4) Know what to do while you're lying there after a fall. It's easy enough to aggravate the injuries you've already taken in a fall or to pick up a few more.

5) Know how to take care of yourself after a fall.

It's February in Denver and this is what our sidewalks look like. The snow is obvious. The black ice is almost invisible and will take you down if your center of gravity shifts just a tiny bit off your vertical axis, but I'm not about to stay inside during the winter, especially since that's my best hiking season.

My first day in Colorado, Christmas 2013, I walked to a nearby park and was reintroduced to black ice. I lay on my back and looked up at the sky while the crows laughed at me. Since then, I've slipped on ice once while shoveling the driveway.

The main thing that usually brings me down is fatigue. When I'm tired, I get sloppy and I don't pay attention to what I'm doing. I'm 69 now and am pretty much always tired, so I have to remind myself to pay attention. Even a ten minute rest can make a big difference.

Another thing is dehydration. I live in a desert state. The humidity is traditionally low as is the air vapor pressure. It sucks the moisture right out of you. Where ever you are, though, it's easy to lose too much water. Lose too much blood volume and that's called shock. It makes you fall down. The body also uses water in it's chemical reactions...for processing energy sources, for repairing damage, for regulation your body temperature, for just about everything. 

Take water with you when you hike. Don't wait until you're thirsty to drink. Drink a little frequently. If your urine is colored much at all, you're not drinking enough.

Eat while you're out. Sugar is a fast energy source. Glucose is the best sugar...if you can find it. Sucrose breaks down into glucose and fructose and fructose isn't effectively used for energy production in the body, so it's half as useful. Fats are like time released energy. Honey and dried fruits are good sources of glucose and nuts are good for fats, so carry a bag of trail mix.

Fall prevention is complex, just about everything you do and how you do it goes into the prevention of falls. In the development of the SAFE (Self-Awareness of Falls in Elderly) test, four factors were found to be important for elderly people to prevent falls (Meei-Ling Shyu, et al., Development and validation of the self-awareness if falls in elderly scale among elderly inpatients, Clinical nursing research 27 (1), 105-120, 2018, abstract https://scholar.google.com/scholar?hl=en&as_sdt=0%2C6&q=fall+prevention+environmental+awareness&btnG=#d=gs_qabs&t=1674935233407&u=%23p%3DlW5gzcWX1K0J)

 Of course, it's a life or death issue for the elderly, but anyone who spends much of their time on their feet need to be aware of these factors. They are 1) awareness of activity safety and environment, 2) awareness of physical function, 3) awareness of medication, and 4) awareness of cognitive behavior. There are a few things that can decrease your chances of falling based on these factors.

First and foremost, occasionally take stock of your surroundings. Two of my worst falls were caused by crumbling material under my feet. In both cases, I was very tired and was not paying attention. You should be sensitive both of what's going on under and around your feet and also what's happening around your head. A friend was once talking so much on the trail (and wearing a baseball cap that obscured his upward vision) that he missed the stout limb that crossed the trail at head height and flat knocked himself out. Using all your senses on the trail and keeping that voice in your head at a minimum will ensure that you don't miss interesting things on the trail, and that you notice things that can put you quickly on the ground.

If you start each step with the initial pressure on the ball of your leading foot (contrary to what the Boy Scout Manual tells you, don't be a heel striker), you will be more aware of what your feet are doing and make adjustments if something goes wrong. 

Check it out. Take a nice broad step and come down on the heel of your leading foot. Freeze in mid stride. Where is the pressure on your feet? It's pushing your feet apart into a split. Swivel your feet around. Your back foot is pretty firmly planted but your forward foot can turn a little from side to side. 

Now try again but come down on the ball of your leading foot. The pressure is pulling your feet together. Also you can turn your leading foot in a wider arc, swiveling both your heel and the bottom end of your lower leg. If you make a misstep, you will want as much freedom of motion in your feet as possible to recover.

Be aware of your center of gravity...where do you feel the downward pull of the earth most. It will be somewhere around your navel, but it shifts around while you walk and the further it gets from the midline between your hips, the more unsteady you'll feel. The more aware of where your center of gravity is, the more instinctually aware of your stability you will be. 

It's harder and harder to stand upright as you're center shifts away from your midline, but you can shift it as far up or down as your knees will allow, and moving it down will also increase your stability. Even a slight crouch will improve your footing on ice or mud.

The two biggest problems with our bipedal stance is how narrowly we can shift our center before we fall, and how much of our weight is on such a small area. In other words, the more friction we have with our support, the less we slide and all our friction is between our two feet and that surface.

I've often increased my contact with the Earth by moving on all fours (a new word has appeared for that. We used to call it "crawling". Now it's "quadropics".) You can either crawl on your hands and knees (or toes) or flip over and crab walk. If you start to slip, you can lower your body to the surface and get even more traction.

How are you feeling? Body discomfort is a huge distraction so an active lifelong learner should maintain good health and should avoid walking on an empty stomach. Simple sugars in dried fruits provide bursts of energy when needed, fats like in nuts and meat snacks and starches in grains provide a time-release effect, and proteins (hard boiled eggs, meat snacks, nuts, cheese) provide some energy but also body maintenance function. Breads, chips, candy are fun but they don't make a good trail food. 

And stay hydrated. You need water, but you also need electrolytes - sodium, potassium, and calcium. Electrolyte (not sports) drinks are good, but so is milk. The problem with milk is that, if you carry whole milk on a hike, you might find that walking motions will effectively churn it to butter.

I had a friend that decided that sweetened condensed milk would be a perfect trail food. Sugars, starches, electrolytes, protein, all in a convenient can. It took about five minutes to come back up. You don't want rich, greasy, or very spicy on the trail. Gastrointestinal problems will quickly dehydrate you.

And get enough sleep before a hike and rest during a hike. Most of my falls have occurred because of fatigue. Fatigue is a big distraction.

The first rule for fall prevention is "pay attention!" If you're a lifelong learner, that shouldn't be a problem, you're all ready soaking up your surroundings. But you should especially be aware of hazards. Loose pavement and gravel have taken me down much more often than ice or mud.

Don't just use your sight. Use all your senses. Black ice is almost invisible. It's snow and ice that has refrozen into an almost featureless surface. But if you step on it, you will certainly feel it. If there's even a chance that there's ice around, swivel your foot around before committing to a step.

Things that startle you also distract you. You'd feel pretty foolish if you jump back from a snake just to land on a pebble, turn your ankle, and fall. But most snakes have a strong, recognizable musk. If you notice a snake before you see it, you won't be startled.

Again, use all your senses.

Now, what do you do if you fall? You usually realize that you're falling and can plan how you fall. The following points are taken from How to fall without injury on the Harvard website (https://www.health.harvard.edu/staying-healthy/how-to-fall-without-injury).

1) Fall forward. You'll have more control and it will be less likely that you will bang the back of your head. I will add that, if you're on stairs or a steep incline, fall up the grade and not down. Walk so that, if you fall you'll fall the right direction.

2) Try to fall sideways. You're going to take more damage if you fall on your face or the back of your head.

3) Grass, dirt, or snow doesn't hurt nearly as much as concrete or ice. Aim toward the soft stuff.

4) Fall away from other people or sharp stuff.

5) Swing your arms to direct your fall.

6) You want as little impact on your head as possible. Twist your shoulder to cushion your head.

7) Lower your center of gravity by bending your knees and keeping your feet down. The lower you are, the softer you fall. If you're walking on ice or mud, squat slightly and stay on the balls of your feet.

8) Relax as you go down. The Harvard site suggests that you "fall like a sack of beans."

9) Fall on your more padded areas, your butt and thigh.

10) Roll as you fall. This is something martial artists learn while training. It spreads the impact over a larger area.

Now, what do you do after you fall? Do you remember your first aid training? Uh...have you had first aid training? Never mind, the Three C's are Check, Call, and Care.

The first thing to check is whether you're in harm's way. If you're in traffic or in danger of falling further, get out of harms way. Don't worry about causing more damage.

If you fall in a safe place don't move. Go over the check list. Start at your head. Does anything hurt there? Are you dizzy? Is your vision affected? Are there any weird smells? Do you taste or smell blood?Then go to your neck and spine. Any pain? Wiggle your fingers and toes. Can you move them? Can you feel them. Any serious pain in your limbs or your torso? 

You want to make sure there are no broken bones, nerve damage, or damage to any vital organs before you move and then move so as not to cause any more damage.

If there's no serious damage, you can move to a more comfortable position. If there does seem to be something seriously wrong, call to someone for help or, if you have a phone handy, use it. Get help.

If there's no one available, that's when that first aid training (and/or wilderness survival training if you frequent the woods) will be useful. Just in case you didn't catch it, I'm recommending that you take first aid training. Sometimes it only costs the time it takes to go to the classes but, even if you have to pay, it's usually not much.

The rest is down time. Take it easy and heal up. Rest, drink plenty of water, eat well, and take antiinflammatory drugs as directed to reduce pain and inflammation.

Take care of yourself. The goal of active, lifelong learning is to learn and to enjoy life, not to kill yourself.