Falls and Concussions in Older Adults
“Help, I’ve fallen and can’t get up.” This iconic phrase from Life Alert commercials highlights a real concern for many older adults: the risk of falling. Falls are the leading cause of both fatal and non-fatal injuries in older adults. According to the Centers for Disease Control and Prevention, one in four Americans over 65 falls each year.
While the focus often lands on visible injuries like hip, wrist or ankle fractures, falls can also result in less obvious but equally serious issues like concussions. Just as you would check for physical injuries after a fall, it’s crucial to recognize the signs of a concussion.
What Is a Concussion?
A concussion is a mild traumatic brain injury that causes a temporary alteration in mental status and may or may not involve loss of consciousness. In simpler terms, a concussion is an injury to the brain that temporarily changes the way you think, feel or function.
Common concussion symptoms include:
- Memory problems and difficulty concentrating
- Foggy thinking or confusion
- Mood swings, anxiety or depression
- Dizziness, headaches or nausea
- Balance problems and sensitivity to light or noise
- Sleep disturbances
It’s important to note that no two concussions are alike. While one person may experience headaches and dizziness, another might have trouble with memory and mood. This variability makes concussions challenging to diagnose, especially in older adults where symptoms like balance issues or forgetfulness may be mistaken for normal aging.
How Do Concussions Happen?
Concussions are typically caused by a blow to the head or body that results in a sudden jarring of the brain. Falls are the most common cause of concussions in older adults, but other sources include motor vehicle accidents and sports injuries.
You don’t have to lose consciousness or directly hit your head to sustain a concussion. A hard fall onto your back, like slipping on ice, can also cause one.
How Can Physical Therapy Help with Falls and Concussions?
Physical therapists are experts in movement and rehabilitation. They play a critical role in helping older adults prevent falls, recover from concussions and address issues like dizziness or instability.
Fall Prevention
Preventing falls before they happen is the best approach. Physical therapists can assess your risk for falling and design an individualized treatment plan to improve your:
Balance — Exercises to enhance stability and reduce wobbling
Strength — Building muscle strength to support safe movement
Mobility — Enhancing your ability to move confidently and independently
Post-Concussion Recovery
While most people recover from a concussion within a few weeks, others may experience lingering symptoms such as headaches, dizziness or trouble concentrating. These are known as persistent post-concussion symptoms. Physical therapists can help with:
Headache relief: Using manual therapy techniques to alleviate tension
Balance and stability: Tailored exercises to reduce dizziness and unsteadiness
Mental focus: Activities that combine physical movement with cognitive challenges to improve concentration
Gradual strength-building: Reintroducing physical activity at a pace that doesn’t worsen symptoms
Addressing Dizziness
Dizziness is not a diagnosis — it’s a symptom that can result from a variety of underlying issues. People describe dizziness in different ways, such as feeling lightheaded, unsteady or experiencing a sensation of the room spinning. It’s a common issue among older adults, with one in four reporting feelings of imbalance or unsteadiness.
One potential cause of spinning dizziness is benign paroxysmal positional vertigo, a condition where tiny crystals in the inner ear become displaced. These crystals disrupt the balance system, making the world feel like it’s spinning, much like stepping off a spinning amusement park ride. Physical therapists can diagnose and treat BPPV using repositioning maneuvers that guide the crystals back to their proper place. In many cases, symptoms resolve in just a few sessions.
However, dizziness isn’t always caused by BPPV. For example, individuals recovering from a concussion may experience dizziness due to a hypofunction of the vestibulospinal reflex, which is one of the last systems to recover after such injuries. Identifying and addressing the specific cause of dizziness requires a thorough evaluation.
Falls and concussions can lead to serious consequences, but with appropriate care and prevention, older adults can maintain their independence and safety. Whether you’re dealing with dizziness, recovering from a concussion or concerned about fall risks, physical therapy offers the tools and support needed to regain balance, confidence and control.
Des Moines University Clinic offers expert care at two convenient locations in Des Moines and West Des Moines. Call 515-271-1717 or visit dmuclinic.org/physical-therapy to schedule an appointment today.
Disclaimer: This content is created for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition.