Falls are one of the largest public health problems among elderly people due to the high morbidity and mortality. Falls cost the NHS 2.3billion annually.
The main reasons for falls in this population are multi-factorial – a fall is the result of the interplay of multiple risk factors such as having a history of falls, muscle weakness, poor balance, visual impairment, slower reaction time, polypharmacy and the use of certain medicines as well as environmental hazards.
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N.B sustained a right triple ankle fracture and dislocation following a slip and fall at home. She was brought to A&E where they wanted to operate on her ankle and hold it in place with a plate due to the complexity of the fractures. However, she did not want any metalwork in her ankle and therefore the ankle was just manipulated under anaesthetic back into the correct position. The foot was managed conservatively and put in a cast for 6 weeks. N.B. attended Aqua physio 2 months after her injury.
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BH is a 59 year old gentleman who was involved in an RTA as a pedestrian in November 2017. He sustained a triple ankle fracture which required surgery to fixate and was subsequently non-weight bearing for 8 weeks after. Once his cast was removed he was fitted with a boot and allowed to fully weight bear, so his rehabilitation could now begin. His main goal was to be able to walk comfortably whilst on his cruise holiday at the beginning of March.
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NDO is a 79 year old lady with a long term history of lower back pain and bilateral shoulder pain, mostly due to OA and age-related changes. She was a professional volleyball and softball player in her youth so her shoulders were worked hard for many years.
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The shoulder is the most mobile joint in the body. It is more of a complex than a single joint as it consists of 5 joints, over 30 muscles and 6 major ligaments. The main shoulder joint is a ball-and-socket joint, which allows a very wide range of movement, therefore it is easily prone to overuse and injury. Shoulder pain is the third most common musculoskeletal complaint presenting to physiotherapy and the pain and disability associated with shoulder problems can have a large impact on individuals’ ability to complete their normal daily tasks.
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