Although fall-related injuries aren’t talked about as frequently as smoking or obesity-related illnesses, they are at epidemic proportions. In the US alone, almost 1 in 3 adults over 65 years old falls each year. Of these older adults who fall, 37.5% report sustaining an injury in the fall.* And most tragically, many of these injuries, such as a head trauma or hip fracture become fatal. In fact, if deaths from falls continue to increase at the same rate, the U.S. can expect 59,000 deaths because of a fall in 2030.**

Yet, it’s not just older adults who get hurt when falling down. Pause and think for a second. There is a good chance you know someone who broke a wrist or twisted an ankle when crashing to the ground. Maybe you’ve suffered your own fall-related battery?

It’s time that we stop talking about falls mainly from a preventative point of view. Not all falls are avoidable. Instead, let’s change the discussion to how to minimize injury when the inevitable happens.

Listed below are seven ways to help you avoid an injury during a fall. These are hard won insights, born from martial artists, skateboarders, and parkour athletes. These individuals routinely drop to the ground, and yet they get up again and again without injury. How they fall and interact with the ground is a curious feat, and a great starting point to the topic of injury prevention.

Be aware of your environment

Athletes who fall down frequently have a heightened awareness of the space around them. Why? Because if you know that a fall is inevitable, you want to drop in such a way that you avoid hitting an unforgiving surface. Slamming your head on a cinderblock is much less pleasant then landing in a soft bush. Likewise, the concrete sidewalk is a much less welcoming landing pad than the patch of grass off to your side.

By scanning the environment and being aware of the world around you, you are better prepared to steer your fall away from danger. Now, you might not always have much leeway to direct your fall, but it is a good aspiration to have.

Incidentally, if you are reading this on your smartphone while you’re walking down the street: Please put your device down. As with texting and driving, distracted walking makes you much more likely to careen into danger.

Don’t freeze!

A common theme in self-defense seminars, is that if you freeze you die. If someone is intent on causing you bodily harm and you don’t respond accordingly, well, harm happens. The same thing applies during a fall.

If you have ever been to a self-defense course, recall how you practiced deflecting and responding to an attacker. You practiced your blocks and strikes over and over again to build your muscle memory. The repetition strengthened your neural pathways to make sure that you would not freeze in the face of danger.

In a similar way, martial artists, skaters, and parkour athletes train themselves to recognize and respond to a fall as quickly as possible. The faster you can recognize that you are going down, the faster you can respond and avoid injury.

Close your eyes for a moment. Imagine that you were ten feet above the ground, walking across the narrow metal beam of a playground swing set. Don’t bother yourself with how you got there – just play along here.

You take one step, a second step, and on the third step you lose your footing. You are starting to FALL.

In this moment, you have two options. Option A: you can do nothing and let the ground rush towards you, as you brace for impact. Or, option B: you scramble and claw to grab the metal beam so that you can drop in a more controlled manner.

Let go and do nothing. Or, react and take control. Those are your options.

Which one do you think has a better chance of avoiding injury?

However improbable that scenario might seem, the same thing applies every time you fall on flat ground. Do nothing. Or, respond and take action.

If you are wondering what type of response and action to take, keep reading. Athletes who fall down a lot cultivate a style of falling that helps keep them from getting hurt. Copy their style and you too can fall without injury.

Avoid straight lines

During a fall, your straight limbs might as well be broken limbs. Don’t believe that? Go watch a few “fail” videos. Striking the ground with outstretched limbs often leads to a broken bone.

Thus, athletes who fall down a lot try to make impact with rounded limbs. They stay loose and lightly flexed across their major joints. From the spine, legs, and arms, their major body segments form into relaxed semicircles.

Consider tipping a kitchen chair backward and then letting it drop back onto all four legs. That leads to a pretty rough landing, right?

Now, imagine tipping a rocking chair backward and letting it rock forward. The curved support of the rocker makes for a much softer landing.

Your goal when learning to fall should be to transform yourself from a rigid kitchen chair into a rounded rocking chair. Harness your inner rocking chair

As another example of what it means to avoid straight lines, place your arms out to your side, and then point your hands back toward your waist. Pretend you were demonstrating to someone the shape of your body as if you were wearing a blow-up sumo wrestler suit. Now, flex your spine a little and go loose in your legs crouching toward the ground a few inches.

Once you are in this position, feel what it is like to be in this ball shape. The more ball-like with rounded surfaces you can become during a fall, the better you can avoid injury.

Spread your impact across multiple body segments

It follows from the last point that dropping entirely onto your wrist, hip, or shoulder without spreading out your impact is a recipe for disaster. The solution is to dissipate your contact across multiple body parts. The ideal strategy is to have a light contact with the distal (far) point of your limbs, with greater absorption happening close to your larger joints and torso.

Think of how an airplane comes in for a landing. The pilot doesn’t drop the plane onto the tarmac all at once. First the rear wheels touch down, then the front of the plane eases onto the ground. The analogy isn’t perfect, but that image of spreading out your contact should be helpful.

Stop thinking of your hands and arms as your main shock absorbers. Instead, consider them as insect-like feelers to contact the ground and re-orient your impact. Strike lightly with your hands, then quickly transition up the chain to your forearm, shoulder, and backside.  Even if your arms are out of the picture for some reason, the same sequencing applies elsewhere on your body. If you are dropping onto your bottom, spread the force across your hip, back, and shoulder.

Stay away from your bony bits

After training yourself to spread out your impact and avoid straight limb-lines, the next thing to work on is avoiding hitting the bony parts of your body. In the medical world, we call these your bony prominences and you have them wherever your bones extend close to the surface of your skin.

Starting from the ground up, here are the main bony prominences to avoid during a fall:

• The side of your ankle (lateral malleolous)
• Your kneecap (patella)
• The side of your hip (greater trochanter)
• The bones of your pelvis, tailbone, and sacrum
• The bony extensions of your vertebrae (spinous processes)
• Your shoulder blade (scapula) and the tip of your shoulder (acromion process)
• Your elbow (olecranon process) and the small bones of your wrist and hand
• And of course, the biggest bony prominence of all: YOUR HEAD!

Training yourself to avoid impact with these bony landmarks takes some practice, but it’s worth it. After 17 years as a physical therapist, I know of numerous cases where a fall onto an elbow or knee led to a fracture. Since they are so close to the surface of your body, these prominences are not well protected and cannot take much impact.

So, how do avoid hitting these tender points? Part of it comes down to spatial awareness and knowing how to tuck your body to provide them with extra protection. The other part revolves on training yourself to avoid falling along the cardinal motions – forward, backward, or sideways. Instead of dropping along these four directions you should become familiar with diagonal paths, 30 to 45-degrees off your main axis. Falling along these diagonal paths provides some protection to your bony parts, and it also uses your body’s padding more effectively.

Wear your muscle as padding

During a fall, the big muscle groups of your body can act as a coat of armor to help keep you safe. By learning how fall in a way that maximizes impact along these muscle groups, your contact with the ground becomes much less disastrous.

In your lower body, we are mainly talking about using your glutes as padding. This means falling along a diagonal path that brings your impact onto one cheek at a time. Of course, this is really only beneficial if you can orient yourself so that your backside strikes the ground first.

Luckily, your upper body is a bit better armored for impact. You have the large muscle wad of your forearm that can help dissipate force. Even your triceps and deltoids can be used to your advantage during fall. Similarly, the wide breadth of your lats (latissimus dorsi) can provide key protection to your trunk.

What should you do if you don’t have that much muscular padding? Consider it one more reason to develop and stick to a strength training regimen. Aging naturally results in the loss of muscle mass over the years, thus you need to be extra diligent to maintain and build muscle as you get older.

Use a roll when appropriate

Lastly, there are certain times when rolling across the ground is the best solution to avoiding a fall-related injury. Over the years, I have fallen and rolled across concrete multiple times without getting hurt. It has happened when skating at the skatepark, training parkour, and even running my dog on a leash. Without the rolls, I’m convinced that either of the falls could have resulted in a trip to the hospital.

Mind you, these were legit, hard falls on concrete with speed involved. Using a roll is so effective, that each time I popped up to my feet with a look of bewilderment:  How I was I not hurt?!

Note though, that the type of roll you do is of huge importance. We aren’t talking about an over-the-neck gymnastics roll. It’s closer to a martial artist’s shoulder roll, but with some slight tweaks. Parkour athletes have perfected this roll for the real world, since they regularly train without the pads or crash mats.

It’s not within the scope of this piece to go into the details of a parkour roll here. Instead, please go meet with a local parkour coach to learn how. If you live in a major US city, the chances are high that there is a parkour gym awaiting your visit.

The main thing is to know that rolling is a movement skill that everyone should to master. Maybe you will need it someday, maybe not. Either way, it is best to be prepared.

Conclusion

Falling down IS a part of life. It’s time health care workers and the public health community recognize that not every fall can be prevented. As someone who wants to stay healthy and whole, make it your mission to learn how to fall without getting hurt. Furthermore, please help spread the knowledge to your loved ones, neighbors, and colleagues.

If you want to learn more about the falling techniques used by parkour athletes, you are in luck. ParkourEDU recently released an online course titled the Art of Falling. This is the first time I have put an affiliate product on the website, and it is because this team puts out such high-caliber material. Amos, the course instructor, is a wonderful coach and a riot to watch. You should check it out.

DISCLAIMER | word to the wise: Please don’t start throwing yourself on the ground willy-nilly because of this article. It’s not a substitute for one-on-one instruction. A good teacher will use appropriate padding and will make other adjustments to minimize your impact. Likewise, people with certain bone disorders, blood disorders, on certain meds, or with other health concerns should definitely talk with their doctor before beginning this type of training.

*CDC Morbidity and Mortality Weekly Report: Falls and Fall Injuries Among Adults Aged ≥65 Years — United States, 2014

**CDC Morbidity and Mortality Weekly Report: Deaths from Falls Among Persons Aged >= 65 years – United States 2007- 2016

Do you have a great story to share about falling down or injury prevention? Please leave a comment below.

Ryan Ford and I published Parkour Strength Training at the beginning of 2016 to ignite a conversation about what it takes to be lifelong practitioner of our sport. Drawing on Ryan’s coaching career, the book discussed the strength, mobility, and joint preparation needed to keep an athlete injury-free.

Yet, besides that writing, there is little published on injury prevention for our community. Finding academic information about parkour injuries, rates, risk factors, or how they occurred is a practice in futility. A study came out of Brazil in 2014, but only 91 individuals were sampled. The conclusions were that age and the duration of a training session were the main variables associated with injuries. It also concluded that more studies were required to develop a more comprehensive prevention strategy.

To that end, perhaps you heard about the survey conducted by Dr. Lafe Harris and myself this past summer. The questionnaire was issued IRB approval and we had a turnout of over 1700 consenting respondents.

From height and weight, number of years training, sex, and prior fitness level, we collected a massive amount of information. Cleaning and organizing the data has taken some time, but we are now in the process of submitting it for academic review. Because the results are still unpublished, we are limited in how much we can disclose at this point.

Nonetheless, we are eager get the results out to everyone as soon as possible. The bullet points below offer a quick summary of our findings. Understand that this is a superficial overview, with more details to follow upon publication.

Survey Summary

• The vast majority of respondents were men, under the age of 35.
• Almost 4/5 of them had an injury that kept them from training parkour in the past year.
• Most injuries resolved in less than 2 weeks, with a much smaller fraction causing impairment that lasted over 6 weeks.
• The injuries were more likely to be sustained while outside or training alone, than indoors or with a group.
• The ankle, knee, and foot were the body regions most frequently injured.
• Sprains/strains and contusion/bruises accounted for the majority of recorded injuries.
• A sprain/strain/tear of the ankle (including the Achilles) was the most common reported injury by individual response count.
• The foot, wrist, and ankle were the 1^st, 2^nd, and 3^rd most common regions to experience a fracture.
• The knee was the most commonly reported bruised/contused body part.
• Landing was the most frequently recorded cause of injuries, followed by falling, and impact with an obstacle.
• Over 1/3 of respondents said that they have experienced a non-traumatic injury, such as a tendonitis or similar syndrome.
• The knee was the most common joint to suffer from a non-acute injury.

Points to Remember

Whether you are a solo practitioner or the coach of many athletes, a few take-homes should jump out:

1. The environment and setting where you practice is important. Training outside or alone presents more risks than indoors or with a group.
2. Landing, falling, and passing obstacles with grace are essential skills. High loads and harsh impacts don’t make for a happy body
3. Parkour athletes need better methods to protect their ankles and Achilles from injury.
4. Like every sport, parkour has its own collection of cumulative and overuse injuries. Prehab work must be part any strength and conditioning program, especially for your knees.

As we dig deeper into the data, new insights are bound surface. Slicing the sample according to age, gender, and experience, should provide a deeper level of understanding.

One theme that stood out was that many people said parkour actually helped them avoid injuries. That is a pretty cool, don’t you think?

Dr. Harris and I are interested to hear your thoughts about this topic. What additional research questions would you like to see addressed? Are our findings congruent with your own experience?

Finally, if you would like to be notified once the official results are published, please add your name to the email list here.

Thanks to Kelly Starrett, everyone knows that if you aren’t strong AND supple, then you’re as good as broken.

In fact, meeting someone who doesn’t work on their mobility nowadays, is about as rare as skateboarder landing a 360 flip on the first try. It doesn’t happen.

Yet, I ask you, how many of you can say that you have a daily agility practice?

Unless you’re a circus acrobat, I’ll venture that you aren’t working on agility every day.

That’s too bad.

The more agile you are, the better athlete you are. More importantly, the more agile you are, the better you can avoid injury.

The importance of a daily agility practice

If you follow me on Twitter or Instagram you know that I love skateboarding. What many of you might not know, is that I turned 39 this week. The risks associated with skateboarding are always top of mind.

Last year I saw a buddy snap his ankle at a skatepark. He slipped on a backside tail slide, and came down on his foot like a limp lawn dart. Pop went his fibula.

Witnessing that was a wake-up call. It was such as simple accident. The more I thought about it, the more I came to think of how important it is to be light on your feet, not just in skateboarding, but all the time.

Stumbles, trips, and missteps happen to all of us. They happen while walking down the sidewalk. They happen in grocery stores, museums, and movie theaters. They happen in the most mundane moments, and in the heat of competition.

If you don’t train yourself to be nimble, then sorry, your movement practice isn’t complete.

Agility isn’t just the hallmark of a good athlete. It’s more than that. Being light on your feet is a crucial life skill.

Falls account for the majority of injury-related deaths in older adults. Think about that for a moment. Working on your agility could save your life someday!

What does an agility practice look like?

First of all, there is no need to make it complicated. Having a daily agility practice can be as simple as working on rapid footwork and simple balance drills. You don’t even have to cut into your normal workout time.

Here are a couple of guidelines:

• Agility work can and should be part of your warm-up activities, especially before sports.
• Practice hopping in and out of different positions, as if you were recovering from losing your balance. Hop forward, sideways, backwards. Go from two feet to one foot, and vice versa.
• Be graceful! Keep excess arm and trunk motion to a minimum
• Use targets on the ground to help refine your feet-eye coordination. If you’ve ever walked down the street, trying not to step on cracks in the sidewalk, then you know what I mean. The more aware of where your feet are, the more agile you become.

For those of you looking for more of a challenge, up the ante by introducing a small obstacle, like a thin block of wood or a piece of PVC pipe. Can you hop over it without getting your feet tangled?

Agility work is meant to test your coordination, and spatial awareness. The rope ladders and tire runs used by strength and conditioning coaches are great examples. Exercises where you quickly switch directions when running between cones is another favorite for team sports.

For another test of your agility, see if you can quickly hop onto and off of a small obstacle. It could be a low step or even the one of the ground rail trainers used in parkour. Can you land softly, stabilize, and then pop off again? What about jumping completely over the barrier and then back again? How about swapping your feet atop the obstacle? Imagine the surface was covered in sticky glue. Could you be so light on your feet that you would not get stuck?

Notice however that none of this resembles plyometric training. None of the jumping or hopping is anywhere near max effort. We’re talking about very small movements.

Keep your vertical and horizontal displacement to a minimum. Likewise, you shouldn’t be making any sound upon impact. Turn your ninja dial to 110%, and be as quiet as possible.

An example agility series to try right now

The following drill is the agility series that I use every time before I go skateboarding. I use it to warm-up my ankles as well as heighten my coordination. Put down your phone, tablet, or whatever device you are reading this on, and give it a spin:

1. Double leg ankle hops
2. Single leg ankle hops
3. Alternating ankle hops
4. Forward/backward hops
5. Lateral hops
6. 4-square hops

That is pretty straightforward, right? All together, it shouldn’t take more than a two minutes to do five to 10 reps of each exercise.

Like I said, that is the little flow that I use before skateboarding. A more thorough daily agility practice could include some of the elements mentioned earlier.

The point is to start incorporating rapid footwork and small balance challenges into your regular exercise programming. Even adding multidirectional hops while jumping rope can have a positive effect on your agility.

The more you practice these agility skills, the easier they become. Start small, and gradually increase the complexity.

If you already have a daily agility practice, what are some of your favorite drills?

I’m always looking for fresh ideas, so please leave a comment below!

*Disclaimer: This article is for information purposes only, and is not a substitute for medical care. Talk with your healthcare provider before beginning this or any other exercise routine.