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San Miguel: The City of Fallen Women (and Men)

By Nancy Johnston Hall

I became one of the “fallen women” of San Miguel when I tripped into a small pit while crossing Insurgentes. The pain from my smashed knee lasted months, and it was sobering. Let’s face it; San Miguel is a city full of pitfalls—or pits to fall into, cobblestones to slip on, unexpected steps to fly down. The lesson I learned right then was to always, always, watch the pavement and scan ahead for problems, with as much attention as I would if I were driving. Now I am never tempted to enjoy the view or turn to talk to someone unless I stop first.

Fall prevention isn’t a sexy topic, I admit. But for anyone interested in staying active and, yes, alive, please read on. According to the World Health Organization, falls are the leading cause of accidental injury deaths worldwide. Falls in older adults are the number one cause of both fatal and nonfatal injuries. In the US, falls are treated in an emergency department every 13 seconds and claim a life every 20 minutes.

People with strong muscles fall less. Sadly, we all lose muscle strength as we age, especially if we’re inactive. Couch potatoes lose as much as three to five percent of their muscle mass per decade after age 30. As we get older, we also lose the important sensors around our lower legs and ankles that help keep balance.


Take these steps proven by research to reduce falls:

•Keep moving to increase muscle strength and balance. Walk regularly, and try water aerobics, yoga and other strength-building exercises. In some studies, t’ai chi exercises have been shown to reduce falls by 47 percent.

•Always hold the railing when you walk up and down stairs or steps.


•Talk to your doctor about whether any medications you’re taking can cause dizziness or affect your balance. Sedatives and some antidepressants can have these side effects.

•Make your home fall-proof. More than half of all falls happen at home. Remove anything you can trip over on stairs and places where you walk including shoes, newspapers, electrical cords and books. Install handrails and lights on all staircases. Remove small throw rugs and use double-sided tape to keep rugs from slipping. Keep items low enough so you can reach them easily, without the need for a step stool or ladder. Fall prevention experts call climbing to reach something “risky behavior.” Put grab bars inside and next to the tub or shower and toilet. Use nonslip mats in the tub or shower and in your bathroom. Improve lighting in shadowy areas of your house, indoors and outside. Make sure you have a clear path to the bathroom at night. Use a small nightlight.

•Wear sturdy shoes even inside your home. Look for shoes with soles that have high-friction natural or synthetic rubber soles, preferably serrated ones for extra grip such as in a Vibram sole. Don’t wear slippers, or if you do, wear only those with nonslip soles. Don’t walk in your stocking feet, especially on bare floors.

Nancy Johnston Hall is a retired health writer with nearly 40 years of experience. She has a master’s degree in medical journalism. Last year Nancy and her husband became part-time residents of San Miguel.


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