When you live in Center City Philadelphia, you are accustomed to seeing cars “booted” for non-payment of traffic tickets, parking in “no parking zones”, or overstaying their welcome at a meter.

But lately I’ve seen and personally experienced another kind of “booting” – orthopedic devices on feet and legs as a result of sidewalk falls due to uneven bricks and concrete, and pot holes in the streets. It seems that every day I observe someone wearing a boot, and let me tell you how uncomfortable an experience that is, especially if you have to sleep with it.

According to the CDC, there has been a 31% jump over a decade among Americans 65-plus, and on any given day, every 18 seconds, an older adult lands in the emergency room because of a fall. Nearly 23,000 deaths a year are linked to falls.

So I talked with folks who empathized with my own situation and came up with a list of suggestions that may be useful to those of us who walk ‘round’ town. Add your thoughts and your own suggestions in the comments section. And look for a future blog that will provide a more in-depth and professional prevention strategy.

Wear sensible walking shoes. Most of us don’t wear high-heeled shoes anymore, yet low heels may not give sufficient support. Open-toed shoes and sandals easily catch on a raised brick, leading to a wobbly balance that lands you on the ground – broken elbows and shoulders anyone? I learned that a shoe with a hard sole that doesn’t easily bend gives better support. Rubber-soled shoes typically found on sneakers fully support your feet. You can always carry another pair of shoes if the occasion warrants.
Prevent distractions. Don’t talk on your cell phone or engage in chatter with a walking partner. Don’t wear headphones to listen to your favorite podcast. Look ahead a few feet to recognize any obstacles in your way – raised bricks from tree trunks, bikers, kids playing on sidewalks. We love all of this about living in the city but it can be dangerous to your well-being.
Be sure to have your vision checked regularly. As we age, we may not be seeing as well as we used to and often eye drops or cataracts blur our vision. The sun glares down and makes it difficult to see ahead while sun glasses may make your walkway a bit dark. When you get new glasses – bifocals or progressive lenses, take time to get used to them.
Check with your doctor to be sure your medications aren’t throwing you off-balance. Medications for chronic or severe pain and sedatives and antidepressants can lead to falls as our body adapts to the infusion of muscle relaxers or opioids, even those which are short-term. Some blood pressure meds have similar impacts.
Test for inner-ear disorder. Vertigo can cause dizziness and affect balance. Head movement can trigger a uncomfortable response and lead to falls. My new rule of thumb: no climbing on step-ladders or changing light bulbs without another person “spotting” me. And if you have a hearing aid, be sure it fits well and use it.
Walk in well-lit areas if you are out in the evening. There are lots of small streets and alley-like walkways in the city. During the day, these short cuts are ok (though that’s exactly where I fell last spring), but at night, avoid at all costs. Besides, they’re safer for you because they are better lit.
Carry a cane, walking stick, or someone’s arm. Do not go out if walkways and surfaces are wet or icy. My husband fell last year and had a torn rotator cuff. Luckily he didn’t require surgery, just intensive physical therapy. He didn’t learn his lesson from a previous fall where he cracked a few ribs.

Don’t let a fear of falling keep you from being active. Try these simple solutions that can keep you safe -- not sorry.

Harriette Mishkin is co-chair of the Communications Committee and a member of Penn's Village. She is founder and principal of Performance Concepts, a management consulting firm.

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