If you have started avoiding walks, stairs or outings because you feel unsteady, we can help you find a starting point. We assess your balance and strength, practice the tasks that are difficult, and build a plan around the places you want to feel confident moving.
One-on-one PT with Dr. Emily Warren, DPT, Cert. MDT. No referral needed. In-person care in Holladay, serving Greater Salt Lake City, and virtual coaching from anywhere.
Falls aren’t just embarrassing — they’re the leading cause of injury-related death in adults over 65, and the leading cause of fractures in people with osteoporosis. Every year, one in four Americans over 65 falls, and for those with osteoporosis, a fall often means a hip fracture, vertebral compression fracture, or wrist fracture that can permanently change their quality of life.
We want to help you keep doing the things you enjoy. Our assessment looks for practical ways to improve strength and steadiness and reduce avoidable hazards.
Why Falls Happen — It’s Usually Not Random
Most falls aren’t accidents. They’re the result of identifiable, treatable risk factors. When We assess a patient’s fall risk, We are looking at several interconnected systems:
Muscle Weakness
Age-related muscle loss (sarcopenia) begins around age 30 and accelerates after 60. Without targeted strength training, most people lose 3-8% of muscle mass per decade. Weak legs mean you can’t catch yourself when you stumble, you fatigue faster on stairs, and you can’t recover from unexpected balance challenges.
Research by Moreland et al. (Journal of the American Geriatrics Society, 2004) identified lower extremity weakness as the single strongest risk factor for falls — more predictive than balance impairments, medication use, or environmental hazards.
Balance System Decline
Balance relies on three systems working together:
- Vision — seeing where you are in space
- Vestibular system — inner ear sensors that detect head position and movement
- Proprioception — sensors in your joints, muscles, and feet that tell your brain where your body is
All three decline with age. When one system weakens, the others compensate — but when two or more are impaired, falls become much more likely. Walking in dim light, on uneven terrain, or while turning your head can overwhelm a compromised balance system.
Medication Effects
Many common medications increase fall risk through dizziness, drowsiness, or blood pressure drops:
- Blood pressure medications (orthostatic hypotension)
- Sleep aids and sedatives
- Antidepressants
- Pain medications
- Antihistamines
If you’re on four or more medications (polypharmacy), your fall risk is significantly elevated. We always review medication lists as part of our fall risk assessment and may recommend discussing adjustments with your physician.
Environmental Hazards
Your home may be working against you:
- Loose rugs and cluttered walkways
- Poor lighting, especially at night
- Wet bathroom surfaces without grab bars
- Stairs without handrails
- Pets underfoot
- Cords across walkways
These hazards are easy to fix once identified, and We provide a home safety checklist as part of our fall prevention program.
See our Bone Builder coaching and class setting
Why we keep our bone-strengthening classes small
Building strength is one part of feeling steadier and more capable in everyday life. Here, Dr. Emily explains how we coach our small bone-strengthening classes, with attention to form, questions and exercise adjustments. We pair that kind of progressive strength work with the balance practice and individual guidance your fall-prevention plan calls for.
A look inside Bone Builder
Watch a short look at the supervised strength-training environment behind Mindful Movement PT’s bone-health work.
Our fall-prevention assessment
We use standardized, validated tests to objectively measure your fall risk and track improvement:
Berg Balance Scale
A 14-item test measuring balance during sitting, standing, and transitional movements. Scores below 45 (out of 56) indicate increased fall risk. This test helps us identify specific balance deficits to target.
Timed Up-and-Go (TUG)
Measures the time it takes to stand from a chair, walk 3 meters, turn around, walk back, and sit down. Times over 12 seconds suggest increased fall risk. This simple test correlates strongly with fall frequency.
30-Second Chair Stand
Measures lower extremity strength and endurance. The number of times you can stand from a seated position in 30 seconds predicts functional independence and fall risk.
Four-Stage Balance Test
Progressively challenging standing positions — feet together, semi-tandem, tandem, and single-leg. Inability to hold tandem stance for 10 seconds indicates increased fall risk.
These tests give us objective numbers to work with. When your TUG time drops from 15 seconds to 9 seconds, we both know your fall risk has meaningfully decreased.
The Fall Prevention Exercise Program
Research supports exercise for fall prevention. A 2019 Cochrane review found a 23% lower fall rate overall, with a 34% reduction for programs combining exercise types. These estimates describe study groups, not a promised result for each person.
Balance Training Progression
We use a systematic progression from simple to complex:
Level 1: Static Balance
- Standing with feet together, eyes open → eyes closed
- Semi-tandem stance → tandem stance
- Single-leg stance with support → without support
Level 2: Dynamic Balance
- Weight shifting in all directions
- Tandem walking (heel-to-toe)
- Stepping over obstacles
- Turning in place
Level 3: Reactive Balance
- Perturbation training — we introduce gentle, unexpected pushes while you practice recovering
- Catch-and-throw exercises while standing on one leg
- Walking with head turns (challenging the vestibular system)
- Walking on varied surfaces
Level 4: Functional Balance
- Carrying objects while navigating obstacles
- Getting up from the floor (critical skill — many falls lead to inability to get up independently)
- Stair negotiation with and without handrails
- Outdoor walking on uneven terrain
Strength Training
You can’t have good balance without adequate strength. Our fall prevention programs integrate the same progressive loading principles we use for bone density programs:
- Sit-to-stand progressions (eventually weighted)
- Calf raises (heel raises) — critical for push-off power
- Step-ups and step-downs
- Hip abduction strengthening — essential for single-leg stability
- Deadlift variations for posterior chain strength
For patients with osteoporosis, this dual approach — building bone density and reducing fall risk — provides the most comprehensive fracture prevention possible. Learn about the best exercises for bone density.
Flexibility and Mobility
Stiff ankles, hips, and thoracic spine limit your ability to respond to balance challenges. We address:
- Ankle dorsiflexion — if you can’t flex your ankle adequately, you can’t recover from forward stumbles
- Hip mobility — needed for stepping strategies
- Thoracic mobility — allows you to look around without losing balance
Build confidence around the tasks that matter
After a fall, ordinary tasks can feel uncertain. Bring the situation that worries you most, such as porch steps, getting up from a chair or walking outside. Dr. Emily can assess the relevant strength and balance demands and develop a progression around them.
Your plan can include practice, suitable support and changes to your environment. Track the tasks you can perform more confidently alongside appropriate balance measures, with medical input on fracture risk and other contributors to falls.
Home Safety: The Other Half of Fall Prevention
Exercise is the most effective intervention, but environmental modification matters too. We provide every fall prevention patient with a home safety review:
Bathroom (Most Dangerous Room)
- Install grab bars near toilet and in shower/tub
- Use non-slip bath mats
- Consider a shower bench or chair
- Ensure adequate lighting — install a nightlight
- Keep a clear path from bedroom to bathroom
Bedroom
- Keep a lamp within arm’s reach of the bed
- Clear the path from bed to bathroom
- Remove loose rugs or secure them with double-sided tape
- Consider bed rails if getting in/out is difficult
Kitchen
- Store frequently used items at counter to shoulder height
- Use a sturdy step stool (not a chair) for high items
- Clean up spills immediately
- Ensure good lighting at work surfaces
Stairs and Hallways
- Install handrails on both sides of stairs
- Ensure good lighting with switches at top and bottom
- Remove clutter from stairs and hallways
- Mark the edges of steps with contrasting tape if visibility is poor
General
- Remove or secure all loose rugs
- Keep electrical cords out of walkways
- Ensure all rooms have adequate lighting
- Consider motion-activated nightlights in hallways
When to Seek Fall Prevention Physical Therapy
Don’t wait until after a fall. Seek evaluation if you:
- Have had any fall in the past year (even without injury)
- Feel unsteady when walking, especially outdoors or on uneven surfaces
- Hold onto furniture or walls when moving through your home
- Have been diagnosed with osteoporosis or osteopenia (understand your DEXA results)
- Take four or more medications
- Have noticed changes in your vision, hearing, or sensation in your feet
- Avoid activities you used to enjoy because you’re afraid of falling
- Have difficulty getting up from a chair without using your arms
Also see our guide on balance disorders and physical therapy for more information on vestibular and neurological balance conditions.
Fall Prevention for Active Older Adults in Utah
Many of our patients aren’t sedentary — they’re hikers, gardeners, and skiers who want to stay active safely. For these patients, fall prevention looks different:
- Trail-specific balance training — practicing on uneven surfaces, slopes, and loose gravel
- Sport-specific conditioning — building the strength and reaction time needed for skiing, cycling, or tennis
- Equipment recommendations — trekking poles, proper footwear, lighting
- Risk-stratified activity planning — knowing which trails, slopes, and activities match your current abilities
Staying active is one of the best things you can do for fall prevention. The goal isn’t to stop doing things — it’s to build the physical capacity to do them safely. See our hiking guide for trail-specific recommendations.
What progress looked like in the LIFTMOR research
LIFTMOR connects bone health with physical capacity: after eight months, supervised training improved average leg-extensor strength by 35.2% and back-extensor strength by 36.0% in postmenopausal women with low bone mass. The low-intensity comparison group improved 8.1% and 11.0%, respectively. Read the trial.
Those are strength-test improvements, not a measured reduction in fractures or falls. We combine strength work with balance and walking practice selected for you. See the bone-density results and participant response figures.
Learn with someone who pays attention to you
Kathy Toponce describes learning weightlifting technique with Dr. Emily and receiving guidance that accounted for her physical challenges. Elizabeth Wing describes attention to form and modifications as she returned to strength training. Their public reviews speak to the experience we want you to have: encouragement, useful feedback and a clearer sense of what to do next.
Frequently Asked Questions
How effective is fall prevention physical therapy?
A 2019 Cochrane review found that exercise reduced the rate of falls by 23% overall in community-dwelling older adults. Programs combining exercise types, commonly balance and functional work with resistance exercise, reduced the fall rate by an estimated 34%. These are research averages, not an individual guarantee.
How many PT sessions do I need for fall prevention?
We choose follow-up timing from your starting point, goals and response. Repeatable balance and strength measures help us decide when to progress and when you are ready for a more independent routine.
Does Medicare or insurance cover fall prevention PT?
We provide individual appointments with time for assessment, questions and practice. Contact us about payment and documentation before booking; coverage and reimbursement depend on your plan.
Can I do fall prevention exercises at home?
Absolutely — that’s the goal. We teach you exercises you can do daily at home. The key is starting with professional assessment and instruction so you’re doing the right exercises at the right level. Some exercises (like perturbation training) are best done in the clinic initially.
My parent has fallen multiple times. What should I do?
Recurrent falls are a medical red flag. They should see their physician for a medication review and medical evaluation, and a physical therapist for a comprehensive balance and fall risk assessment. The sooner we intervene, the better the outcomes.
I’m only in my 50s. Is fall prevention relevant for me?
Yes — prevention is always easier than rehabilitation. If you have osteoporosis, balance concerns, or simply want to maintain your physical abilities as you age, starting a balance and strength program now gives you a substantial head start.
Don’t Wait for the Fall
Every fall prevented is a fracture prevented, a surgery avoided, and independence preserved. The research is clear: fall prevention physical therapy works Invest in your safety now.
Book your evaluation online or call/text (385) 332-4939. No referral needed in Utah.
Written by Dr. Emily Warren, DPT, credentialed McKenzie therapist with 14+ years of clinical experience. Founder, Mindful Movement PT, Holladay, UT.
Related Reading
- The LIFTMOR Protocol — High-Intensity Training That Builds Bone
- BoneFit-trained Physical Therapy in Utah
- Can You Reverse Osteoporosis with Exercise?
Ready to Build Stronger Bones?
Our bone health program combines BoneFit-trained exercise design with the evidence-based LIFTMOR protocol. Whether you have osteoporosis, osteopenia, or want to prevent bone loss, we can help.
Schedule a Free 15-Minute Bone Health Consultation Or call (385) 332-4939
Written by Dr. Emily Warren, DPT, credentialed McKenzie therapist
Dr. Emily is the owner of Mindful Movement PT in Salt Lake City. She is a credentialed McKenzie therapist. Learn about Dr. Emily’s credentials and clinical background, or explore how assessment, education and exercise guide care at Mindful Movement PT.
Serving Greater Salt Lake City — new appointments in Holladay
Salt Lake City Clinic
1892 S 1000 E, Salt Lake City, UT 84105
Near Sugar House & 9th & 9th
Holladay Clinic
4890 Highland Dr, Holladay, UT 84117
Near Cottonwood Heights & Millcreek
Serving Holladay, Salt Lake City, Sugar House, Millcreek, Cottonwood Heights, Murray, Sandy, Draper, Park City & surrounding communities. Virtual coaching appointments also available. 385-332-4939 | Book Online