The Joint Effort Podcast

Strong Steps: Preventing Falls And Fractures As You Age

• Dr. Noelle DiGioia Guthrie & Tiffany Belculfine, PA • Episode 4

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How Can I Prevent Falls And Fractures As I Age?

If staying upright feels harder than it used to, this conversation hands you a simple, science-backed roadmap to protect balance, build stronger bones, and keep your independence. We pull together what actually works—environment fixes, smart movement, and targeted nutrition—so you can act with confidence instead of fear.

We start with the hazards that hide in plain sight: dim hallways, cords and clutter, skipped railings, and outdated glasses. Then we pair those fixes with training that teaches your body to react faster and recover from stumbles. You’ll hear why Tai Chi is a sleeper hit for older adults, how to practice safe balance drills at home, and the walking strategies that beat slippery sidewalks and crowded aisles. The stance lesson is memorable: make yourself bigger, not smaller, to center your weight and stay stable.

Bone strength gets equal billing. We explain the use it or lose it principle in everyday terms—bones build along lines of stress—and share how walking, resistance work, and daily tasks send the right signals to your skeleton. You’ll get clear guidance on calcium and vitamin D targets by age, why consistency matters more than megadoses, and how nutrition, strength, and balance training stack to reduce fracture risk. We round it out with real‑world pitfalls like silent cats, scattered toys, and acorns underfoot, plus practical gear advice on supportive shoes, canes, and walkers.

Ready to turn worry into a plan you can live with? Press play, take one small step today, and share the tip you’re going to try first. If this helped, subscribe, leave a review, and pass it to someone who needs a steadier tomorrow.

To learn more about The Bone and Joint Center at Magee-Womens Hospital visit: https://www.pghbjc.com
Dr. Noelle DiGioia Guthrie
300 Halket St.
Pittsburgh, PA, 15213
412-683-7272

To learn more about The Wellness Center for Bone and Joint Health visit: https://www.boneandjointhealth.org
Tiffany Belculfine
300 Halket St., Suite 1601
Pittsburgh, PA, 15213
412-641-8594

SPEAKER_03:

Welcome to the Joint Effort Podcast, where mobility meets reality and your future self says thank you. Your hosts, Dr. Noel DeJoya Guthrie of the Bonin Joint Center at Mickey Women's Hospital, and Tiffany Belkaf, physician assistant at the Wellness Center for Bonin Joint Health, serving adults across Western Pennsylvania. If your knees sound like bubble wrap, your hips argue with putting on socks, or your side-eying stairs, you're in the right place. From arthritis and osteoporosis to everyday aches, they'll break it down and build you back up with a personalized plan for real life. The show is informational without a substitute for talking to the clinician. Now, let's get you moving. Here are Dr. Noelle and Tiffany.

SPEAKER_02:

Staying steady on your feet is not just about balance. It's about protecting your independence and health. Welcome everyone. I'm co-host and producer Julie Schwenzer in the studio with Dr. Noel, the Joya Guthrie of the Bone and Joint Center at McGee Women's Health, and Tiffany Belkafine, physician assistant at the Wellness Center for Bone and Joint Health. Ladies, it's a pleasure to be back with you. Yes, thank you. And Tiffany, it would be great to have you taking the lead on this one. How can I prevent falls and fractures as I age?

SPEAKER_01:

So it is so important for people to realize that there is not a one-solution answer to that question. There are so many individual facets that we all need to be aware of. First of all, realizing that a lot of the time, this time of year, it's December. That is when people preach fall prevention, but it's actually important all year round. It's not just something we worry about in the cold weather. We want to make sure that we can prevent falls at any point during our lives, any season, any day of the year. Those are all really important things to watch out for. One thing that people often don't think about is getting their vision checked. I know that doesn't seem like it's connected, but if people can't see where they're going, or if they have glasses and their prescription isn't up to date, that can increase their risk for falls for sure. Another thing to think about is their home environment. So a lot of people know things like they should use their cane, they should use their walker, they should be careful on the steps with not holding too many things in their hands. But maybe they have railings and they're not using them. Or maybe they have an area of their home that is dark and they can't see. If they wake up in the middle of the night, they can't see to get to the bathroom and things like that. We want to make sure that that access is clear for them too. And then all of the things like clutter in our homes. We have to make sure that we know where our stuff is. Try to pick things up off the floor. Don't have piles, don't have clutter with cords and you know, things that are all in a heap. Because if we're not expecting those things to be there, those could really be a detriment to our health.

SPEAKER_02:

And what about bone health? How does that play a role in preventing fractures? What can we do?

SPEAKER_01:

That's a great question. So with our bones, if our bones are not as strong as they once were, they can't support our balance and they can't support our body weight as we move. So if we don't have that good support on board with strong bones and strong muscles to support us, we're more likely to have a more serious fall because we could not be able to recover ourselves in the process.

SPEAKER_02:

And can you give us some examples of exercises that we can do, maybe starting in the 40s, the 50s, 60s? And I'm sure you you ladies probably recommend don't even wait that long. Start whenever you can.

SPEAKER_01:

Yes, bone health is is a concern for everybody, every age. And we often think of these issues in our older patients and our older family members, but anybody could have a fall at any time. So it is important to be aware of things like that and know what to do. So definitely when we are talking about exercise, we want to make sure that everybody is getting good strength training and also balance training. Because in order to recover, your body needs to know what's normal and it needs to know how to get back to that point. So if you're reaching for a big box that's overhead and you start to fall backwards, your body has to know how to recover from that posture so you don't fall the whole way backwards. And that's balance work. That's really important. For older adults, Tai Chi is actually a really helpful exercise because it helps incorporate that balance and that flow for them in many different ways. And then there are plenty of things people can do at home to practice their balance too. But we never practice balance exercises in the bathroom because it's slippery and it's wet and that's a big danger zone.

SPEAKER_02:

Oh, that's a good tip and a good reminder because sometimes people like to, you know, look in the mirror and yes, when they can.

SPEAKER_00:

Just one thing from the like physiological science uh side of things. So we there's a saying in orthopedics called use it or lose it. So bone, actually, the physiology of bone, um, bone builds along lines of stress. So the more stress and force that you place on your bones, like aka walking, exercise, strength training, the stronger your bones will be because the more it builds up. Um, so you know, I think that's a good way for people to connect what's happening in your bones to what you actually should be doing, you know, with your body on a daily basis.

SPEAKER_02:

And how can um supplements or, you know, getting calcium, vitamin D, how can that help us? And and I know it's hard to say what you recommend per person because everybody's different and at a different stage in their life, but you know, any any advice on that and how we take those?

SPEAKER_01:

So definitely for strong bones, we do have some different guidelines depending on how old people are and what their other health concerns may be. But for the general public, I think a safe rule of thumb would be a thousand milligrams of calcium a day if they're less than age 70, and 1200 milligrams of calcium a day if they are over the age of 70. And what that does is that supports that strong bone health that absorbs the calcium into the bones the proper way with assistance from vitamin D as a mineral, and then we can see those bones stay strong. And then adding the exercise only helps.

SPEAKER_02:

Um, are there any other practical tips that you would give? Like you mentioned sight, you know, make sure your vision is okay. And I know that's already going and just looking in different directions now. You I have to either bring the page closer, put the page away. It's crazy. But for hearing, what about that? How does that play a role in preventing, you know, injuries or accidents?

SPEAKER_01:

So hearing, I don't think is as much of a concern, but especially if people have something like a small animal or a small child who resides with them, being aware of where that particular creature is could be helpful. Um, you know, cats are very sneaky. Cats sneak up on you and and they're quiet and they don't make any kind of noise. And then before you know it, they're jumping in front of you and you lose your balance and you fall. So being aware of the things in your environment that are unpredictable are just as important as the things that you can actually control and predict. So, you know, if you again have a small child in your environment, they may leave toys on the floor, they may leave Legos on the floor. Those are not only painful to step on and awful, but they're also something that could affect your balance. Those are a similar indoor concern to something like acorns on a sidewalk outside. So people have to know how to navigate those. And unfortunately, a lot of times people walk around in a bubble and they're sort of like, don't fall, don't fall, don't fall, don't fall. When in actuality, they need to be practicing and challenging their balance so that they do know what to do to prevent those problems in the first place. Another really helpful thing is making sure that people have good footwear that is strong, sturdy, supportive. Shoes that have a back are actually really beneficial because they are more likely to support the weight of the ankle and the foot. And shoes that don't have a back would be more likely for people to have a trip and ball risk.

SPEAKER_00:

I know some people don't, but I always tell my patients, you know, I'd rather you use that if you're walking far distance or you're parking somewhere and have to walk than fall. You know, it's it and to remind other people, like Tiffany was saying, around you cats, dogs, children not to run into you when your balance is a little off. I think, you know, that's a a very practical thing that anyone can can use.

SPEAKER_02:

Well, thank you so much. And when you were speaking about this, I was really thinking about the cats with the bells around the neck and how I didn't get it when I was younger, but I get it now. You can hear them coming that way. That's so true. Look out for those animals and ice outside right now, that's for sure.

SPEAKER_01:

And I always also like to remind people that if you watch a baby walk when they're first learning to walk, if you look at a baby, they make themselves very big, they take up space, they're spreading their arms out, they're spreading their legs out, kind of doing this like sumo wrestler walk. They're doing that because that's how they feel most stable. When people try to prevent falls, a lot of times they pull themselves inward and they're like almost walking on tiptoe. They're so, so tentative, and they're not taking up that space to give their center of gravity balance. So that can also be a useful tool that if someone is walking into the grocery store, um, you know, spread your legs a little wider and kind of do like a penguin or a Frankenstein walk. That can help you maintain that good balance if you're not so certain as well.

SPEAKER_02:

Oh, that's great advice. Thank you so much, ladies. You always are very helpful and we appreciate all of your practical tips. We'll see everyone next time with more guidance for staying strong and safe. Thank you. Thank you.

SPEAKER_03:

That's today's dose of strength, balance, and better movement from the Joint Effort Podcast. Ready for care that fits your life and gets you moving? To schedule an appointment with Dr. Noel for your surgical and injection needs, call 412-683-7272. Or visit PGHBJC.com. Or if you are looking for lifestyle changes that are not surgical, contact Tiffany Belkefine. Call 412-641-8594. Or visit boneandjointhealth.org. Healthy bones and happy joints make every day better. Until next time, keep moving, stay steady, and take care of yourself.

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Let's get you moving.