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Saving Face: Facial fractures among older adults during recreational activities are on the rise -- here's how to avoid injury and play it safe
Unlike the generations that came before them, baby boomers aren't content to while away their retirement years. Today, people choose to keep moving well into their 60s, 70s, and beyond, by participating in recreational activities like jogging, cycling, or team sports. Staying active is undoubtedly good for your health, but it can lead to injuries -- and not just the hip fractures and ankle sprains you might expect.
Adults ages 55 and older are vulnerable to facial injuries, especially fractured noses and eye sockets, according to a study published in JAMA Facial Plastic Surgery. The study found you don't have to engage in a high-octane sport like hockey or surfing to get hurt. More sedate activities such as walking and gardening can also lead to broken bones in your face.
While researchers have devoted time and attention to studying hip fractures and head injuries in the over-55 set, they haven't focused as much on facial fractures. A group of investigators at Wayne State University in Detroit evaluated this understudied area of injury by reviewing a national emergency room-visit database.
The researchers discovered that more than 20,500 adults ages 55 and older visited emergency departments for facial fractures from 2011 through 2015. Overall, the incidence of facial fractures in this age group rose more than 45 percent during a five-year period.
AGE AND ACTIVITY TYPE MATTER
Most of those injured -- 60.5 percent -- were men, likely because they engage in higher-risk activities than women. Men were most likely to break a bone while cycling, which accounted for 35.7 percent of fractures, or playing team sports (19.7 percent). Although a substantial number of women were injured while biking (14.9 percent), females suffered the bulk of their fractures while dog walking (17.3), gardening (15.5), participating in nature activities (14.6), or working out at the gym (7.7).
Cycling was the activity attributed to the greatest proportion of facial fractures among men and women combined, at nearly 27 percent. Other activities that made the list included:
* Team sports such as baseball and softball -- 15.4 percent
* Outdoor activities like fishing, hiking, and camping -- 10.1 percent
* Gardening -- 9.5 percent
* Walking and jogging -- 5.5 percent
* Golfing -- 2.7 percent
The activities responsible for the greatest number of fractures differed by age group. For example, bike riding accounted for more bone injuries among people ages 55 to 64, while walking, gardening, and jogging led to more fractures among those ages 65 and older.
The study had some limitations. Only patients who were admitted to an emergency room were included in the data-base. The study didn't include patients who visited urgent care clinics or a private doctor, so the statistics may have underestimated the actual percentage of facial injuries among older adults. The severities of injuries sustained also weren't reported.
MORE THAN BONE DEEP
Breaking your nose or eye socket or cracking your jaw can do more than cause pain and leave behind cosmetic damage. These injuries can affect your ability to talk, breathe, swallow, and see, which can have profound effects on your ability to live independently. Besides obvious symptoms such as pain and facial deformity, signs of a fracture include face, cheek, or lip numbness; a nosebleed; discoloration beneath the eyes; blurry or double vision; swelling; trouble swallowing or breathing; and an inability to close your mouth properly.
Each type of facial fracture can affect you in different ways:
* A broken nose can cause swelling, pain, and permanent disfigurement. The two nasal bones break easily because they're thinner and more prominent than other bones. Sometimes the injury is minor and heals on its own. But if your nose has been bent out of shape or breathing is impaired, you'll likely need surgery.
* A fractured eye socket can cause a collection of blood called a hematoma to form behind the eye. A hematoma can interrupt both nerve signals and blood flow to the retina, which could lead to permanent blindness. An orbital fracture that causes double vision or is too severe to heal on its own will need surgery.
* Fractures to the jaw and cheeks cause swelling and pain. Sometimes the injury affects the alignment of the teeth and can be severe enough to require surgery.
WHY YOU MUST STAY ACTIVE
Your likelihood of falling while riding your bike or walking increases as you get older. Normal aging changes and conditions can weaken the muscles that support you, throw off your balance, impair your depth perception, and slow the reflexes you rely on to stabilize you.
Although fracture risk is real, worries over breaking a bone shouldn't prevent you from staying active. Regular exercise strengthens your bones and reduces your likelihood of falling and breaking them. The Centers for Disease Control and Prevention (CDC) recommends that you get at least two hours and 30 minutes of moderate-intensity aerobic exercise and two or more days of muscle-strengthening exercises each week. If you like to cycle, jog, or ski, don't stop because of concerns over fractures -- just take a few precautions to protect the bones of your face from injury.
WHEN CYCLING:
*Wear a helmet every time you ride. The helmet should meet U.S. Consumer Product Safety Commission standards.
* Make sure your bike fits you well. When you sit on the seat, your feet should touch the ground.
* Check the bike regularly to make sure the brakes and gears work well and the tires are properly inflated.
* Learn to fall correctly. Keep your hands on the handlebars so your entire body, not your face, absorbs the blow.
WHEN HIKING, WALKING, OR JOGGING:
* Wear well-fitting, rubber-soled sneakers or shoes.
* Walk or jog at a pace that's comfortable for you. Don't try to push yourself too hard, because you could lose your footing.
* If you have mobility limitations, walk om smooth, paved surfaces. Avoid uneven paths, rocky trails, and cracked sidewalks. Consider using a walking stick.
* Pay attention to the road or sidewalk ahead of you.
* Don't become distracted by talking on your phone or texting while you walk.
* If you start to get tired, turn around and go home.
WHEN GOLFING:
* Stay on the course. Don't wander into sand traps or other areas with uneven surfaces that could trip you up.
* Wear golf shoes with cleats that give you more traction on the green.
* Don't stand close to anyone who is about to swing.
WHEN PLAYING A TEAM SPORT LIKE BASEBALL OR SOFTBALL:
* Wear a helmet that protects your head and face. Use a helmet with a face guard when batting.
* The helmet should fit snugly, with the ear holes directly over your ears.
* Protect your eyes with a face shield or plastic goggles that meet ASTM standards when you play sports like hockey or racquetball.
Generally, wear the proper protective gear indicated for your chosen leisure-time activity. For example, wear a light-weight helmet when engaging in activities such as horseback riding and skiing.
FIRST AID FOR A FACIAL FRACTURE
Call 911 if someone sustains a facial, head, or neck injury and is unconscious, confused, dizzy, or nauseated. Don't attempt to move the person or remove any helmet or protective gear. If the person is conscious and not incapacitated, the injury may still be severe and need emergency medical attention. In this case, seek medical help immediately. Applying ice in the interim may reduce pain and swelling.
In some cases, doctors can reset broken bones without surgery, done most often for a broken nose. If you sustain a severe facial fracture, you may need surgery to reset or reposition broken bones. You may also need reconstructive surgery, especially if multiple bones are fractured. Because these types of surgeries may be complex, you'll want to be sure that the procedure is performed by one or more skilled specialists, such as an oral and maxillofacial surgeon (an expert in face, mouth, and jaw surgery), an otolaryngologist (an ear, nose, and throat specialist), a plastic surgeon, and an ophthalmologist (an eye specialist).