How physiotherapy helped Lewis manage his falls risk and return to the nightlife he loves in his words
Life changed after my brain injury
Before my brain injury, going out clubbing was a normal part of my life. I loved the music, the lights and the freedom of being on the dance floor with my friends. Afterwards, something that had once felt effortless became difficult and frightening. My balance was unpredictable; my reactions were slower and busy environments of the club could overwhelm me.
What made this harder was that I did not always recognise what was going on. My brain injury had affected my insight, so I could not always judge accurately how tired I was, how unsteady I had become, or when a situation had gone beyond what I could safely manage. This showed up as impulsiveness — deciding to cross a crowded floor, stand up quickly or push on without a break, without registering the risk that was obvious to everyone around me.
I began to fall more often, and each fall affected my confidence and could ruin the night out. The doormen would think I was drunk and we were often asked to leave. Going clubbing seemed unrealistic and too risky to my family who pointed out the hazards: dark rooms, flashing lights, people moving unpredictably and nowhere obvious to sit.
Gradually, I stopped going out to stay safe, to stop being a burden on my friends, and stop my family worrying, but that felt like an important part of who I was had been taken away.
Physiotherapy – getting back on track!
Becca, my physiotherapist asked what mattered to me. I did not say that I wanted to ride a bike or run a set distance. I said, “I want to go clubbing again.” And her next question was “And what is stopping you?” And my answer about the fear and risk of falling shaped everything we did next.
Sessions focused on the practical skills I needed outside of my home: improving my leg and core strength, practising balance reactions, changing direction safely and walking over different surfaces. Getting up and down off the floor.
We also worked on pacing, because fatigue made my balance worse. Initially reluctantly, I began to understand how learning how to use an electric wheelchair became an important part of this plan. It would give me more freedom to travel through town without using all my energy before I reached the dance floor!
Rather than trying to remove every risk, I learned with Becca’s support how to recognise when my body was struggling and what I could do next — slow down, pause, use support, transfer into my wheelchair or take a proper break.
We gradually made the practice more like a night out. I rehearsed moving while distracted, coping with people passing close by, standing for longer and stepping to a rhythm. Becca helped me plan safe transport, sensible footwear, rest points and a way to tell my friends when I needed space or support.
Each small step gave me confidence that clubbing could be on the cards again.
A falls management plan gave me structure
None of this would have held together without a proper falls management plan behind it. Early on, Becca and I sat down and worked through where and when I was most likely to fall, and why — fatigue, low lighting, uneven or crowded floors, quick changes of direction, distraction. Naming these triggers took away some of their power. Instead of a vague, constant worry about falling “somewhere, at some point,” I had a clear picture of my personal risk factors and a plan for each one and it was something I could share with others.
The plan covered all areas of my life, not just clubbing:
Environment checks – scoping out venues in advance where possible, choosing ones with clear routes, seating and manageable lighting, and going at quieter times first.
Energy and pacing rules – set points in the evening to stop and rest, using my electric wheelchair proactively rather than waiting until I was already struggling.
Recovery strategies – specific techniques for what to do if I felt unsteady, including how to lower myself safely, how to get up again, and when to just stay down and call for help.
Communication with my friends – simple, agreed signals so they would know when I needed space, support or to sit down, without me having to explain everything in the moment.
A review process – checking in with Becca after each outing to talk through what had gone well and what needed adjusting, so the plan kept evolving with me rather than staying fixed.
Acknowledging the risk, and accepting and planning for it, made sense. After all you go through a safety briefing every time you get on a plane, you accept the risk and have a plan should the worst happen.
Accepting and sharing the risk stopped falls being something I ignored, but worried my friends and family a worried about, into something shared.
Having a written plan which I could discuss with and practice with my friends was empowering. Whilst we took it seriously, learning with Becca how to get up and down from the floor safely together turned out to be good fun.
I had to accept my insight into my own risk was not always reliable, hearing how my friends felt about the risk of me falling and their concerns, made me think – because the plan was not just for me.
My friends and family found the falls plan reassuring – it meant the people around me could catch what I might miss, and I could still say yes to a night out without carrying the full weight of managing my own risk alone or burdening others with a responsibility.
Falls became something had a plan for, which changed how I felt entering into a venue. I was not pretending the risk was gone; I was carrying a set of tools I trusted and had already practised.
Getting back into the groove!
My first night back was not about staying until closing time or walking everywhere independently. We chose a familiar venue, went early when it was quieter. I used my electric wheelchair to get around, and we took regular rests together just soaking up the atmosphere, then stood and danced for short periods when I had the energy. Having the wheelchair gave me the freedom to stay involved, manage fatigue and build my endurance across the evening. Me and my boys – We had a great evening
“Physiotherapy did not simply help me stay on my feet. It helped me get back to a life that felt like mine.”
Some days my balance is better than others, and I still have to make choices that other people may not notice. My falls management plan is not something I use once and put away — I still update it with my physiotherapist as my needs change. The difference is that I now have strategies, confidence and a team that has listened to what matters to me. Recovery has not meant returning to exactly who I was before my injury. It has meant finding a safe, realistic route back to the people, places and experiences that give my life meaning.
Thank you, Becca Dickson, for being my physiotherapist and listening to what mattered to me!