Winter Fall Injury Risks and Ways to Improve Strength and Balance

Avoiding Falls in the Colder Months

Dr. Kevin Smidt

Winter conditions can create plenty of hazards, from black ice in parking lots to ladder use while hanging holiday decorations and carrying heavy loads into the home.

As people get older, muscles weaken when they are used less, which leaves adults over 65 especially susceptible to falls, says Dr. Kevin Smidt, an orthopedic surgeon at Orthopedic ONE who focuses on hip and knee reconstruction.

“People don’t fall all of a sudden because they turn 65,” Smidt says. “For younger people, our body is able to react and brace ourselves to catch ourselves, and so as we get older and we lose those things – the balance, coordination, strength, endurance – that same person isn’t able to catch themselves. That’s how they fall and that’s how they get injured.”

With that in mind, there are steps people can take to lower the chance of a fall while also improving overall health.

Understanding the risks

The Centers for Disease Control and Prevention says 1 in 10 falls among older adults, the highest-risk group, leads to an injury that requires limited activity and medical care. Smidt says wrist fractures are the most common injury, though compression fractures in the spine, shoulder or hip fractures, and rotator cuff tears can also happen.

In addition to seasonal dangers such as changing weather, holiday decorations and gifts left around the house, year-round hazards like rugs, roaming pets and poorly lit walkways can contribute to falls. Smidt says prior fractures are also a major concern because they can point to earlier bone weakness.

“In that age group, making sure you’re keeping up with your bone health (is important),” he says. “(Talk) with your primary care (doctor) about whether or not you need a bone scan to look at your bone health and your bone quality.”

Other factors vary from person to person. Smidt notes that some medications, including those used for blood pressure, anxiety and depression, can raise the risk, as can conditions such as osteoporosis.

Moving carefully

Smidt’s main advice is to be especially careful during the first and last 10 feet of any trip, since that is when many falls occur.

“I really try to emphasize to my patients what I call the transition zone. That’s moving from one place to another, getting in and out of the car, the first step out of your house or down the stairs,” he says. “We tend to focus on the middle part, but not the transition zone.”

Paying closer attention in those moments can improve safety. It helps people stay aware of their bodies and surroundings, Smidt says, making it easier to spot hidden dangers such as black ice.

For balance, he recommends shoes with good traction and the penguin walking method: take short steps, keep your feet wider apart, shift your weight forward or centered, and leave at least one hand free to help balance, similar to a penguin’s waddle.

He also says making more trips between locations with care is usually better than trying to carry everything at once.

“We (tend to) want to take as few trips as possible, but when you have your hands tied up and you don’t have visualization of where you’re walking or stepping, that’s a big risk,” he says. “I would recommend – for (carrying) groceries, laundry, a child, anything, really – just have one hand free and make sure you look where you’re walking to avoid any fall.”

When to get checked

After a fall, Smidt recommends pausing for a few seconds to assess pain before trying to stand.

Immediate medical attention is needed if there is loss of consciousness, pain in the head or neck, broken skin, deformity or bleeding, or if walking or bearing weight is not possible. Urgent care is also appropriate for pain when touched, especially in the wrist.

If there is some pain but weight-bearing is still manageable, Smidt says to watch the injury closely over the next 24 to 48 hours. Use the R.I.C.E. method: rest, ice the area, apply compression with an Ace wrap or tight clothing if swelling develops, and raise the injured area above the heart to reduce swelling.

Even if the injury seems to have healed, it is important to tell a primary care doctor or physician so any injury can be monitored and repeated falls or injury risk can be documented.