How Can I Protect Against Having a Broken Bone from a Fall?

The best way to avoid a broken bone is to avoid a fall. Certain safety tips are recommended by the National Institutes of Health:

Outdoor safety tips

• When the ground is slippery or wet, such as in rainy or snowy weather, use a walker or cane for added stability and wear shoes with rubber soles for added traction.



• When it is cold or snowy, wear warm boots (so the feet do not go numb) with rubber soles for added traction.



• Pay attention to the floor in public buildings because many floors are made of highly polished marble or tile that can be very slippery, especially if the floor is wet.



• Find and use delivery services, such as 24-hour pharmacies or grocery stores that take orders over the phone and deliver, especially in bad weather.



• When going out, keep the hands free by using a shoulder bag, fanny pack, or backpack instead of a clutch purse or a bag or wallet held in the hands.



• Always stop at curbs and check the height before stepping up or down. Be careful using walkways for wheelchairs, grocery carts, bicycles, etc, because the incline up or down may lead to a fall.

Indoor safety tips

• Floor safety
  
  
  • Keep all rooms neat and tidy and especially keep things off the floors.
  
  
  
  • Floor surfaces should be smooth and level but not slippery. Always pay attention to changes in floor levels, especially at thresholds and in doorways.
  
  
  
  • Wear supportive shoes without high heels even at home. Avoid walking around in socks, stockings, or floppy slippers to avoid tripping or slipping.
  
  
  
  • Make sure all carpets and rugs are stuck to the floor or have skid-proof backing so they cannot slide around when someone steps on them.
  
  
  
  • Keep electrical cords and telephone lines out of the way.
     
• Stair and bathroom safety
  
  
  • Make sure stairs have plenty of light and that there are handrails on both sides. Placing fluorescent or colored tape on the edges of the top and bottom steps may help make them more visible.
  
  
  
  • For safety in the bathroom, install bars to grab onto on bathroom walls beside tubs, showers, and toilets. Consider using a plastic chair with a back in the shower.
  
  
  
  • Always use a rubber bath mat in the shower or tub so the chance of slipping is reduced.
     
• Lighting
  
  
  • Keep a flashlight with fresh batteries beside the bed in case of a power failure.
  
  
  
  • Make sure the lights in a room can be turned on from the doorway. A ceiling light with a light switch by the door or lamps that can be turned on by a switch are possible solutions. Another option is to install voice- or sound-activated lamps (such as the Clapper).
  
  
  
  • Use at least 100-watt bulbs in the home so that lamps are brighter.
     
• Telephones and contact
  
  
  • A portable phone or cell phone that can be taken from room to room is another option to improve safety in the home. This helps prevent a fall caused by rushing to answer the phone, and it can be used to call for help if an accident occurs.
  
  
  
  • Arrange for daily contact with a family member or friend. This increases the chance of receiving immediate help in case of an accident.
  
  
  
  • Monitoring companies are also available if living alone. They will respond to a call 24 hours a day.
     
• Other safety issues
  
  
  • If using a step stool, use a sturdy one with a handrail and wide steps. It is better to reorganize closets, cabinets, and shelves so climbing on a stool or bend over is not necessary.
  
  
  
  • Always keep enough prescription medications to last at least one week at home. Also, talk to a doctor or pharmacist about these medications. Determine whether any medication or combination of medications may increase the risk of falling.

Improving balance

A person can evaluate balance by looking in a mirror. The body may lean or sway back and forth or side to side while walking or standing still. This may be an indication of the ability to balance because lots of body sway often indicates decreased ability to balance, making a person more likely to fall.

Practicing balancing exercises every day is helpful. Elderly persons or those with medical problems should check with their doctor before performing exercises to help with balance.

• Hold onto the back of a chair or the counter top and practice standing on one leg at a time for a minute. Gradually increase the time spent balancing on one leg. Try balancing with eyes closed. Finally, try balancing without holding onto anything.



• Hold onto the back of a chair or the counter top and practice standing on the toes for a count of 10. Then rock back to balance on the heels for a count of 10. Repeat.



• Hold the back of a chair or a counter top with both hands and make a big circle to the left with the hips but do not move the shoulders or feet. Then do this to the right. Repeat 5 times. 

Remember that the force of a fall (how hard a person lands) is a significant factor in whether a person will have a broken bone or not. Take the following steps to lessen the chances of breaking a bone if a fall occurs.

• Try not to fall sideways or straight down because a hip fracture is more likely to occur than if the fall is in other directions. If possible, try to fall forward or to land on the buttocks.



• Even though a broken arm or wrist may result, try to land on the hands because a broken arm has fewer complications than a broken hip.



• Break a fall by grabbing onto counters or other surfaces around.



• Walk carefully, especially on hard or slippery surfaces.



• When possible, wear protective clothing for padding or wear hip (trochanteric) pads. Talk to a doctor about hip padding.

Early detection of low bone mass (osteopenia) or osteoporosis is the most important step to protect against broken bones from falls. If a person has osteopenia or osteoporosis, he or she can take action to stop the progression of bone loss. Remember effective treatment or prevention cannot take place if the person does not know he or she has or is at risk for osteoporosis.

Certain factors, such as female sex, family history of osteoporosis, use of medicines that increase bone loss, small body size, and an inactive lifestyle, are associated with increased risk of developing osteoporosis (see Prevention of Osteoporosis and Bone Mineral Density Tests for details on risk factors). 

If any of these risk factors or other signs of osteoporosis are present, a doctor may recommend that the bone mass is measured. Even though risk factors can indicate the possibility of low bone density, only a bone mineral density (BMD) test can be used to measure current bone density, diagnose osteoporosis, and determine the risk of fracture. Bone mineral density tests measure the solidness and mass (bone density) in the spine, wrist, and/or hip, which are the most common sites of fractures due to osteoporosis. Other tests measure bone density in the heel or hand. These tests are performed like x-ray films. They are painless, noninvasive, and safe (see Bone Mineral Density Tests for more information).

Doctors examine bone mineral density test results to do the following:

• Detect low bone density (osteopenia) before a fracture occurs



• Confirm a diagnosis of osteoporosis if broken bones (fractures) have already occurred



• Predict the chance of having a fracture in the future



• Determine the rate of bone loss and monitor the effects of treatment (tests done to monitor treatment are usually conducted every year or so)

Decreasing bone weakness

Preserve existing bone mass and density (strength) to decrease the risk of broken bones and disability from falling. The many treatments available today have been shown to work quickly (within 1 year), and they reduce the risk of fracture by up to 50%. Protect the health of bones by following osteoporosis treatment and prevention strategies (see Treatment of Osteoporosis and Prevention of Osteoporosis).

• A calcium-rich diet is essential to strong bones. A diet high in calcium should provide 1200 mg of calcium from a combination of foods and supplements.



• The body needs vitamin D to absorb the calcium from the diet. Obtain 400-800 international units (IU) of vitamin D each day from diet or supplements.



• Participate in weight-bearing exercise (exercise that works against gravity) and resistance exercise 3 times a week. Weight-bearing exercises include walking, hiking, jogging, climbing stairs, tennis, and dancing. Resistance exercises include using free weights and weight machines found at gyms and health clubs.



• Talk to a doctor about having a bone density test (a special x-ray that measures the strength of the bones and indicates the risk for fracture).



• Talk with a doctor about medications for osteoporosis to stop bone loss, improve bone density, and reduce fracture risk.