Osteoporosis and Fall Prevention

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Falls are a common cause of life-altering injuries in people with osteoporosis. Luckily, most falls can be prevented. Being aware of the risk factors, keeping your body strong and making your environment safe can help mitigate most falls. While accidents are never planned, you should learn ways to protect yourself from fall-related injuries by preventing falls from happening in the first place.

Disclaimer: If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Well Guide contain information from peer-reviewed research, medical societies and governmental agencies; however, these articles are not a substitute for professional medical advice, diagnosis, or treatment.

Why should you worry about falls if you have osteoporosis?

Unfortunately, falls happen. Each year about one in three people over the age of 65 falls (Bone Health & Osteoporosis Foundation, 2018). Fall-related injuries are the leading cause of accidental death in Americans age 65 and older (National Institute of Health, 2018). Falls often lead to fractures (bone breaks), especially in people with osteoporosis (Bone Health & Osteoporosis Foundation, 2018). This is because the gradual loss of bone characteristic of osteoporosis results in fragile bones (National Institute of Health, 2018). A simple, low-to-the-ground fall in someone with osteoporosis can lead to multiple fractures, instantly altering one's lifestyle and potentially their long-term independence. Learning good fall prevention strategies could change these statistics.

Fractures in people with osteoporosis are quite common, which is why fall prevention is so important. One in three women and one in five men over 50 years of age have fractures related to osteoporosis (Cummings-Vaughn, 2011). The most common fractures in people with osteoporosis are vertebral compression fractures, hip fractures, and wrist fractures (Bone Health & Osteoporosis Foundation, 2018).

Hip fractures tend to cause more problems than other broken bones, leading to chronic pain, a loss of independence and long-term disability, among other things (Bone Health & Osteoporosis Foundation, 2018). It is common for people to require some type of home care or transfer to a nursing home following a hip fracture because it can lead to difficulty taking care of themselves (Bone Health & Osteoporosis Foundation, 2018).

What are risk factors for falls?

Risk factors for falls include poor balance, weak muscles, vision problems, certain diseases, alcohol use, certain medications, taking a lot of different medications, and having fall hazards in the home (Bone Health & Osteoporosis Foundation, 2018).

How can you prevent fractures (bone breaks) that result from falls?

The best way to avoid fractures that result from falls is to learn proper fall prevention strategies to avoid falling in the first place. However, because eliminating falls completely is not always possible, maintaining a strong and active lifestyle with good nutrition (hello calcium and vitamin D!) and a combination of balance exercises and strengthening exercises can ensure you are doing all that you can to keep your bones strong and your body healthy (Bone Health & Osteoporosis Foundation, 2018). Ensuring your living space is free of clutter can also contribute to preventing falls at home. Bottom line: fall prevention is key.

How to prevent falls

Exercise has been shown to reduce falls and fall-related fractures in people with low bone density (Cummings-Vaughn, 2011). It is recommended that exercise interventions for individuals with osteoporosis include balance training and muscle strengthening to best reduce falls (Cummings-Vaughn, 2011). You should:

  • Perform balance exercises regularly (3 days per week or more). Exercise programs that include balance components have been shown to be the most effective types for reducing fall risk and fall-related fractures (de Kam et al, 2009).
  • Perform muscle strengthening exercises 2-3 days per week for all major muscle groups, especially your hip, thigh, and ankle muscles. The stronger you are, the less likely you are to fall. 

Given that both balance and strengthening exercises have their benefits, an exercise plan that incorporates both is your best strategy for staying upright and out of the emergency room. Preventing falls at home and having the right fall prevention interventions to incorporate into your life is key.

Other tips for preventing falls include:

  • Stay up-to-date on your vision prescriptions and appointments
  • Check with your healthcare provider to see if any medications you are taking increase your fall risk (Bone Health & Osteoporosis Foundation, 2018).
  • Wear shoes with closed backs that have non-slip soles (Bone Health & Osteoporosis Foundation, 2018).

Fall-proof your home environment by doing the following:

  • Remove tripping hazards such as throw rugs and cords.
  • Make sure all carpets and area rugs have skid-proof backs or are attached to the floor (Bone Health & Osteoporosis Foundation, 2018).
  • Use a non-skid rubber mat in the shower or tub (Bone Health & Osteoporosis Foundation, 2018).
  • Make sure you have sufficient light when you need to get up and move around your house, especially when you wake up at night to go to the bathroom. 
  • Install sturdy handrails on both sides of your stairs (Bone Health & Osteoporosis Foundation, 2018).
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  1. Cummings-Vaughn LA, Gammack JK. Falls, osteoporosis, and hip fractures. Med Clin North Am. 2011;95(3):495-x. doi:10.1016/j.mcna.2011.03.003
  2. de Kam D, Smulders E, Weerdesteyn V, Smits-Engelsman BC. Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials. Osteoporos Int. 2009;20(12):2111-2125. doi:10.1007/s00198-009-0938-6
  3. Boning up on osteoporosis. Bone Health and Osteoporosis Foundation. Updated March 2018. Accessed August 7, 2022. http://www.bonehealthandosteoporosis.org/wp-content/uploads/BoningUpBrochure_8.5x11.pdf.
  4. Preventing Falls and Related Fractures. NIH Osteoporosis and Related Bone Disease National Resource Center. December 2018. Accessed April 3, 2022. https://www.bones.nih.gov/health-info/bone/osteoporosis/fracture/preventing-falls-and-related-fractures.
  5. Sinaki, M, Pfeifer M. Non-Pharmacological Management of Osteoporosis: Exercise, Nutrition, Fall and Fracture Prevention. Springer, 2017.

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