Falling Accidents and Injuries

Falling accidents and injuries are some of the most common reasons for people to seek medical attention. Falls can be no big deal if you don’t get any injuries — except for maybe your pride. But they can also result in dangerous or life-changing injuries.

Unintentional falls are a leading cause of injuries for almost all age groups in the United States. And falls are a bigger concern for people in two age groups: children around ages 1 to 2 and adults over 65.

Signs and symptoms of common injuries from falls

• No harm: This is when you fall, but aren’t hurt. You don’t need any kind of treatment.
• Minor harm: This includes smaller, superficial injuries like bruises, cuts (lacerations) or low-grade sprains. You can generally self-treat these issues at home.
• Moderate harm: This isn’t an emergency, but you still need professional care (like at an urgent care). It includes wrist and ankle sprains that limit your use of that limb, larger cuts (especially on your arms, legs or head), broken ribs or spine, or minor concussions.
• Major harm: Injuries of this severity are medical emergencies. They include broken bones in your hip, pelvis, arms, legs or hands. Traumatic brain injuries and brain bleeds also belong in this category.

Fall causes

Fall-related injuries can happen for many reasons. Some common examples include:

• Sports- and leisure-related falls
• Falls at work
• Surfaces you didn’t know were slippery, like a floor that you couldn’t see was wet
• Unstable or uneven surfaces, like cracked or loose sections of pavement
• Simple human error, like tripping on something you didn’t see

But for some groups, falls are more likely to happen in specific ways.

Fall causes in children

As toddlers learn to walk, they have a very high fall risk. Children also may not have the experience to avoid falls in certain places. Examples include:

• Stairs
• Open windows
• Furniture
• Beds, especially for infants and toddlers, and bunk beds in general
• Using playground equipment
• Playing in or around treehouses

Causes of falls in older adults

In older adults, it’s common for falls to happen because multiple factors add up. As they do, your risk of a fall becomes more and more likely. Experts organize the factors into the following categories:

• Medical conditions
• Medications
• Sensory, motor and balance issues
• Environmental
• Psychological, social and demographic

Medical conditions

It’s common for people to fall because of changes or long-term effects of medical conditions. Examples include:

• Strokes
• Movement disorders like Parkinson’s disease
• Dementia
• Vision loss
• Muscle weakness (asthenia) or loss of muscle mass (sarcopenia)
• Frailty

Medications

Many of the most common medications cause side effects that increase your risk of falls. Examples include:

• Blood pressure medications
• Anxiety medications with sedative effects
• Opioids

Your risk of a fall also goes up if you take five or more different medications daily. That’s because medications often intensify the others’ side effects.

Sensory, motor and balance issues

When your senses aren’t working properly, a fall becomes more likely. Multiple senses — especially vision, touch and balance — are important for getting around.

One example of a sensory issue that can lead to falls is vision loss. Another is diabetes-related neuropathy. Over time, Type 2 diabetes can damage nerves in your legs and feet. If you can’t feel your legs or feet, it can keep you from feeling uneven surfaces underfoot or stopping yourself from tripping. And if you can’t see where you’re going or obstacles in your path, you’re more likely to fall.

Environmental factors

These are factors from outside your body that can contribute to a fall. Examples include:

• Home furnishings: Rugs or other furnishings can pose a tripping hazard. Slippery surfaces, especially in bathrooms, can also cause falls.
• Lack of grab bars and railings: Falls are more likely when there’s nothing to grab for support, especially in bathrooms, on stairs and in other areas.
• Footwear: What you put on your feet can make falls more or less likely.
• Weather and climate: Snow or ice on walkways around your house can make falls more likely.

Psychological, social and demographic factors

Some factors about yourself or your background can contribute to a risk of falling. Examples include:

• Previous falls: If you fall once, you’re more likely to fall again in the future.
• Age: About 1 in 4 adults over age 65 fall at least once a year. For those 85 and older, it’s about 1 in 3.
• Living situation: People who live alone are more likely to fall. This can be because they try to do things on their own that require help.
• Needing help with activities of daily living (ADLs): People who need help with ADLs — like bathing, dressing or feeding themselves — are more likely to fall.
• Fear of falling: People who fear falling are much more likely to do so.

Fall complications

There are many potential complications of fall-related injuries. In general, the complications depend on what kind of injuries you had from the fall, the care you received and your health history.

If you’re over 65, fall-related complications are more likely to cause life-changing complications. These can include:

• Extended hospitalization: You may need to stay in the hospital longer because of fall-related injuries.
• Long-term or permanent disability: That includes permanent disabilities and/or needing to use mobility aids like a cane, walker or wheelchair.
• Loss of independence: This can include needing to live with family, in assisted living or in a long-term care facility.
• Death: A 2023 analysis found that over 85% of fall-related deaths in the U.S. happen in adults over 65. And a 2016 study found that about 15% of older adults who fall die within a year. Those statistics are part of why taking steps to prevent falls is so important.

How doctors diagnose fall-related injuries

Healthcare providers can diagnose fall-related injuries using a variety of methods. They’ll start with physical and neurological exams. They’ll also likely use imaging scans to look for broken bones and/or internal injuries. The most likely imaging scans include:

• X-rays
• Computed tomography (CT) scans and CT angiograms
• Magnetic resonance imaging (MRI)
• Ultrasound

Lab and diagnostic tests are also possible. Experts often use them to look for underlying conditions or factors that could have contributed to the fall. Because there are many possible tests, your healthcare provider is the best source of information for your specific case.

How are fall-related injuries treated?

The treatments for fall-related injuries depend on multiple factors. The factors include the specific injuries and their severity, your health history and many other factors. Your healthcare provider is the best person to tell you about treatment options.

Are falls preventable?

While falls can happen for reasons outside your control, it’s very possible to prevent most falls from happening. Falls are most likely to happen at home. Because of that, many of the best ways to prevent falls are ones you can put to work around your home.

Preventing falls for older adults

Some key ways to prevent falls for older adults include:

• Stay active: Physical activity or programs like physical therapy may help improve your strength and balance.
• See your healthcare provider regularly: Regular checkups let your provider check for medical conditions and review your medications to manage your fall risk.
• Focus on your feet: Take care of your feet, especially if you have chronic conditions like diabetes. Make sure you wear shoes that fit properly and replace them as needed.
• Take care of your eyes: Make sure your eyeglasses prescription is up to date by seeing your eye care specialist at least every one to two years (or more frequently if needed).
• Ask about home safety assessments: Occupational therapists and other experts may be able to do these assessments to identify potential hazards in your home.
• Use nightlights around your home: They can help you avoid falls due to unseen obstacles.

Preventing falls for children

The following may help prevent children from falling or protect them from serious injuries:

• Restrict access: Use gates, doors, locks and other means of childproofing to keep toddlers away from places they might fall, like stairs.
• Prevent climbing: Move climbable furniture away from windows or other places that children might fall from.
• Supervise: Keep an eye on your children in situations where they might climb or fall.
• Teach: Start teaching your children early on not to climb or go places where they might fall.

When should I see my healthcare provider about falls?

In addition to regular checkups, you should see your provider if you repeatedly start to fall but catch yourself. These near misses can be an early sign of issues that could lead to a later fall.

It’s also a good idea to talk to your provider if you’re experiencing medication side effects that could contribute to falls. Some examples include dizziness, drowsiness or coordination issues.

When should I go to the hospital?

You should always go to the hospital after a fall if any of the following apply:

• You take blood thinners (anticoagulants): These drugs make it harder for your blood to clot, which can lead to dangerous internal bleeding (even if you don’t have a visible injury). This is especially important if you hit your head, chest, back or abdomen.
• You think you have a serious injury like a broken bone: If you can’t use a limb like usual, you should get professional medical care.
• You might have a head injury: This includes hitting your head hard enough to black out or “see stars.” That also goes for delayed symptoms like confusion, drowsiness or behavior changes.

You should also get medical care immediately if you fell because of symptoms of a stroke, heart attack or other medical emergency.

What questions should I ask my healthcare provider?

Some questions that you may want to ask your healthcare provider include:

• What can I do to reduce my risk of a fall?
• What programs or organizations in my area might be able to help me reduce my risk of falls at home?
• Are there activities that might help me prevent a fall?