Preventing Hip Fractures in Older People

With a global aging population, the importance of balance and fall prevention has never been greater.

In this group of older adults, falls play a major role in not reduced quality of life, but also premature death. Falls lead to reduced quality, reduced quantity. In fact, in over 65s, falls are the greatest cause of accidents, the main cause of serious injury, and the number one cause of accidental deaths. One third of over 65s, that’s one in three, suffers at least one fall a year. Now here’s the scary part. These falls don’t take place slipping on a wet floor, or climbing the stairs, or stepping over a curb. They take place simply by walking. More people over the age of 65 are injured by walking than driving, or any other daily activity. These falls occur during activities of daily living. If the tasks of daily living cannot be completed due to fear of falling – quality of life drops. Here begins a viscous cycle. Weakness and incorrect prevention training lead to a fall, which increases the chance of suffering from further falls. Couple this with osteoporosis and low bone mineral density caused by a lack of weight bearing exercise and the situation becomes even more grim. Statistics show that the rates of premature death are greatly elevated following a broken hip caused by a fall. Why? Because exercise stops and the body shuts down. The aim of this post is to break the fall cycle – before it even begins.

As we age, changes in the musculoskeletal (changes in muscle mass and fibre type), neurological (ability to respond to environment) and cardiovascular (reduced exercise tolerance) systems, along with loses of sensual acuity create an increased predisposition to falls.

Couple this with a reduction in lean body mass (largely due to loss of bone mineral density), and the risk of suffering a fracture (usually a break of the neck of the femur, or hip) is multiplied.

Three classes of initiatives can be taken to prevent hip fractures:

Preventing Falls:

  1. Undertake an exercise program.
  2. Modify the environment to remove factors causing falls.
  3. Educate to reduce the risk of falling.
  4. Review medication combinations.

Enhancing Bone Mineral Density:

  1. Undertake an exercise program.
  2. Get sufficient levels of vitamin D from sunshine.
  3. Supplement vitamin D and calcium.

Protect from impact (physical barrier over the hip):

  1. Energy shunting shields.
  2. Energy absorbing pads.

Exercise, almost by definition is hard. This is not to say exercise is complicated, just hard. It involves considerable resources, time and effort. Not to say that these aren’t returned one hundred fold, because they are, but resources non-the-less. Enter balance. One of the few facets of exercise where considerable improvement can be gained with few resources. Little time, little effort. Training for improved balance doesn’t make you sweat. It doesn’t make you ache, or sore the next day. If done correctly and efficiently, it doesn’t take a lot of time. And yet the benefits are significant.

Dan Williams

Dan Williams


Dan Williams is the Director of Range of Motion and leads a team of Exercise Physiologists, Sports Scientists, Physiotherapists and Coaches. He has a Bachelor of Science (Exercise and Health Science) and a Postgraduate Bachelor of Exercise Rehabilitation Science from The University of Western Australia, with minors in Biomechanics and Sport Psychology.