A Physiotherapist’s Guide to Safeguarding Your Hips

In Canada, thousands of older adults are hospitalized each year due to fall-related hip fractures. Unfortunately, as a physiotherapist, I’ve seen many clients navigate these potentially life-altering injuries that often lead to loss of independence, prolonged rehabilitation, and reduced quality of life. It’s not all doom and gloom though, the risk of having a hip fracture can be reduced by having a proactive plan.  Physiotherapy guidance in improving the safety of your environment and building an exercise program designed to improve balance, agility, and strength should be part of that plan.

A hip fracture occurs when the upper part of the femur breaks, often due to a fall.  Seniors are more vulnerable due to age-related factors like decreased bone density (osteoporosis), reduced muscle strength, and impaired balance.  Canadian winters pose an additional danger with the icy, uneven and unpredictable terrain.

Key risk factors for hip fractures include:

• Environmental conditions
• Reduced physical fitness
• Reduced reaction times

By addressing these factors, you can feel confident that you are taking proactive steps to reduce your risk of hip fracture.

Environmental conditions

By improving the safety of your environment, you can reduce your risk of falling and subsequently reduce your risk of hip fracture.  Indoor considerations include removing tripping hazards (ie: throw rugs, clutter, wires), wearing supportive footwear with good treads and ensuring good lighting in all rooms/hallways.  Outdoor considerations include the use of proper footwear and choice of terrain.  Both indoors and outdoors, it is important to consider the use of gait aides (walking poles, canes, walkers) based on your mobility needs.  Consultation with a physiotherapist can help you feel confident in which factors are most relevant to you; this can help you build a personalized plan.

Physical Fitness

Physiotherapy guidance in building an exercise plan to addresses strength, balance and mobility can help address any gaps you may have due to past injury, chronic health conditions and normal age-related changes in these systems.

The strengthening exercises likely to be most helpful here will focus on building hip, abdominal and back muscle strength.  There are many different exercises that can be helpful but they are best if tailored specifically to the individual based on their own health history.

Balance training should include both static (standing still) and dynamic (staying stable while moving) exercises.  These exercises should be difficult (but safe) to execute in order to really challenge your body.  Professional guidance here in selecting appropriate exercises is key to ensuring your safety.

Mobility exercises for the ankle are important to reduce the risk of “catching” the toe when walking.  Hip and knee mobility are also important to allow the normal joint mechanics while walking.

Reaction Times

In addition to strength, balance and mobility, it is important to train how your body responds to quick changes in demands.  The ability to move or reposition quickly and unexpectedly is key in reducing the risk of a fall.  A personalized plan here is important to ensure your safety while engaging with the exercises.  Some of my favourite reaction exercises include using an agility ladder, wobble board or ball toss.

Preventing hip fractures isn’t just about avoiding injuries; it’s about maintaining your quality of life. If you’ve not already spent some time considering how to safeguard your hips against a possible fall, consider meeting with a physiotherapist to create a personalized fall risk reduction plan.