Physiotherapy After a Fall in Elderly Patients

Finding the cause

Falls rarely have a single cause. A physiotherapist looks at several possibilities:

• muscle weakness, especially in the legs
• balance problems
• walking pattern changes
• dizziness or low blood pressure on standing
• medication side effects
• poor eyesight
• foot problems or unsuitable footwear
• home hazards like rugs, poor lighting or slippery floors

Some of these need a doctor's input, such as medication review or blood pressure checks. The physiotherapist often coordinates with the medical team.

Fear of falling

After a fall, many older adults develop a fear of falling again. That fear often leads to reduced activity, which weakens muscles and worsens balance, making another fall more likely. Addressing fear is part of treatment. Gradual, supported practice of activities that feel risky rebuilds confidence.

Rehabilitation

Strength. Leg strength is the foundation. Sit to stand, step ups, calf raises and hip exercises.

Balance. Progressive balance practice, from standing with feet together to walking challenges.

Walking. Improving walking pattern and endurance, with the right walking aid.

Getting up from the floor. Learning a safe technique, or how to stay safe and call for help if you can't get up.

Home changes. Grab rails, night lights, removing trip hazards.

After a fracture

Hip, wrist and spinal fractures are common after falls in older adults. Rehabilitation follows the medical team's guidance on weight bearing. Our post fracture exercises guide explains the general approach.

Where rehab happens

Many older adults recover best at home, where training fits their real environment. Our guide to home physiotherapy after a fall explains how that works.

Medication and blood pressure checks

Some falls in older adults come from causes that exercise alone won't fix. Several medications, including some for sleep, blood pressure, mood and pain, can cause dizziness, drowsiness or low blood pressure on standing. Taking several medications at once increases the risk.

Blood pressure that drops when standing up, called orthostatic hypotension, is a common cause of falls. It often shows up as dizziness when getting out of bed or standing from a chair. Physiotherapists sometimes check lying and standing blood pressure during an assessment.

If these factors are suspected, the physiotherapist will suggest a review with the doctor. Addressing them alongside strength and balance training gives the best chance of preventing further falls.

Preventing the next fall

The goal isn't only recovery from this fall, but reducing the chance of the next. Long-term strength and balance exercise, regular reviews and a safer home all contribute.