Fear of Falling

Fear of falling is the most common fear reported in older adults and it causes changes in behavior, as well as four predictable changes in walking pattern.

Many people who fall or feel off balance develop the fear of falling. Some people may develop a fear of falling from hearing about their friends who have fallen.

People who fall often start limiting their outings and social activities due to a fear of falling, which can lead to social isolation and sadness. Interestingly, most falls occur on level surfaces inside the person’s own home.

That fear also then leads to social anxiety where individuals don’t want to leave the home. Sometimes due to falling, individuals can even develop agoraphobic behavioral tendencies.

Eventually, the fear of falling can lead to depression and suicidal ideation, as well as increasing the caregiver burden and reducing the quality of life.

Four Predictable Changes to Walking

A research team at the University of Pittsburgh, lead by a well-known physical therapist named Susan Whitney, has discovered that fear of falling creates four predictable changes in the walking pattern:

  • less arm swing
  • less trunk rotation
  • shorter steps
  • less stability from side to side

With less stability from side to side, fear of falling can mean that you’re more likely to tip over to the side. For example, if you’re not swinging your arms, you’re more likely to tip over.

If we can get on top of this by educating our community on fall prevention strategies and providing appropriate care after the very first fall that an individual experiences, then essentially the ripple effect is that our whole community will benefit.

Fear of falling should be reported to the Primary Care Physician, so the physician can make appropriate referrals such as the Vestibular Rehabilitation or other Physical Therapy.


This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.

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