Why Falls Matter After 65

You are reaching for a book on a high shelf. You turn too quickly. Your foot catches the edge of the rug. Before you know it, you are on the floor, and the room is spinning.

For many seniors, this is not a rare accident. About one in three Canadians over the age of 65 falls at least once a year. Falls are the leading cause of injury, hospital visits, and loss of independence among older adults in Canada. A broken hip, a head injury, or even a bad fright after a fall can change a person's life in a single afternoon.

But here is the part that does not get said often enough: most falls are preventable. Falls are not an unavoidable part of getting older. They happen for specific reasons, weak legs, poor balance, poor vision, side effects of medicines, hazards at home, and most of those reasons can be improved. That is where physiotherapy comes in.

At Renew Physiotherapy in Surrey, we work with seniors every week who want to stay steady on their feet, keep doing the things they love, and avoid the fall that changes everything. This guide explains why seniors fall, how physiotherapy assesses your fall risk, the exercises that actually help, how to make your home safer, and what to do in a Surrey winter, when icy sidewalks make every step a test.

Why Do Seniors Fall?

A fall is rarely caused by one thing. It is usually a combination of small changes that add up over time. Understanding the reasons is the first step to preventing them.

Weaker leg muscles. After the age of 50, muscle strength declines by about 1 to 2 percent a year. By 70, many people have lost a third of the strength they had at 40. Weaker legs mean slower reactions, a less steady step, and much more difficulty catching yourself when you trip. Getting up from a chair, climbing stairs, and stepping over a curb all get harder, and each one becomes a small fall risk.
Poorer balance. Balance depends on three systems working together: the inner ear (the vestibular system), the eyes, and the nerves in the feet and legs that tell the brain where the body is. With age, all three can weaken. If one system is already struggling, a small extra problem, like a dark room or an uneven sidewalk, can be enough to cause a fall. If dizziness is part of your picture, you can read our guide to vertigo treatment in Surrey to understand how the inner ear affects balance.
Vision changes. Cataracts, glaucoma, macular degeneration, and even an out-of-date glasses prescription make it harder to see hazards. Depth perception weakens too, so judging the height of a step or the edge of a curb becomes less reliable. Poor vision is one of the most common and most fixable causes of falls.
Medicines. Many common medicines can increase fall risk. Blood pressure medicines can cause dizziness when you stand up. Sleeping pills and anxiety medicines can slow your reactions and make you unsteady. Some medicines for pain, depression, and bladder problems have the same effect. Taking four or more medicines at once raises the risk further. If you feel dizzy or unsteady after starting a new medicine, tell your doctor. Never stop a medicine on your own.
Chronic conditions. Arthritis, diabetes, Parkinson's disease, stroke, and neuropathy (nerve damage in the feet) all affect balance and walking. Arthritis in the knees or hips changes the way you walk and makes it harder to recover from a stumble. Diabetes can damage the nerves in the feet, so you feel the ground less clearly. If joint pain is part of your picture, our guide to arthritis treatment in Surrey explains how physiotherapy helps.
Home hazards. Most falls happen at home, not outside. Loose rugs, cluttered floors, poor lighting, slippery bathroom floors, and stairs without handrails are the usual culprits. A home that was safe at 50 can become dangerous at 75, simply because the person living in it has changed, not the house.
Fear of falling. This is the hidden one. After a fall, or even after a near-fall, many seniors become afraid of falling again. They move less, go out less, and avoid stairs and uneven ground. But moving less makes the legs weaker and the balance worse, which makes the next fall more likely. Fear of falling is itself a cause of falling, and breaking that cycle is one of the most important things physiotherapy does.

How Physiotherapy Assesses Your Fall Risk

You cannot fix a problem you have not measured. A physiotherapy fall-risk assessment is a thorough check of the things that keep you steady. It usually takes about an hour, and it is not painful or frightening.

Balance tests. The physiotherapist will ask you to stand with your feet together, with your eyes open and then closed, and to stand on one leg for as long as you can. They may use a timed test, like the Timed Up and Go, where you stand up from a chair, walk three metres, turn around, walk back, and sit down. The time it takes, and how steady you are, tells a lot about your fall risk.
Gait assessment. The physiotherapist watches you walk: your step length, your speed, how much your arms swing, whether you shuffle, and whether you need to look at your feet. A slow, shuffling walk with short steps is a sign of higher fall risk, and it is also very fixable with the right exercises.
Leg strength testing. Strong legs are your first line of defence against a fall. The physiotherapist tests the strength of your hips, knees, and ankles, and how many times you can stand up from a chair in 30 seconds. If your legs are weak, the assessment tells us exactly which muscles need work.
Flexibility and joint range. Stiff ankles, hips, and knees change the way you walk and make it harder to recover from a trip. The assessment checks how far each joint moves, and whether stiffness is part of the problem.
Vestibular screening. If you have dizziness, spinning, or a feeling of being off balance, the physiotherapist will check the inner ear system. Vestibular problems are a common and very treatable cause of falls, and our vestibular rehabilitation guide explains how it works.
Footwear and walking aids. The physiotherapist checks whether your shoes are helping or hurting, and whether a cane or walker would help you, and if so, how to use it correctly. A walking aid that is the wrong height, or used incorrectly, can increase fall risk instead of reducing it.
Home and lifestyle review. The assessment also covers your home setup, your medicines, your vision, and your daily routine. The result is a clear picture of your personal fall risk and a plan to reduce it, built around your body and your life, not a generic handout.

7 Balance and Strength Exercises to Try at Home

These exercises are the ones physiotherapists prescribe most often for falls prevention. They are safe for most seniors, but only if you do them the right way: near a sturdy support, slowly, and without pushing through pain or dizziness. Hold on to a kitchen counter, a heavy chair, or a wall. If you feel dizzy, unsteady, or unwell during any exercise, stop and sit down. And if you have not had a fall-risk assessment yet, get one first, so your physiotherapist can confirm which exercises are right for you and how many repetitions to do.

1. Heel-to-Toe Walk

Stand near a wall or counter. Place one foot directly in front of the other, so the heel of the front foot touches the toes of the back foot, like walking on a tightrope. Take 10 small steps forward, then turn around carefully and walk back. This trains your balance in a straight line and is one of the best exercises for preventing falls.

2. Single-Leg Stand

Stand behind a sturdy chair and hold the back lightly with one hand. Lift one foot off the floor and balance on the other leg for 10 seconds. Switch legs. Repeat 5 times on each side. As you get steadier, try holding with just a fingertip, then without holding at all, but always with the chair within reach. This is the single most useful balance exercise there is.

3. Sit-to-Stand

Sit in a sturdy chair with your feet flat on the floor. Lean forward slightly, push through your heels, and stand up without using your hands. Sit back down slowly. Repeat 10 times. This builds the leg strength you need for stairs, getting out of a car, and catching yourself when you trip. If standing without hands is too hard at first, use your hands and build up over time.

4. Heel Raises

Stand behind a chair, holding the back. Rise up on your toes, lifting your heels off the floor, and hold for 2 seconds. Lower slowly. Repeat 10 to 15 times. Strong calf muscles help you push off with each step and recover your balance when you stumble.

5. Toe Raises

In the same position, lift your toes and the front of your feet off the floor, keeping your heels down. Hold for 2 seconds and lower slowly. Repeat 10 to 15 times. This strengthens the muscles at the front of the shin, which lift the foot clear of the ground and stop you from catching your toe on a rug or a step.

6. Side Leg Lifts

Stand behind a chair, holding the back with one hand. Lift one leg out to the side, keeping your body upright and your toes pointing forward. Hold for 2 seconds, lower slowly. Repeat 10 times on each side. Strong hip muscles keep you steady when you step sideways or shift your weight.

7. Marching in Place

Stand near a support and march in place, lifting your knees to hip height, for 30 seconds to 1 minute. Swing your arms naturally. This builds leg strength, coordination, and endurance all at once, and it is a good way to warm up before the other exercises.

Do these exercises 3 to 4 times a week. A little bit, done regularly, is far better than a big session once in a while. If an exercise causes pain, dizziness, or breathlessness, stop and tell your physiotherapist. The program should be adjusted to you, not the other way around.

Home Safety Checklist

Most falls happen at home, which means your home is the easiest place to prevent them. Go through this checklist room by room, or ask a family member to go through it with you.

  • Lighting: Make sure every room, hallway, and staircase is well lit. Put night lights in the hallway and bathroom so you never walk in the dark. Replace dim bulbs with brighter ones.
  • Rugs and mats: Remove loose rugs, or tape them down with double-sided tape. Throw rugs in the bathroom and kitchen are a common cause of falls.
  • Clutter: Keep walkways clear of shoes, bags, cords, and magazines. Move furniture so there is a clear path through each room.
  • Bathroom: Install grab bars beside the toilet and in the shower or bath. Use a non-slip mat in the tub. Consider a shower chair if standing in the shower is tiring or unsteady.
  • Stairs: Make sure handrails are on both sides of the stairs and are firmly fixed. Keep the stairs clear and well lit. Mark the edge of each step with a contrasting colour if it is hard to see.
  • Footwear: Wear shoes with low heels, firm soles, and a good grip. Avoid slippers with smooth soles, backless shoes, and walking in socks on hard floors.
  • Cords and cables: Move electrical cords, phone chargers, and extension cords away from walkways, or tape them to the wall.
  • Reaching: Keep the things you use every day, like the kettle, the phone, and your medicines, within easy reach. Avoid standing on chairs or step stools to reach high shelves. If you must reach up, use a stable step stool with a handrail, never a chair.
  • Pets: Small pets underfoot are a real fall risk. Be aware of where your dog or cat is, especially at night, and consider a bell on their collar.

A safer home does not have to look like a hospital. Small changes, a grab bar, a brighter bulb, a rug removed, can make a large difference.

What to Do After a Fall

Even with the best prevention, falls can still happen. Knowing what to do in the minutes after a fall makes a real difference.

Stay calm and stay still for a moment. Do not jump up right away. Take a few slow breaths and check yourself for pain, bleeding, or numbness. If you hit your head, or if you cannot move a limb, or if the pain is severe, do not try to get up. Call for help, by phone, by a personal alarm, or by shouting, and wait for assistance.
If you are not seriously hurt, get up slowly and safely. Roll onto your side, then onto your hands and knees. Crawl to a sturdy piece of furniture, like a chair or a bed. Put both hands on the seat, bring one knee up and place that foot flat on the floor, then push up with your arms and legs to sit on the chair. Rest there for a few minutes before standing.
Tell someone. Even if you feel fine, tell your family doctor and your physiotherapist about the fall. A fall is important information, not something to be embarrassed about. It may be the first sign of a new problem, a medicine side effect, a vision change, or a balance problem that needs attention. Your physiotherapist can reassess your fall risk and adjust your exercise program.
Do not let fear take over. The most common mistake after a fall is to stop moving. People stay in bed, avoid stairs, and stop going out. But inactivity makes the legs weaker and the balance worse, which makes the next fall more likely. The right response to a fall is not less movement, it is better movement: an assessment, a plan, and a gradual return to activity with support.

Winter in Surrey: Icy Sidewalk Tips

Surrey winters are milder than most of Canada, but that makes them dangerous in a different way. Temperatures hover around freezing, so rain turns to ice overnight, sidewalks freeze and thaw, and black ice appears on paths that looked clear. Here is how to stay steady through a Surrey winter.

Choose your footwear. Wear winter boots with a deep tread and a rubber sole. Ice grippers, the slip-on rubber attachments with metal studs, cost very little and make a large difference on icy sidewalks. Avoid smooth-soled shoes, high heels, and leather soles in winter.
Walk like a penguin. On icy ground, take short, flat steps, keep your knees slightly bent, point your toes out a little, and keep your arms out to the sides for balance. It looks silly and it works. Slow down and allow extra time, so you are never rushing on ice.
Use supports. Hold handrails on stairs and ramps. Use a cane or walking stick in winter, even if you do not need one in summer. The extra point of contact gives you balance and a way to test the ground ahead of you.
Salt and sand your own paths. Keep a bag of salt or sand by the door and spread it on your steps, driveway, and the sidewalk in front of your home. Clear snow promptly, before it freezes into ice.
Stay active indoors. Winter is when seniors move the least, and that is when strength and balance decline the fastest. Keep doing your balance exercises at home, walk indoors at a mall or community centre on bad-weather days, and consider a supervised exercise class. Staying active through the winter is one of the best things you can do for falls prevention.
Ask for help. If the sidewalk is icy and you have to go out, ask a family member or neighbour to walk with you. There is no shame in it, and it is far better than a fall.

When to See a Physiotherapist

Book a fall-risk assessment if any of these sound familiar:

  • You have fallen in the past year, even once, or you have had a near-fall
  • You feel unsteady when you walk, turn, or stand up
  • You avoid stairs, uneven ground, or going out alone because you are afraid of falling
  • You have dizziness, spinning, or a feeling of being off balance
  • You have weakness in your legs, or difficulty getting up from a chair
  • You have a condition like arthritis, diabetes, Parkinson's disease, or a previous stroke
  • You take four or more medicines, or you started a new medicine and feel dizzy
  • Your family has noticed that you walk more slowly, shuffle, or hold onto furniture

You do not need a doctor's referral to see a physiotherapist in BC. You can book directly. And the best time to come is before a fall, not after one. Prevention is faster, easier, and far less painful than recovery from a broken hip.

If you have back pain that makes walking or standing difficult, it is worth reading our guide to lower back pain treatment in Surrey, because back pain and falls often go together, and treating one helps the other.

Frequently Asked Questions

I have never fallen. Do I still need to worry about falls prevention?

Yes, and this is the best time to start. Falls prevention works best before the first fall, not after it. Balance and strength decline gradually, often without you noticing, until one day a small trip becomes a fall. A fall-risk assessment at 65 or 70, when you are still steady, gives you a baseline and a simple exercise program that keeps you steady for years. It is much easier to maintain balance than to rebuild it after a fall.

Can physiotherapy really prevent falls?

Yes. Research shows that physiotherapy, especially balance and strength training, reduces falls by about 25 to 30 percent in older adults. The exercises work because they target the exact reasons people fall: weak legs, poor balance, and slow reactions. Combined with home safety changes and the right footwear, physiotherapy is the most effective falls prevention there is.

How long does it take to improve my balance?

Most people notice a difference in 4 to 6 weeks of regular exercise, and the improvement continues for months. Balance is a skill, and like any skill, it improves with practice. The key is consistency: three to four short sessions a week, every week, not one big effort now and then. Your physiotherapist will re-test your balance after 6 to 8 weeks so you can see the progress.

I use a cane. Does that mean I have failed at falls prevention?

Not at all. A cane or walker is a tool, not a defeat. Used correctly, a walking aid reduces your fall risk and lets you walk further and with more confidence. The important thing is that it is the right aid, at the right height, and that you know how to use it. Your physiotherapist can check all of that in one visit. Many people who use a cane still do balance exercises, and their balance improves over time.

My mother fell and broke her hip. What can I do to help her?

First, make sure she has a fall-risk assessment with a physiotherapist once she is medically cleared. Hip fracture recovery is slow, and the fear of falling again is often the biggest barrier. A physiotherapist can rebuild her leg strength and balance gradually, and advise on home safety, footwear, and walking aids. Second, help her stay active and social. Isolation after a fall is common and makes recovery harder. Walking with her, doing exercises together, and keeping her connected to family and friends all help.

Stay Steady, Stay Independent

Falls are not an unavoidable part of getting older. They happen for reasons, and most of those reasons can be changed. Stronger legs, better balance, clearer vision, a safer home, and the right footwear add up to a large reduction in risk. And the earlier you start, the better the result.

If you live in Surrey and you want to stay steady on your feet, keep doing the things you enjoy, and avoid the fall that changes everything, book a fall-risk assessment at Renew Physiotherapy. We will measure your balance, strength, and walking, explain the results in plain language, and build a plan that fits your body and your life.

We are located at 5722 176a Street, Surrey, BC V3S 4H2. Call us at (236) 450-0171 or email Info@renewclinics.ca to book an appointment.

You can also read our guides on vertigo treatment in Surrey and arthritis treatment in Surrey if dizziness or joint pain is part of your picture.

Staying steady is not about luck. It is about strength, balance, and a plan. Let us help you build yours.