When an older person walks a dog, hold the leash in the palm and never wrap it around the hand, keep the leash short, and train the dog first not to lunge forward on the leash
In the United States, fractures among people aged 65 and over while walking a dog were about 1700 in 2004 and about 4400 in 2017. About 80% were women, nearly 30% needed a hospital stay, and by single body site hip fractures were the most common. At a hand-surgery clinic, about three-quarters of patients whose hands were injured by a dog leash were hurt because the leash was wrapped on the hand and the dog pulled. So hold the leash in the palm, keep it short, and train the dog not to lunge forward.
Holding the leash in the palm and shortening it costs noth…
U.S. emergency surveillance data, scaled up to the whole country, counted fractures in people aged 65 and over…
Holding the leash in the palm and shortening it costs nothing; walk with the older person once and show them. Training the dog not to lunge takes time. You can teach it yourself or hire a dog trainer, which costs money, and prices vary widely by region. The hard part is that older people are used to retractable leashes and to wrapping the leash around the wrist, so they have to change the habit.
U.S. emergency surveillance data, scaled up to the whole country, counted fractures in people aged 65 and over who fell while walking a dog on a leash. There were about 1671 in 2004 and about 4396 in 2017, and the rise was statistically significant. Among the people with fractures, 78.6% were women, and 28.7% were hospitalized. By single body site, the hip was the most common, at 17.3%. By broad region, the upper limb was the most common, at 52.1%. Another national emergency dataset covers 2001 to 2018. Injuries related to a dog leash were estimated at about 360000 visits (exact figure 356746). Of those, 193483 visits were injuries from being pulled by a dog, and 136767 visits were trips or entanglement in the leash. Injuries per million people rose from 25.4 to 105.5. A hand-surgery clinic saw 443 patients with hand injuries from a dog leash over 5 years. About three-quarters were injuries to the hand or fingers from the leash wrapping and the dog pulling (the abstract says 337 people, 75.9%). About a fifth needed surgery (96 people, 21.6%). The U.S. Centers for Disease Control and Prevention counted about 86629 fall-injury visits a year from 2001 to 2006 that were related to cats and dogs. Of those, 88.0% were related to dogs. Among the dog-related falls, 26% happened while walking the dog, and 21.2% were the dog pushing or pulling the person down.
Pirruccio K, Yoon YM, Ahn J (2019). Fractures in Elderly Americans Associated With Walking Leashed Dogs. JAMA Surgery, 154(5), 458-459. https://doi.org/10.1001/jamasurg.2019.0061；Forrester MB (2020). Dog leash-related injuries treated at emergency departments. American Journal of Emergency Medicine, 38(9), 1782-1786. https://doi.org/10.1016/j.ajem.2020.05.082；Plusch K, Givner D, Wiafe B, Lutsky K, Beredjiklian P (2026). Hand and Wrist Dog-Leash Injuries in the Outpatient Setting: A Review of 443 Cases. Hand, 21(4), 582-586. https://doi.org/10.1177/15589447241299128；CDC (2009). Nonfatal fall-related injuries associated with dogs and cats — United States, 2001-2006. MMWR, 58(11), 277-281. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5811a1.htm；Rosa R, Buckley RE (2024). Leash-related injuries associated with dog walking: an understudied risk for dog owners? Journal of the American Veterinary Medical Association, 262(7), 973-978. https://doi.org/10.2460/javma.23.11.0608
Open source linkHolding the leash in the palm instead of wrapping it around the hand is advice from the doctors at that hand-surgery clinic. They state that this protects the fingers and wrist but does not stop a lunging dog from pulling a person down. They also recommend a shorter leash: with a short leash the dog cannot build up speed, so the pull is lighter, while a long leash can also snag on things and trip the walker. A retractable leash extended to full length is a long leash. But no study has compared whether retractable or ordinary leashes cause more falls, and a 2024 review states there are no data on which type of leash was in use when injuries happened. Training the dog not to lunge on the leash was mentioned by the US CDC and by the authors of the fracture paper. That paper also suggests that older people who are thinking about getting a dog pick a smaller one. No study has calculated how many falls these measures prevent, so the benefit size is set as small by judgment. Whether bones can survive a fall: Section 1, item 39 (bone density screening) and item 40 (treat osteoporosis if found). Practicing balance in daily life: Section 1, item 13 (balance and leg strength). Whether dog walking counts as exercise: Section 2, item 44 (count dog walking toward walking volume). Main beneficiaries: your parents and grandparents.