Preventing Falls After Orthopaedic Surgery: How To Recover Safely
Accidentally falling down is one of the most serious risks after orthopaedic surgery - yet it’s often overlooked. Whether you’ve had a joint replacement, fracture fixation, tendon repair or any procedure affecting the feet and legs, your body is in a temporarily vulnerable state. A fall during this time has the potential to significantly delay healing, damage surgical repairs, and lead to additional complications such as fractures, dislocations, or infections from wound trauma.
Research that reviewed 1.28 million joint arthroplasty (hip and knee replacements) patients reported that approximately 13% experienced a fall within the first year post-surgery, with 1% of these occurring while they were still in hospital. 1Another 2025 specialist review focusing on hip arthroplasty reported that roughly 30–40% of patients experience at least one fall within the first year after surgery, with a higher risk in older adults and those recovering from hip fracture repairs.2
Even younger patients may be at risk, particularly if they return to activity too soon, underestimate mobility challenges, or have underlying balance or strength deficits. The consequences can be both physical and psychological: one fall can increase fear, reduce confidence, and hinder progress in rehabilitation.
Hence, fall prevention is a crucial part of any recovery plan - and a large focus of what we do here at Merivale Podiatry when working with post-surgical patients. It goes far beyond just “being careful.” It’s about understanding your body’s current limitations, adapting your environment, and working with both your podiatry team and wider healthcare team to support your recovery in a way that keeps you safe, confident, and steadily progressing.
Why You’re at Greater Risk of Falling Post-Surgery
Several factors come together after surgery that increase your fall risk, even if you’re typically steady on your feet:
- Reduced muscle strength and joint control: Orthopaedic surgery often involves periods of rest, immobilisation, or reduced activity, all of which lead to temporary muscle atrophy. This weakness can impact your ability to balance, walk confidently, or recover your balance if you stumble.
- Pain and stiffness: Pain changes how we move. Post-surgical discomfort can cause you to walk with an uneven gait or offload from the operated limb, both of which can throw off your balance.
- Changes in gait or mobility aids: Crutches, walkers, moon boots, or braces are commonly used post-operatively and we help our patients with many of these. While helpful, they can make movement more cumbersome, increase the effort required to stay upright, and introduce new movement patterns that you’re still learning to coordinate.
- Medication side effects: Common post-surgical medications, such as pain relief, muscle relaxants, or anti-inflammatories, can cause dizziness, drowsiness, or delayed reaction times, all of which make a fall more likely.
- Impaired proprioception and balance: After surgery, the communication between your joints and brain (known as proprioception) can be disrupted, especially when swelling, inflammation, or immobilisation is present. This impairs your ability to judge body position and respond quickly to instability.
- Overconfidence or fear of movement: We’ve seen some patients be so eager to return to independence that they overestimate their physical readiness. Others become fearful and stiffen up during walking, which paradoxically increases fall risk.
At our clinic, we help you recognise which of these risk factors may be present for you, and create a tailored strategy to manage them effectively. This often includes a combination of physical support (like orthotics), practical advice, and education around safe movement and activity pacing.
The Role of Podiatrists in Fall Prevention
Podiatrists play a crucial role in an effective falls prevention strategy following orthopaedic surgery. While much of the focus tends to rest on the operated joint itself, foot mechanics and gait patterns play a central role in how we maintain balance and move through our days.
One of the first things we’ll assess once you’re up to being mobile on your feet after your op is how your walking has changed. We’ll:
- Perform a detailed gait and balance assessment to identify instability or compensation patterns
- Evaluate foot posture and loading patterns, especially if you’re offloading from your surgical side
- Assess whether custom foot orthotics or supportive bracing could help to improve your alignment and proprioception
- Review your footwear to ensure it’s safe, supportive, and matches your recovery stage
- Work closely with your surgical or rehab team to ensure our care complements your overall plan
We also monitor your progress over time, making adjustments to your support or strategy as you regain strength and mobility. Our aim is always to help you recover with as few setbacks and risks as possible.
Footwear: The Unsung Hero of Fall Prevention?
Footwear often makes the difference between a confident step and a risky misstep, especially when your body is healing. When we work with post-surgical patients, footwear is one of the first things we assess.
Shoes that are too worn out, too unsupportive, or simply poorly fitted can undo a lot of the progress you're making in rehab. We often see patients transition from a moon boot or post-op shoe into regular footwear - and this transition is a key time when falls can happen.
We recommend shoes that have:
- A secure fastening (e.g. velcro or laces) to stop slipping
- A stable heel counter to support the rearfoot
- Non-slip soles to help with grip and balance
- Supportive structure to reduce the work your foot needs to do at each step
- The right fit for your orthotics, if prescribed
If you're unsure whether your current footwear is helping or hindering your recovery, our podiatrists can assess it during your appointment and help you choose something more suitable if needed.
Custom Foot Orthotics to Improve Stability
We prescribe custom foot orthotics for many post-surgical patients to help improve gait, reduce compensations, and enhance overall stability. Having lower limb surgery means your balance and walking pattern can be impacted for months, even after the wound has healed.
Our orthotics are fully customised based on your biomechanics, recovery goals, and the stage you’re at in your post-operative plan. For fall prevention, we may include features like:
- Deep heel cups and posting for better rearfoot control
- Supportive arch features to reduce joint strain and muscle fatigue
- Proprioceptive enhancements to help you ‘feel’ your feet more clearly during movement
- Cushioned or shock-absorbing materials to reduce impact
We also make sure your orthotics are matched to your footwear and to your recovery stage. We also have the ability to fine-tune your device throughout your recovery so you’re always optimally supported.
Home Environment Adjustments
We regularly discuss home safety with our post-surgical patients, as many falls occur not while out walking but during everyday tasks at home. During your appointments, we can help you identify common hazards and offer advice that fits your lifestyle. Suggestions often include:
- Non-slip mats in the bathroom and kitchen
- Improved lighting, especially for night-time bathroom trips
- Removing trip hazards like cords or low-lying furniture
- Grab rails and shower stools for bathroom safety
- Keeping essentials within reach to avoid unnecessary bending or climbing
We may also recommend speaking to an occupational therapist for more detailed environmental modifications if needed. The goal is to make your home work for you while you’re recovering, not against you.
Working With Your Healthcare Team
We believe the best outcomes happen when everyone is on the same page. That’s why we work closely with your orthopaedic surgeon, physiotherapist, and other healthcare professionals to make sure your fall prevention plan is integrated into your overall recovery.
Our podiatrists often receive referrals directly from surgeons or rehab specialists, and we’re experienced in managing the podiatric needs that arise before and after surgery. Whether it’s adjusting your orthotics, assessing your gait, or advising on safe footwear transitions, we make sure our care complements the rest of your recovery pathway.
If something isn’t going to plan, such as unexpected pain, instability, or concern about falling, we’ll help coordinate next steps or referrals to ensure it’s addressed quickly and thoroughly.
You can call us on 03 355 9481 or book your appointment online here.