When an elder walks the dog, hold the leash in the palm, do not wrap it around the hand, keep the leash short, and train the dog 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.

Cost

Holding the leash and keeping it short costs nothing. Walk with the elder and show them once. Training the dog not to lunge takes time. You can teach the dog yourself or hire a trainer. Hiring someone costs money, and prices differ a lot by place. The hard part is that the elder is used to a retractable leash and used to wrapping the leash around the wrist, and has to change that.

Benefit

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.

Notes

Holding the leash in the palm and not wrapping it on the hand is advice from the doctors at that hand-surgery clinic. They state that this protects the fingers and the wrist. It does not stop a person being pulled down when the dog lunges. They also suggest keeping the leash short: on a short leash the dog cannot build speed, so the pull is lighter; on a long leash the line also catches on things and trips people. A retractable leash let all the way out is a long leash. No study has compared retractable leashes with ordinary leashes for which one leads to more falls. A 2024 review states that there are no data on what kind of leash was in use at the time of injury. Training the dog not to lunge forward on the leash is mentioned both by the U.S. Centers for Disease Control and Prevention and by the authors of the fracture paper. That fracture paper also suggests that an elder who is thinking of getting a dog pick a smaller dog. No study has calculated how many fewer falls these steps produce, so the benefit magnitude is judged small. Whether the bones can take a fall: section 1, item 39 (a bone-density test) and section 1, item 40 (if osteoporosis is found, treat it). Balance practice: section 1, item 13 (balance and leg strength). Whether walking the dog counts as exercise: section 2, item 44 (count dog walking toward the walking total). The people who benefit are mainly your parents and grandparents.

Sources · 5

1. Pirruccio K, Yoon YM, Ahn J (2019). Fractures in Elderly Americans Associated With Walking Leashed Dogs. JAMA Surgery, 154(5), 458-459. doi.org/10.1001/jamasurg.2019.0061
2. Forrester MB (2020). Dog leash-related injuries treated at emergency departments. American Journal of Emergency Medicine, 38(9), 1782-1786. doi.org/10.1016/j.ajem.2020.05.082
3. 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. doi.org/10.1177/15589447241299128
4. CDC (2009). Nonfatal fall-related injuries associated with dogs and cats — United States, 2001-2006. MMWR, 58(11), 277-281. cdc.gov/mmwr/preview/mmwrhtml/mm5811a1.htm
5. 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. doi.org/10.2460/javma.23.11.0608