Help older dog walkers hold the leash without wrapping it around their hand and train the dog not to lunge

Cost: Holding and shortening a leash costs nothing; accompany the older person and show them. Training takes time, whether done personally or with a paid trainer whose fees vary locally. Changing a habit of using a long retractable leash or wrapping it around the wrist can be difficult.

In plain language: US emergency-department estimates for fractures while walking leashed dogs among people aged 65 and older rose from around 1,700 annually to 4,400; around four fifths were women, and nearly three tenths were hospitalized. Hip fractures were the most common single-site category. In a hand-clinic series, about three quarters of leash injuries involved a wrapped or entangled hand or finger when the dog pulled. The source recommends holding the leash in the palm without wrapping it, keeping it shorter and training against lunging.

Findings reported by the source: National estimates for dog-walking fractures in Americans aged 65 and older were 1,671 in 2004 and 4,396 in 2017, a statistically significant increase. Women accounted for 78.6%, and 28.7% required admission. Hip fractures accounted for 17.3% as an individual site; upper-extremity fractures together accounted for 52.1%. Another national emergency dataset for 2001–2018 estimated 356,746 leash-related injuries: 193,483 involving being pulled and 136,767 involving tripping or entanglement. Estimated injuries per million increased from 25.4 to 105.5. A five-year hand-clinic series included 443 patients, of whom 337 (75.9%) had hand or finger entanglement injuries and 96 (21.6%) needed surgery. CDC data for 2001–2006 estimated 86,629 annual nonfatal fall injuries involving dogs or cats, 88.0% involving dogs. Among dog-related falls, 26% occurred while walking the dog and 21.2% involved being pushed or pulled by it.

Source author's evidence grade: B; not site verification or professional approval.

Notes: The hand-clinic authors' advice to avoid wrapping protects fingers and wrists; they explicitly note that it does not prevent a lunging dog from pulling the person over. They recommend a shorter leash to limit the dog's acceleration and reduce entanglement. A fully extended retractable leash is also a long leash. However, the source says no study directly compared fall risk for retractable versus ordinary leashes; a 2024 review noted missing data about leash type at injury. Training against pulling was suggested by CDC and the fracture-study authors, who also suggested smaller dogs for older people considering ownership. No study quantified how many falls these measures prevent, so the source's small-benefit label is judgment-based. See chapter 1, entries 39 and 40 for bone-density assessment and osteoporosis treatment; chapter 1, entry 13 for balance exercises; and chapter 2, entry 44 for dog walking as physical activity. The source particularly considers parents and grandparents as beneficiaries.

Original source bibliography (titles retained as supplied): 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