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Falls risk after surgery
Falls are one of the most common complications in the weeks after surgery. Reduced strength, medication side effects, and unfamiliar mobility aids all raise your risk. Use this tool to understand your risk level and what prevention steps apply to you.
Why does surgery increase falls risk?
Surgery raises falls risk through several compounding factors: general anaesthetic and strong pain medication can leave you unsteady, muscle strength drops quickly with reduced activity, and many people are using a new mobility aid (crutches, a walker, a frame) for the first time while still adjusting to it. Source: NICE CG161: Falls in older people (last checked Oct 2026)
A fall soon after surgery can be serious — it can damage a surgical repair, cause a new fracture, or lead to a long hospital readmission. Falls are consistently reported as a leading cause of injury-related hospitalisation in people recovering from surgery, particularly after lower-limb orthopaedic procedures. Source: CDC STEADI initiative (last checked Oct 2026)
The good news: falls risk after surgery is largely modifiable. Supervised mobilisation, the right walking aid, and a few home safety checks meaningfully reduce the chance of a fall during recovery.
Risk factors that affect your falls risk after surgery
Falls risk after surgery is not the same for everyone. Published guidance identifies specific factors that, when present, significantly increase the chance of a fall during recovery.
- Type of surgery, major lower-limb orthopaedic procedures such as hip replacement, knee replacement, or hip fracture repair carry the highest falls risk due to altered weight-bearing and balance.
- Reduced mobility: needing a cane, walker, frame, or being non-weight-bearing significantly raises fall risk, especially in the first days of using a new aid.
- Medications, sedatives, sleeping tablets, strong pain relief (opioids), and some blood pressure medications can cause dizziness, drowsiness, or a sudden drop in blood pressure on standing.
- Previous falls: a fall in the past 12 months is one of the strongest predictors of a future fall.
- Age — falls risk rises with age, particularly over 65.
- Vision problems, uncorrected vision makes it harder to judge steps, thresholds, and obstacles.
- Home hazards, loose rugs, poor lighting, clutter, and stairs without rails are common, fixable contributors to falls during recovery.
- Fear of falling, ironically, being overly cautious or fearful can alter gait and balance in ways that increase risk.
How falls are prevented after surgery
Falls prevention after surgery is a core part of post-operative care, especially after lower-limb procedures. NICE CG161 and the CDC STEADI framework set out the recommended approach.
- Supervised early mobilisation — getting up and walking with supervision from a physiotherapist or nurse before you are left to move independently.
- Correct use of mobility aids: a crutch, walker, or frame fitted and adjusted to your height, used consistently rather than only "when needed."
- Medication review, your care team checking whether any of your medications (sedatives, opioids, blood pressure tablets) are increasing your falls risk and adjusting where possible.
- Home hazard modification, removing loose rugs, improving lighting, clearing walkways, and installing grab rails where needed before you return home.
- Vision check, an up-to-date glasses prescription if vision is a contributing factor.
- Strength and balance exercises, as prescribed by your physiotherapist, to rebuild stability during recovery.
Symptoms to watch for: when a fall needs urgent attention
- A fall with no obvious injury, but new pain or stiffness afterwards
- Increasing fear or anxiety about moving around
- A near-fall or stumble that shook your confidence
- Bruising that is spreading or getting worse
- Fall with head injury or any loss of consciousness
- Unable to stand or bear weight afterwards
- Severe pain, swelling, or visible deformity (possible fracture)
- Confusion or drowsiness after a fall
Any fall after surgery is worth mentioning to your surgical or care team, even without obvious injury — it may prompt a formal falls risk assessment and a change to your recovery plan. Do not wait to see if symptoms settle on their own after a significant fall.
Understanding Falls Risk After Surgery
A fall in the weeks after surgery is one of the most common, and most preventable, recovery complications. Reduced strength, the after-effects of anaesthesia and pain medication, and unfamiliarity with a new mobility aid all combine to raise your risk during this period. Most falls during recovery are minor, but a fall can damage a surgical repair, cause a new fracture, or lead to hospital readmission. Understanding your risk level helps you and your care team put the right precautions in place.
Why Surgery Increases Falls Risk
Several factors combine to raise falls risk after surgery. General anaesthetic can leave you unsteady for days afterwards. Strong pain medication, particularly opioids, can cause drowsiness, dizziness, or a drop in blood pressure on standing. Muscle strength declines quickly with reduced activity, and balance and coordination are often affected by the surgical site itself, especially after lower-limb procedures. Many people are also using a new mobility aid (crutches, a walker, or a frame) for the first time while still adjusting to it.
Procedure Type and Risk Level
Risk varies considerably depending on what type of surgery you have. Based on guidance from NICE (CG161, 2013, updated 2019) and the CDC STEADI initiative, major lower-limb orthopaedic surgery — particularly total hip replacement, total knee replacement, and hip fracture repair — carries the highest falls risk, due to altered weight-bearing and balance during recovery (last checked Oct 2026). Spinal surgery also carries meaningful risk due to restricted movement and nerve-related balance effects. Major abdominal, cardiac, and general surgery carry moderate risk, largely from general weakness and medication effects. Minor surgery and day procedures carry lower risk, but are not zero-risk, especially in older adults.
Individual Risk Factors
Your personal risk profile matters as much as the type of surgery. Factors that increase individual falls risk include: a previous fall in the past 12 months, use of sedatives, sleeping tablets, or strong pain medication, blood pressure medication that can cause dizziness on standing, uncorrected vision problems, age over 65, cognitive changes or confusion, home hazards such as loose rugs, poor lighting, or clutter, and fear of falling itself, which can paradoxically alter gait and balance in ways that increase risk.
Falls Prevention: What Your Care Team May Use
Falls prevention is tailored to overall risk. Measures include supervised early mobilisation: getting up and walking with a physiotherapist or nurse present before you move independently, which is one of the most effective strategies. Correct fitting and use of a mobility aid (crutches, a walker, or a frame) adjusted to your height is essential, used consistently rather than only when you feel unsteady. A medication review checks whether sedatives, opioids, or blood pressure tablets are contributing to your risk. Home hazard modification before you return home, removing rugs, improving lighting, and clearing walkways, addresses one of the most common preventable causes. Strength and balance exercises prescribed by a physiotherapist help rebuild stability over the following weeks.
Warning Signs: When to Act Urgently
Any fall after surgery is worth mentioning to your surgical or care team, even without obvious injury, as it may prompt a formal falls risk assessment. Seek urgent medical attention for a fall involving head injury or any loss of consciousness, being unable to stand or bear weight afterwards, severe pain, swelling, or visible deformity suggesting a possible fracture, confusion or drowsiness following the fall, or a fall followed by chest pain or breathlessness. Any of these symptoms after a fall warrant urgent medical assessment — call 000 in Australia or 999 in the UK, or attend the nearest emergency department.
About This Tool
This falls risk checker is compiled from NICE CG161 (Falls in older people: assessing risk and prevention, 2013, updated 2019), the CDC STEADI (Stopping Elderly Accidents, Deaths & Injuries) initiative, and healthdirect falls-prevention guidance. It is designed to help you understand your risk level and have an informed conversation with your surgical or care team — not to replace their clinical assessment. Your care team may conduct their own formal falls risk assessment, particularly after lower-limb orthopaedic surgery.
Sources: NICE CG161 (2013, updated 2019) · CDC STEADI initiative · healthdirect, Falls prevention