Dr. Chan

When a Fall Changes Everything: What You Need to Know About Hip Fractures

With the changes in weather recently and more snow and ice around the corner, it is the time of year when the risk of falling goes up. Nobody plans to fall. But for Canadians over sixty, a simple stumble can mark a dramatic turning point in life. Hip fractures send 30,000 Canadians to hospitals each year, and the road back is rarely easy. Understanding what lies ahead—and taking steps to prevent it—can make all the difference between independence and dependence.

The statistics tell a sobering story. One in four Canadians who break a hip after age fifty never regain their previous level of function. Many never return home. But here’s the thing: knowledge is power, and preparation is protection.

The Reality of Recovery

A hip fracture isn’t like breaking your wrist or spraining an ankle. This is major trauma to one of your body’s weight-bearing joints, and healing demands time, patience, and determination.

Most hip fractures require surgery. Surgeons either repair the break with a screw through the core of the femur or replace the joint with a full or partial replacement. The typical recovery timeline stretches three to six months, though some people need up to a year to reach their maximum improvement. Here are the stages to recovery:

Day 1

Physical therapy starts immediately—usually the day after surgery. Yes, it hurts. Yes, it’s exhausting. But early movement is critical to prevent blood clots, pneumonia, and the muscle wasting that can trap you in a bed. During the first week, the goal is to get you up and walking with a walker or crutches, able to toilet yourself and get up and down the stairs. Pain control, muscle cramps, bleeding, confusion, blood clots and pneumonia are the things to look out for. The research shows going home sooner translates into the fewer the complications. 

Weeks 1-6

The next six weeks, you’ll be fully weight bearing but use a walker or crutches. Simple tasks like showering, getting dressed, and climbing stairs are concerted efforts. Some will require home care to help with some of these basic tasks. Others will require weeks in a rehabilitation facility before going home.  There will be a follow up appointment in the cast clinic to check on the incision and the progress of the fracture usually 2-3 weeks after surgery. Look out for signs of infection such as: worsening pain, the wound opening up or the surgical site draining fluid. 

Weeks 8+

After six to eight weeks, your surgeon generally clears all restrictions. However there will be continued work required to regain the previous strength and balance, which can take up to a year. 

Tips for Recovery

A Pain in Butt

Understanding pain is normal. The goal for post-operative pain control is a moderate level of pain. Accepting that a moderate pain is normal and working with physiotherapy to mobilise a soon as possible is important to recovery. However using pain medication is not a failure and using pain medications 25 minutes before exercise will allow you to get more out of each exercise session if pain is an issue. Also understand that there are different types of pain associated with hip surgery. There is local traumatic pain from the break and surgery but there may also be other associated pain syndromes that do not respond as well to typical analgesics such as muscle cramps and neuropathic pain. If your pain is not responding to your prescribed pain medications, talk to your doctor or surgeon.

Protein

Your body requires a lot of protein in the recovery process. The Canadian guidelines suggest 1g -1.2g of protein for every kg of body mass. However newer research suggests that after surgery, seniors should be consuming 1.2g-1.5g of protein for every kg of body mass. As a reminder, a serving of chicken breast has 30g of protein. While it might be challenging to get a senior to eat that much meat in a day, other considerations are the BoostⓇ and EnsureⓇ meal supplements of the protein max varieties also carry 30g per serving. Also pulses such as beans and lentils carry a lot of protein as well.

 Prevention: Your Best Defence

Protect Your Bones

Osteoporosis makes bones fragile and prone to fracture.  There is a large care gap with only 21% of people over aged 65 receiving osteoporosis medication. Your family doctor will assess your risk factors and get a bone density test to stratify your risk of osteoporosis. Adequate calcium and vitamin D, along with medications when needed, strengthen bones significantly. If you have had a fracture in your hips or spine, you are considered high risk of getting further fractures.

Strengthen Your Body

I have harped on this many times, but resistance training reverses declines in muscle size and strength with age. This also improves the recovery from a hip fracture. Additionally, resistance exercise stimulates bone strength with the stressors on bones. Weight-bearing activities like walking, gentle strength training, and tai chi reduce fall risk by up to forty percent. Talk to your doctor about a program that fits your current fitness level.

Make Your Home Safer

Most falls happen at home. Remove throw rugs and clutter from walkways. Install grab bars in bathrooms and handrails on both sides of stairways. Improve lighting, especially in hallways and bathrooms. Keep frequently used items within easy reach. Ensure your walkways to the house are cleared regularly. These simple modifications prevent countless injuries.

Review Your Medications

Some medications cause dizziness, confusion, or balance problems. Blood pressure drugs, sedatives, and even some over-the-counter sleep aids increase fall risk. Ask your doctor or pharmacist to review everything you take, including supplements.

Check Your Vision

Poor vision contributes to many falls. Get annual eye exams and update prescriptions promptly. Cataracts, glaucoma, and macular degeneration all impair depth perception and balance.

The Cost Beyond Dollars

Hip fractures exact a heavy toll. Within one year of the injury, twenty to thirty percent of Canadian patients die from complications like pneumonia, blood clots, or infections. Another twenty to twenty-five percent placement in a facility or higher level of care. Even those who recover often face permanent limitations in walking, climbing stairs, and living independently.

The hidden challenge isn’t just physical. Depression affects nearly half of hip fracture patients. The loss of independence, the pain, the slow progress—it weighs on the spirit. Family support and frank conversations with your doctor about these feelings are essential.

Beyond Neighbours has helped many people speed up their return home after a hip fracture. Contact us to find out more.