When elderly family members walk dogs: Hold the leash in the palm rather than wrapping it around hands or wrists, keep the lead short, and train the dog not to surge forward

In the United States, annual fractures among adults aged 65 and older associated with walking leashed dogs surged from roughly 1,700 to 4,400 cases, with women accounting for nearly 80%. The hip was the single most common fracture site, and nearly 30% of patients required hospitalization. Among patients sustaining hand injuries from dog leashes, approximately three-quarters occurred when a sudden jerk tightened a leash wrapped around the hand or fingers. Keep the leash gripped in the palm, maintain a short lead, and train dogs not to pull aggressively.

Gripping the leash properly and shortening lead length costs nothing—simply walk with your elder once to demonstrate proper technique. Training a dog not to surge takes time, either trained personally or through a professional trainer (incurring variable local fees). The main difficulty is changing ingrained habits if seniors are accustomed to retractable leashes or tightly wrapping webbing around their wrists.

US national emergency department surveillance data estimate that annual fractures among individuals aged 65 and older walking leashed dogs rose from 1,671 in 2004 to 4,396 in 2017—a statistically significant increase. Among fracture victims, 78.6% were women and 28.7% required inpatient hospital admission. By anatomical site, hip fractures were the most frequent single injury (17.3%), while upper extremity fractures comprised 52.1% across broad categories. Another nationwide emergency database covering 2001–2018 estimated 356,746 dog-leash-related injuries: 193,483 involved being pulled down or strained by a dog, and 136,767 involved tripping or entanglement. Population injury rates climbed from 25.4 to 105.5 per million individuals. In a 5-year study at an outpatient hand surgery clinic reviewing 443 leash-related hand injuries, 75.9% (337 patients) occurred when a leash wrapped around the hand or fingers was abruptly yanked by the dog, and 21.6% (96 patients) required surgical intervention. CDC surveillance (2001–2006) showed approximately 86,629 fall-related injuries annually involving pet cats and dogs, with 88.0% attributable to dogs; 26% occurred while walking dogs, and 21.2% were caused by dogs pushing or pulling their handlers.

Gripping the leash firmly in the palm without wrapping it around fingers or wrists is explicitly recommended by hand surgeons: it protects fingers and wrists against spiral fractures and degloving injuries, though it does not completely prevent falls caused by aggressive surges. Keeping the lead short prevents the dog from building kinetic momentum and reduces trip hazards. Extended retractable leashes function as hazardous long lines; however, no controlled trials have isolated fall incidence between retractable versus standard fixed leashes (noted in a 2024 JAVMA review). Behavioral loose-leash training is recommended by both the CDC and orthopedic trauma researchers. For seniors considering adopting a new pet, researchers recommend smaller, lower-mass breeds. Benefit magnitude is rated small as exact reduction percentages for these combined interventions have not been evaluated in randomized trials. For bone fracture resilience, see Chapter 1, Rule 39 (bone mineral density screening) and Rule 40 (osteoporosis medication). For elder balance training, see Chapter 1, Rule 13. For counting dog walking toward daily physical activity goals, see Chapter 2, Rule 44. Beneficiaries are elderly parents and grandparents.

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