Ladder Falls Are on the Rise - Doctors and Experts Share Safety Tips

Whether pruning trees before a storm, decking the house for the holidays, tackling spring cleaning chores, or just changing a light bulb, most people rely on ladders to get the job done. But extreme caution is the watchword, say our doctors, who see it all in the emergency room and in the clinic. 

"I've seen falls from even short ladders and step ladders cause devastating and life-changing injuries in patients. Always think safety first," says orthopedic and sports medicine surgeon Dr. Scott Brotherton.

"I have noticed a growing number of fractures of the calcaneus, or heel bone, resulting from ladder falls," adds foot and ankle surgeon Brandon Taylor, M.D. "Many of these falls are preventable."

The feet are often the first body part to absorb the impact of a ladder fall, but other orthopedic injuries from this type of tumble include fractures of the leg, elbow, pelvis, spine, arms, ribs, and wrists. 

The American Academy of Orthopedic Surgeons reports that emergency departments treated 580,000 people for ladder-related injuries in 2018 alone. In addition, according to the Centers for Disease Control and Prevention, about 300 ladder falls end in death. While some of these falls are related to construction and handyman work, 97 percent occur at homes and farms. 

Older American Report More Ladder Falls

During the pandemic, people spent more time tackling home improvement projects but not necessarily hitting the gym. Older people, especially, reported they were out of shape – which increases the risk of falling and leads to a greater fear of taking a tumble - a vicious cycle that keeps some people sedentary.

A University of Michigan poll taken during the height of the pandemic found that one-quarter of older adult respondents experienced a fall between March 2020 and January 2021. Forty percent of them fell more than once during this period. This poll accounted for all falls, however, and not just on ladders.

While lack of fitness for climbing can be one reason to ladder falls, experts agree that there are more compelling factors:

• A lack of proper equipment
• Using the ladder in an unsafe place
• Failing to wear protective gear
• Slacking on precautions

Ladder Safety Tips

The doctors at Orthopedic Specialists offer safety tips based on personal and professional experience.

"I highly recommend you have a spotter in some situations," says Dr. Brotherton. "For me, if I use a ladder alone, I always carry my cell phone in my pocket. That way if I fall, I can call someone for help or ask Siri to call 911." A smartwatch can serve the same function. 

 Adds orthopedic spine surgeon Dr. Andrew Maser: "You probably should not use a ladder if you have balance issues or shoulder and neck problems."

The National Institute for Occupational Safety and Health (NIOSH) and the Ladder Safety Institute offer other tips to keep you safer as you climb the rungs:

• Use a ladder that's right-sized for the job, and inspect it for damage and slippery rungs
• Position the ladder securely
• Wear slip-resistant shoes
• Maintain a 3-point contact (two hands and a foot, or two feet and a hand) when climbing and descending 
• Keep your body within the side rails
• Never stand on the top two rungs
• If necessary, attach safety equipment such as a harness or rope 
• Don't try to move an unstable ladder
• Don't climb a ladder in rainy or windy conditions

If you are unsure of how to use a ladder safely, check out instructions on the American Ladder Institute or NIOSH website, or download CDC's Ladder Safety smartphone app for pointers on the go.