Falls are Australia's biggest injury problem. Exercise is one of the best answers
Falls rarely make headlines, yet they are Australia's leading cause of injury hospitalisation and injury death.
The scale of the problem
According to the Australian Institute of Health and Welfare, falls account for 43% of injury hospitalisations and 42% of injury deaths (AIHW, Falls). In 2021 to 22 there were 233,000 fall related hospitalisations. People aged 65 and over made up 60% of those hospitalisations and 94% of fall deaths, and most falls in older people happen at home.
What the evidence says works
A Cochrane review of 108 randomised trials with more than 23,000 older people living in the community found exercise reduces the rate of falls by about 23%, or around 195 fewer falls per 1,000 people each year. The number of people who fall drops by about 15% (Sherrington et al., Cochrane, 2019).
The type of exercise matters:
Balance and functional training: 24% fewer falls (high certainty).
Multiple types combined (balance, functional, resistance): 34% fewer falls (moderate certainty).
Tai chi: 19% fewer falls (low certainty).
Why this matters after joint replacement
People recovering from knee replacement are often older, less steady on their feet and doing much of their recovery at home. Building balance and functional exercises into rehabilitation supports both the new knee and the patient's safety.
Practical points for clinicians
Include balance, not just strength. Balance and functional training is the component with the strongest evidence.
Make it doable at home. Most falls in older people happen there, and home is where the exercise needs to happen too.
Keep it going. Benefits depend on regular practice over time, so plan for adherence from the start.
This article is general information for health professionals and is not clinical advice.
