Most falls don't break anything. But almost all of them break something harder to see: the confidence that got you up and moving in the first place. What you do in the days and weeks afterwards decides which way that goes.
This is the part of falls prevention that gets least attention, so we've written it down.
Why "rest is best" is wrong
In a well-known study, healthy adults with an average age of 67 spent ten days in bed. They lost around a kilogram of lean leg muscle and 13% of their knee strength. Ten days. Younger adults lost less in nearly a month. NHS deconditioning campaigns put it bluntly: for someone over 80, ten days in bed can mean ten years of muscle ageing.
That's the trap after a fall. You're sore, you're shaken, you rest. The rest weakens the legs that failed you. The weakness makes the next fall more likely. And the system won't catch you quickly: 79% of hip-fracture patients wait more than a week for community rehab to start.
So the instruction is: rest the injury, not the person.
The first 48 hours
If you've fallen and you're on the floor: don't rush. Check for pain in the hip, wrist or head. If you can't get up, or you have severe pain, call 999. If you're unsure, 111. If you can get up, do it in stages: roll onto your side, get onto hands and knees, crawl to a sturdy chair, kneel with the strong leg forward, push up and turn to sit.
Tell someone. Even a fall with no injury should go to your GP; it may be the first sign of something fixable: a medication side effect, low blood pressure, an eye prescription, a foot problem.
For a bruise, sprain or knock: cold reduces pain and swelling. An instant ice pack or a gel pack from the freezer, wrapped in a tea towel, for 15 to 20 minutes, a few times in the first two days. Never directly on skin. Modern first-aid guidance (the "PEACE and LOVE" principles) is clear that ice is for comfort, not for speeding healing, but comfort matters, because pain is what stops people moving.
Protect, elevate, compress the injured part if it's swelling. Then leave it alone and let your body do its job.
Days 3 to 14: start moving
Once the acute pain settles, movement is the treatment. Gentle at first: walking around the house, standing up from the chair a few extra times a day, ankle circles, the seated warm-up exercises from the NHS sitting programme.
Heat helps here. A warm gel pack on a stiff hip or knee for ten minutes before you move loosens things up and makes the first steps easier. It's not a cure; it's a way to get you started.
If you were given exercises by a physio or in hospital, this is when to do them, every day, not just on good days.
What to keep at home
Cold for the first two days, heat once the acute pain settles. These are the packs UK hospitals use. The gel pack goes in the freezer or the microwave and is reusable; the instant packs need no freezer at all, so one in a handbag, the car or by the bed is ready the moment it's needed. Always wrap in a cloth and never apply directly to skin.
Hot & Cold Pack
Freezer or microwave. Reusable gel pack, hospital grade
| Single pack | £2.99 |
| Box of 14 | £21.00 |
| Box of 28 | £36.96 |
Instant Ice Pack
Squeeze to activate. No freezer needed, single use
| Pack of 25 | £15.99 |
Want both? 14 hot & cold packs + 25 instant ice packs for £29.99. Prices include VAT.
Weeks 2 to 8: rebuild
This is the window that decides your next year. Progressive strength work two or three times a week is what restores the muscle you lost and builds the reserve that stops a stumble becoming a fall.
Studies of rehabilitation after hip fracture consistently used progressive resistance training with elastic bands and ankle weights, two to three times a week for around three months, and found improvements in strength, walking speed and function. You don't need to have broken a hip to benefit.
The chair-based programme we published yesterday is exactly the right starting point: seated, band-based, progressive, ten minutes. [Download it here.] Start at week 1 whatever your fitness was before the fall.
Throughout: the confidence problem
Fear of falling affects more than half of people over 70 and causes nearly 40% to restrict what they do. After a fall it spikes. And it's self-fulfilling: the less you do, the weaker you get, the more likely you fall.
The good news is that exercise is also the best treatment for the fear. A review of 50 trials found strength and balance programmes measurably reduce fear of falling, and the effect is largest in programmes that combine strength, balance and practice at real-life movements, like standing from a chair.
Remember the woman in Worcestershire who got herself up off the floor. The strength mattered. The belief mattered more. You build both the same way.
When to get help
See your GP or ask for a falls assessment if you've fallen more than once in a year, if you feel unsteady, if you're on four or more medications, or if the fear itself is stopping you leaving the house. NICE guidance says you should be offered a multifactorial assessment and a strength and balance programme. Ask for it.
Sources: Kortebein et al., JAMA 2007 and J Gerontol A 2008; East Sussex Healthcare NHS Trust, deconditioning; National Hip Fracture Database Annual Report 2025; Dubois & Esculier, BJSM 2020 (PEACE & LOVE); NHS, Sitting exercises; Progressive resistance training after hip fracture, systematic review, J Funct Morphol Kinesiol 2025; Zijlstra et al., Age and Ageing 2007; Feng et al., Physical Therapy 2021; NICE NG249.
