Hip Fracture Prevention: Protecting Your Bones as You Age

Why is a hip fracture so serious as you age?

A hip fracture is one of the most consequential injuries in later life — it can end a person's independence, not just their mobility for a few weeks. Research summarised in a 2025 narrative review reports that one-year mortality after a hip fracture typically ranges from about 15% to 30%, and that fewer than half of survivors regain the functional status they had before the break Medical Sciences (Basel), 2025.

Those two numbers explain why bone health specialists treat hip fracture prevention as a priority. Many people who fracture a hip never return fully to walking, shopping or living alone as they did before, and a proportion need long-term care afterwards. The encouraging flip side is that the main drivers of hip fracture — weak bones and falls — are both things you can influence long before a break ever happens.

What actually causes most hip fractures?

Most hip fractures are the result of a fall, not a heavy impact. The same 2025 review notes that up to 90% of hip fractures occur after low-energy trauma such as slipping or a minor misstep Medical Sciences (Basel), 2025. In other words, the typical hip fracture is not a dramatic accident — it is an everyday stumble that a strong skeleton might have shrugged off.

That single fact reframes prevention. If most fractures need both a fall and a bone weak enough to break, then you have two independent levers to pull: make the bone stronger, and make the fall less likely. The rest of this guide walks through both, because the best protection comes from doing them together rather than choosing one.

How can stronger bones lower your hip fracture risk?

You build and defend bone strength mainly through the right kind of exercise and the right nutrients — and, where a clinician advises it, medication. The Royal Osteoporosis Society is explicit that two forms of activity matter: weight-bearing (impact) exercise and muscle-strengthening (resistance) exercise, advising that "the best way to help your bone strength is to do both impact and strength exercises" Royal Osteoporosis Society. Impact means activity where you are on your feet and your bones bear your weight — brisk walking, stair climbing, jogging or dancing — while resistance means working your muscles against a load, such as weights, resistance bands or bodyweight moves. Our guide to the best exercises for bone health covers how to combine them.

There is also population-level evidence that staying active pays off at the level of the hip itself. The Royal Osteoporosis Society's "Strong, Steady and Straight" consensus notes there is evidence that being physically active is associated with a reduction in hip fracture risk, and that exercise maintains bone strength and reduces the loss of bone mineral density The Endocrinologist, 2020.

Nutrition supplies the raw materials. The Royal Osteoporosis Society advises that most adults need 700mg of calcium a day, because calcium "gives your bones the strength and hardness they need" for everyday activities Royal Osteoporosis Society. Good sources include dairy, fortified plant alternatives, tinned fish eaten with the bones, tofu and leafy greens. Calcium only works well when your body can absorb it, which is where vitamin D comes in: it helps the body absorb and use calcium to keep bones and muscles strong, and most adults need 10 micrograms (400 IU) a day, with a daily supplement generally advised over the darker autumn and winter months Royal Osteoporosis Society. A balanced diet with enough protein rounds out what bones and muscles need.

Where bones have already thinned into osteoporosis, medication can reduce fracture risk — but whether that applies to you, and which treatment, is a decision for your GP or a specialist based on your individual risk.

How can fewer falls lower your risk?

Because most hip fractures follow a fall, reducing falls is just as important as strengthening bone — and much of it is practical. The NHS advises staying active with activities that improve strength and balance at least twice a week, and making your home safer by removing things you could trip over, such as loose wires or rugs NHS. It also recommends having regular eye tests, wearing shoes or slippers that fit well and have good grip, and speaking to a GP or pharmacist if you think your medicines could be affecting your balance NHS.

Balance and strength training is the exercise side of falls prevention. The Royal Osteoporosis Society explains that balance exercises make your muscles stronger and keep you steady, so you are less likely to fall and break a bone Royal Osteoporosis Society, and the "Strong, Steady and Straight" consensus recommends balance and muscle-strengthening exercise for people over 65, noting good evidence that exercise and physical activity reduce the risk of falls The Endocrinologist, 2020. Structured programmes such as Tai Chi or Otago-style routines are popular for exactly this reason: the International Osteoporosis Foundation points out that people with better posture, balance and muscle power are less likely to fall, and cites evidence that after about 15 weeks of Tai Chi people fall around half as often as their peers International Osteoporosis Foundation. If you are new to exercise or already unsteady, ask your GP or a physiotherapist what is safe for you before you begin.

How do you find out your hip fracture risk?

The proactive move is to stop guessing and get an actual estimate of your risk — then act on it with your GP. One widely used tool is FRAX, a computer-based algorithm developed in 2008 at the WHO Collaborating Centre, University of Sheffield, which calculates your 10-year probability of a major osteoporotic fracture and of a hip fracture from clinical risk factors — including previous fracture, a parent's hip fracture, smoking, steroid use, alcohol and rheumatoid arthritis — with or without a bone density measurement Journal of Endocrinological Investigation, 2024. For a plain-English walk-through of how that estimate is built and read, see our guide to fracture risk and FRAX.

A FRAX score is most useful when paired with a picture of your actual bone health. Establishing a baseline — and then monitoring how it changes over the years — helps you and your clinician see the direction of travel rather than a single snapshot. A radiation-free REMS ultrasound scan is one way to establish that baseline and track it over time; it complements clinical care rather than replacing it, and it does not diagnose in the way a doctor does. If you are over 50 and want to understand where your bones stand, our overview of bone density after 50 is a good starting point, or you can look into a bone health assessment to establish your own baseline.

Whatever route you choose, the principle is the same: a hip fracture is largely preventable, the levers are stronger bones and fewer falls, and the earlier you know your risk, the more you can do about it.

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This article is part of our bone health series. To understand what a scan can tell you, read our guide to bone density after 50.