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senior walking in snow
Published By Dr. Rein Tideiksaar on December 08, 2015

There’s little doubt that regular walking helps elders avoid falling. By strengthening bones and increasing muscle strength, flexibility and sense of balance, walking is an important fall prevention strategy.

Unfortunately, many elders aren't walking enough. About 60 percent of elders are not regularly active, and 25 percent are essentially sedentary. One in three men and half of women are completely sedentary by the time they reach 75 years old. Sadly, a sedentary lifestyle results in muscle loss, poor balance and increased fall risk.

So why aren’t elders walking more? There are several reasons:

  • Elders may believe loss of strength and endurance are due to aging. But these losses are largely due to inactivity.
  • Elders, especially those who fear falling, believe they are preventing falls by not walking. However, less activity makes individuals weaker and unsteady, which increases their risk of falling.
  • Some elders may fail to see the benefits of regular walking and give up. To improve balance, individuals need to walk briskly. Because elders rely less on ankle muscles and more on hip muscles to walk, strengthening one’s ankle muscles is beneficial.

Walking on the ground, treadmills and elliptical machines

<p">Elders interested in a regular walking program often ask, “Which is better: walking on the ground or walking on a machine?” Each is different.</p">


  • Walking on an elliptical machine results in greater use of muscles in the buttocks and thighs than walking on the ground, but less activation of calf muscles.
  • Ellipticals put less stress on joints than walking on the ground; they are best for individuals with achy hips, knees and back.
  • Walking on the ground provides a better workout for hamstrings, calves and ankle muscles, which are important for balance.

There are differences between walking on a treadmill and walking on the ground. Walking outside (up hills, different terrains) works the leg muscles more. Treadmills, however, can be adjusted to mimic the terrain of an outdoor walk, while eliminating heat and other obstacles that can present a fall risk.

Starting an exercise routine

What works best is really determined by an individual’s health status and his or her exercise needs. For any individual, it is important to understand there is some risk of injury, especially when walking on a treadmill or elliptical. However, both have armrests and handles that offer stability.

Walking is key to reducing the risk of falls. For safety, individuals should check with a doctor about their planned walking program, including the use of machines.

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Rein Tideiksaar Ph.D., PA-C (or Dr. Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, N.J., a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. Check out Dr. Rein’s professional profile on LinkedIn: If you have any questions about preventing falls, please feel free to email Dr. Rein at

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