Treating dog walkers’ hand and wrist injuries could cost the NHS an estimated £23 million, according to the results of a review of the evidence that was published online today (25 June) in the journal Injury Prevention.

Women and people aged 65-plus are most at risk from being pulled along on a dog’s lead, according to the article, written by first author Brandon Lim, who is based in general surgery, Sengkang General Hospital, Singapore, and colleagues. Three of his four co-authors work in trauma and orthopaedic surgery at Raigmore Hospital, Inverness.

The authors note that hand and wrist injuries of all types make up from 10 per cent to 30 per cent of all emergency department visits.

Five relevant studies found

Dr Lim and his fellow researchers looked for relevant studies, with a view to quantifying the risk profile and estimating the types and costs of hand and wrist injury among dog walkers in the UK.

Out of an initial haul of 102 studies, five were included in the evidence review. All were published from 2012 to 2024 and included a total of 491,373 patients, nearly three quarters of whom (364,904) were female. Some 65,623 (nearly 13.5 per cent) were younger than 18, and 152,247 (31 per cent) were older than 65. 

In all, 491,400 injuries had been sustained while dog walking. Of these, 110,722 (22.5 per cent) were specific fractures or soft tissue injuries to the hand and wrist. Finger fractures were the most common injury (34,051; 31 per cent), followed by wrist fractures (27,904; 25 per cent), finger soft tissue injuries (26,959; just over 24 per cent), and wrist soft tissue injuries (18,920; 17 per cent).

The dog’s direct or indirect role in the injury was reported in four of the included studies (458,749 patients). Being pulled by a lead with/without a fall, was the most common cause of a direct injury, accounting for over two thirds of incidents (314,189; 68.5 per cent). 

Tripping over the leash/dog and falling (20 per cent); and getting tangled up in the leash with (11 per cent) or without (1 per cent) a fall made up the rest.

[This study] ‘does highlight a significant number of such injuries to be attributable to dog ownership, particularly in the elderly and female population’ [Brandon Lim et al]

Older women ‘more susceptible’

One study reported an additional 14 indirect injuries, which wouldn’t have happened had the dog not been present: 11 of these occurred while walking the dog but weren’t caused by the dog pulling the handler on the leash. 

Dog walking did not emerge as any riskier than any other activity for sustaining a hand or wrist injury. But women and older adults were disproportionately affected by dog walking injuries. 

This is not entirely surprising, given that older women are more likely to have osteoporosis and so be more susceptible to fractures, while older people generally are more likely to have balance and gait issues and to have impaired eyesight, Dr Lim and his fellow researchers suggest.

Based on data from the included studies, and assuming that the UK population comprises 45 million adults, the potential annual costs of surgery and casts for broken wrists alone, as a result of dog walking, could exceed £23 million annually in the NHS in England, estimate the researchers.

And this doesn’t include the wider economic toll of these patients not being able to work, and the potentially increased care demands required, they add.

Caveats and conclusions

The researchers acknowledge various limitations to their findings. Four of the five included studies were carried out in the USA. And three used the same data source. Trends in dog ownership, dog breeds, leash type and walking environments weren’t analysed in the included studies either.

Dr Lim and his colleagues note: ‘Although this review does not show dog-walking to be an outstanding risk factor for causing hand and wrist injuries within the adult population compared with all other causes, it does highlight a significant number of such injuries to be attributable to dog ownership, particularly in the elderly and female population.’ 

They state: ‘Teaching safer leash-holding practices, such as holding the leash in the palm as opposed to finger or wrist wrapping, or leash choice, such as avoiding retractable devices that can lead to sudden increases in tensile force at the end of their working range, may be recommended.’ Dog obedience training may also be helpful, they add.

Fact file

Cases of dog walking injuries have been rising in recent years in tandem with an increase in dog ownership and dog walking to improve fitness, explain the researchers.  In the UK alone, there are around 8.5 million dogs: one for every seven to eight people.

Despite the many cognitive and physical health benefits of dog ownership, it is not without its risks of injury, they add. But few studies have reported on hand and wrist injuries sustained while dog walking. Hand and wrist injuries of all types of make up from 10 per cent to 30 per cent of all emergency department visits.

To access the full version of the article – titled Dog walking-related injuries of the hand and wrist: a systematic review Doi: 10.1136/ip-2025-045629 – see: https://injuryprevention.com/lookup/doi/10.1136/ip-2025-045629

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