Hand and wrist injuries among dog walkers cost the UK millions

The annual cost of hand and wrist injuries among dog walkers in the UK is estimated to top £23 million, with women and the over 65s most at risk as a result of being pulled along on the dog leash, finds a review of the available evidence, published online in the journal Injury Prevention.

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, despite the fact that all types of hand and wrist injuries make up between 10% to 30% of all emergency department visits.

To plug this knowledge gap, the researchers scoured research databases, looking for relevant studies, with a view to quantifying the risk profile and estimating the types and costs of hand/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 between 2012 and 2024 and included a total of 491,373 patients, nearly three quarters of whom (364,904) were female. Some 65,623 (nearly 13.5%) were younger than 18, and 152,247 (31%) were older than 65. 

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

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 leash with/without a fall, was the most common cause of a direct injury, accounting for over two thirds of incidents (314,189; 68.5%). 

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

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 didn't emerge as any more risky 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, say the researchers, 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, they 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.

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.

But they 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." 

And they suggest: "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.