Why These “Small Things” Matter So Much

When people talk about falls, they often think about big causes – a dizzy spell, a serious illness, dangerous weather. But many falls have very ordinary partners:

• Slippers that flap or slip off when you hurry to the door.
• Shoes that are too loose, too tight or worn smooth underneath.
• A walking stick used in the wrong hand, at the wrong height, or with a worn rubber tip.
• A frame that someone shuffles too far in front of them, instead of staying inside it.

None of these look dramatic. They are quiet, everyday details – but they sit exactly where the body meets the ground. If balance, vision or strength have changed with age or illness, these “small” details can decide whether a wobble becomes a fall.

What Makes a Safer Shoe or Slipper?

There is no single perfect shoe for everyone, but most falls teams and foot specialists look for the same basic features. When you next pick up a shoe or slipper, ask it a few questions:

• Does it stay on my foot?
  A back to the shoe, a strap, laces or Velcro fastening helps the shoe move with you, not away from you.
• Is the sole firm with a good grip?
  Very soft, “spongy” soles can twist; very smooth soles can slide. Look for a firm sole with a pattern that grips.
• Is the heel low and broad?
  A low heel (often around 1–1.5 cm) with a wide base is usually steadier than a narrow or high heel.
• Do my toes have room?
  A rounded or square toe box gives space for toes and reduces rubbing or clawing.
• Does it fit snugly – not tight, not loose?
  If your foot slides round inside, your brain has to work harder to balance.

Common Footwear That Quietly Increases Risk

Nobody needs to feel ashamed if they own these – they are sold everywhere. But it is worth knowing they may make falls more likely:

• Backless slippers or mules that fall off the heel when you lift your foot.
• Very soft “spongey” slippers which twist under you or compress unevenly over time.
• Old slippers with flattened heels and worn-down grip.
• High heels or very narrow heels, even for short trips indoors.
• Walking around in socks or tights on hard floors, especially if smooth or shiny.

If you love a particular pair, you do not have to throw them away on day one. But it is sensible to ask:

• “Are these the safest things to wear when I am tired, rushing or going to the bathroom at night?”
• “Could I keep them for short, sitting-times and choose something safer for moving around?”

Slippers Versus Shoes at Home

Many older adults associate slippers with comfort and home. Unfortunately, many common slippers are also:

• Loose around the heel.
• Soft and floppy at the sides.
• Made with soles that become shiny and slippery with wear.

A growing number of NHS and charity campaigns talk about “dangerous slippers” because hospital falls teams see the results: hip fractures, wrist fractures and long recovery journeys after “just a slip in the kitchen”.

For some people – especially if you have already fallen – the safest choice is actually a comfortable pair of indoor shoes:

• High-sided, with a back that hugs the heel.
• Fastenings you can adjust if your feet swell during the day.
• Thin-to-medium firm sole with good grip (not thick, bouncy platforms).

Supportive slippers do exist – often with Velcro straps and firm soles – but “floppy favourites” are worth reviewing. If money is tight, local schemes, handyperson services or family may be able to help prioritise one good pair at a time.

Walking Sticks – Tools, Not Badges of Failure

Many people delay using a walking stick because it feels like a sign of “getting old”. In reality, the body has already changed – the stick simply makes that change safer. Used properly, a stick can:

• Share some weight when one leg, hip or knee is painful or weak.
• Give the brain an extra contact point with the ground, improving balance.
• Increase confidence to walk a little further or move more often at home.

Getting the Height and Side Right

General principles that many physiotherapists use include:

• Height: when you stand upright in your usual shoes, with arms relaxed by your side, the top of the stick is often set around the level of your wrist crease.
• Side: if one leg is weaker or more painful, the stick is usually held in the hand opposite that leg, so that stick and weaker leg move together and share the load.
• Grip: the handle should feel comfortable and secure, without forcing your wrist into an awkward angle.

These are starting points only. The safest approach is to have a physiotherapist, occupational therapist or trained mobility adviser watch you walk with the stick and adjust it for you.

Looking After the Rubber Tip (Ferrule)

At the bottom of most sticks there is a rubber tip – the ferrule. Its job is to grip the floor and soften the contact. Over time it wears smooth, cracks or becomes uneven, especially if used outdoors. Signs it may need replacing include:

• The pattern on the bottom has worn flat.
• Cracks around the edges or splits when you bend it.
• The stick feels “slippy” on surfaces where it used to feel firm.

Ferrules are usually inexpensive and can sometimes be supplied or fitted by community services. A worn ferrule turns a helpful stick into a hidden hazard, so it is worth checking regularly.

Walking Frames – Staying Inside the “Safe Box”

Walking frames (Zimmer frames, rollators) give more support than a single stick. They can be very helpful if:

• Both legs are weak or painful.
• Balance is poor and you feel wobbly much of the time.
• You are recovering from illness or surgery and feel fragile on your feet.

Frames are usually sized and issued by hospital or community services. Even with a “perfect” frame, how you use it matters:

• Stay inside the frame: your body should be roughly between the front and back legs, not several steps behind it.
• Do not pull on it to stand: stand up using the arms of the chair or bed first, then place your hands on the frame once you are upright.
• Check rubber feet: like stick ferrules, the rubber tips on frame legs can wear smooth.
• Watch thresholds and rugs: small lips or edges can catch the frame; better to remove trip hazards than “bump” the frame over them.

Some frames are designed mainly for indoors, others for outdoors. It is worth checking which type you have before using it on uneven pavements or long distances.

Feeling Embarrassed? You Are Not Alone

Many people describe a similar journey:

• At first, they refuse a stick or frame – “I’m not that bad yet.”
• They limit outings, avoid certain rooms or feel trapped at home.
• When they eventually try a walking aid fitted properly, they are surprised at the relief and stability it gives.

It may help to ask:

• “What do I value more – looking ‘unaided’ for now, or moving more safely and freely for longer?”
• “Would I judge a friend for using a frame if it helped them stay independent?”

Using a stick or frame is not “giving up” – it is choosing equipment that matches your current body, the same way you once chose reading glasses when your eyes changed.

Footwear, Walking Aids and the Home Environment

Footwear and walking aids work best when the home environment is on their side. Even the best shoes struggle on:

• Loose rugs, uneven mats and curled edges.
• Polished floors without any grip.
• Cluttered paths with cables or piles of magazines.

If you have not yet read it, our Home Hazards – Room-by-Room Safety Walkthrough pairs well with this page. Combining:

• Safer footwear under your feet.
• Well-chosen walking aids in your hands.
• A kinder layout around you.

gives your balance three layers of support instead of one.

Printable Mini-Checklist – My Feet and Walking Aids

You can print this section, keep it on the fridge and tick what you feel is already good enough. Circle anything you want to discuss with a professional, family member or carer.

How PHAT Sessions Support Safer Feet and Steadier Steps

PHAT Zoom sessions are not shoe shops or equipment clinics – but they do quietly support everything in this guide:

• Strengthening the legs and core so your body makes better use of shoes and aids.
• Practising balance in a controlled way, often close to a chair or surface you can hold.
• Encouraging you to think about footwear before class – many participants switch from loose slippers to safer options.
• Offering a space to talk about wobbles, near-falls and “that step I worry about”, without embarrassment.

Over time, people often report:

• Standing up more easily from chairs.
• Feeling less anxious walking through their own home.
• Having the confidence to ask their GP or therapist for a review of their stick or frame.