Slipping on Ice: How to Protect Your Feet and Ankles This Winter

In Southwest Montana, winter means months of packed snow, frozen driveways and parking lots that glaze over after every thaw. One wrong step on a patch of ice can turn a trip to the mailbox into a twisted ankle, or worse.

Falls are a real health risk, especially as we get older. The CDC reports that more than one in four older adults falls each year, and that about 319,000 older people are hospitalized for hip fractures every year.¹ The good news is that a few habits can lower your risk on ice. Here's what the research and public health agencies suggest, and how to tell when an ankle injury needs care.

Why Are Falls on Ice Such a Big Deal?

Most falls don't cause serious harm, but some do. The CDC says about one in ten falls leads to an injury that limits activity or needs medical care. Falls cause most hip fractures in older adults, and they are the leading cause of traumatic brain injury in this age group.¹

Ice adds to the risk. A study of fall injuries in Sweden called falls caused by icy roads "a prevalent public health problem during winters," especially for older people.⁸

For your feet and ankles, a slip can lead to a sprain. The American College of Foot and Ankle Surgeons (ACFAS) notes that sprained ankles often come from a fall, a sudden twist, or walking on an uneven surface.⁶ Twisting or rolling the ankle and falling are also common causes of a broken ankle.⁷

What Kind of Boots Help on Ice?

Your footwear is your first line of defense. OSHA, the federal workplace safety agency, calls insulated, water-resistant boots "with good rubber treads" a must for walking during or after a winter storm. It also suggests keeping a pair of rubber over-shoes with good treads that fit over your regular shoes.³

MedlinePlus, from the National Library of Medicine, recommends shoes with low heels that fit well, and notes that rubber soles can help keep you from slipping.⁴ A few practical points:

• Check the tread. Worn, smooth soles give you less grip. Look for deep rubber treads.³
• Pick a good fit. Choose shoes and boots with low heels that fit well.⁴
• Don't wear dress shoes outside. If you need them at work or church, wear boots or over-shoes outdoors and change inside.³

For more on choosing shoes that fit your feet, see our article on proper footwear.

Do Ice Cleats Really Work?

Strap-on ice cleats (traction devices that slip over your boots) are popular in snowy places. The evidence is encouraging but limited. A 2023 study looked at Swedish towns that gave free ice cleats to older adults. Ice-related fall injuries dropped by an estimated 8% on average in those towns. But the result wasn't statistically certain, and the authors noted that larger, more careful studies are still needed.⁸ The researchers concluded that handing out cleats "can decrease the incidence of ice-related injuries among older adults."⁸

In short, cleats may help, but they aren't a guarantee. Use them along with good boots and careful walking, not instead of them.

How Should I Walk When It's Icy?

OSHA advises taking short steps and walking at a slower pace on icy or snowy walkways, so you can react quickly when traction changes.³ MedlinePlus adds a few more tips:⁴

• Avoid sudden movements or quick changes in position.
• Stay away from water or ice on sidewalks when you can.
• Ask your provider about a cane or walker if you feel unsteady.
• Ask your provider whether any of your medicines can make you dizzy.

The CDC also suggests having your eyes checked at least once a year. If you wear bifocals or progressive lenses, ask about distance-only glasses for walking outside.² Clearing and de-icing walkways quickly after a storm helps too.³

Can Exercises Help My Balance?

Yes, strength and balance matter. MedlinePlus notes that weak muscles and balance problems are common causes of falls.⁴ The CDC recommends exercises that make your legs stronger and improve your balance, such as Tai Chi.²

MedlinePlus describes some simple moves you can do at home:⁵

• Toe stand: Hold the back of a sturdy chair. Rise up onto your toes as high as you can, then slowly lower your heels. Repeat 10 to 15 times. This strengthens your calves and ankle muscles.
• One-foot balance: Practice standing on one foot during everyday moments, like waiting in line.
• Sit to stand: Practice standing up from a chair without using your hands.
• Walking: Regular walking builds strength, balance and endurance.

Start slowly, and check with your provider about which exercises are right for you. Stop and talk to your provider if you feel pain, dizziness or trouble breathing.⁵

I Slipped and Twisted My Ankle. What Now?

An ankle sprain is an injury to one or more ligaments, usually on the outside of the ankle. Symptoms can include pain, swelling, bruising, stiffness and trouble walking.⁶ ACFAS warns that a more serious injury, such as a fracture, can happen along with a sprain.⁶ That's why an ankle that's badly hurt should be checked rather than "walked off."

For a sprain, ACFAS describes these first steps:⁶

• Rest: Stay off the injured ankle.
• Ice: Use an ice pack with a thin towel between it and your skin for 20 minutes, then wait at least 40 minutes before icing again.
• Compression: An elastic wrap may help control swelling.
• Elevation: Raise the ankle slightly above the level of your heart.

ACFAS also says rehab should begin right away, because delayed rehab can make proper healing less likely.⁶ You can read more in our article on ankle sprains and on our ankle pain page.

When Should I Get Checked After a Fall?

MedlinePlus advises contacting your provider if you have fallen, or even if you almost fall.⁴

Get care right away if you have signs of a broken ankle, such as immediate and severe pain, swelling and bruising, tenderness to the touch, not being able to put any weight on the foot, a deformed-looking ankle, or numbness and coolness in the foot.⁷ Call our office, or go to an emergency room if the injury is severe.

A podiatrist can examine your foot and ankle, order X-rays if needed, and talk with you about treatment.⁶ If foot pain, numbness or an old injury makes you feel unsteady on your feet, that's worth a visit too.

The Bottom Line

Ice is part of life in Montana, but falls don't have to be. Wear boots with good rubber tread, consider ice cleats, take short slow steps, and work on your leg strength and balance. If you do slip and hurt your ankle, rest and ice it, and get it checked if you can't put weight on it or the pain is severe.

If ankle pain or unsteady footing is holding you back this winter, our podiatrists can help. Request an appointment and our team will follow up within one business day. You can also find your nearest office on our locations page.

This article is for general education and isn't a substitute for medical advice. Talk with a podiatrist or your doctor about your own symptoms.

Sources

1. Facts About Older Adult Falls. Centers for Disease Control and Prevention (CDC). www.cdc.gov
2. Preventing Falls and Hip Fractures. Centers for Disease Control and Prevention (CDC). www.cdc.gov
3. Winter Weather: Hazards and Precautions. Occupational Safety and Health Administration (OSHA), U.S. Department of Labor. www.osha.gov
4. Preventing Falls. MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine. medlineplus.gov
5. Exercises to Help Prevent Falls. MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine. medlineplus.gov
6. Ankle Sprain. American College of Foot and Ankle Surgeons (FootHealthFacts.org). www.foothealthfacts.org
7. Ankle Fractures (Broken Ankle). OrthoInfo, American Academy of Orthopaedic Surgeons (AAOS). www.orthoinfo.org
8. Eklund E, Holmberg R, Svensson M, Gustavsson J, Bonander C. Quasi-experimental evaluation of municipal ice cleat distribution programmes for older adults in Sweden. Injury Prevention. 2023;29(5):378–383. pmc.ncbi.nlm.nih.gov