Hip protectors for elderly people: what the reviews show, and where they fall short

What are hip protectors, and how are they meant to work?

A hip protector is a shield worn over the hip bone. Cochrane describes two kinds: hard plastic shields and soft foam pads, usually fitted into pockets in specially designed underwear.¹

The idea is simple. A hip fracture usually follows a fall or an injury, and it is more common in older people and in people with osteoporosis.³ If a pad takes some of the force of a fall onto the hip, the bone may be less likely to break. That is the idea the trials test, not a result in itself.

That is a protective idea, not a preventive one. A hip protector does nothing to make a fall less likely. It is worn in case a fall happens. This matters later, because the research tests exactly that: whether wearing the pads leads to fewer broken hips.

A hip fracture is serious. The NHS says it needs hospital treatment straight away, that surgery usually happens on the day of arrival or the day after, and that recovery can take several weeks or months.³ The NHS also says that osteoporosis weakens bones, and that it is often found only when a fall or a knock causes a fracture.⁵ That is the background to why people look for ways to cushion the hip.

For the wider picture on keeping on your feet, see falls prevention for older adults. For how falls risk is actually assessed, see falls risk assessment in the UK.

What do the reviews say about preventing hip fractures?

The best single source is the Cochrane review by Santesso and colleagues, published in 2014. It pooled 19 studies, nine of them cluster randomised, with about 17,000 people whose average ages ranged from 78 to 86.¹ Only the abstract was read for this guide, not the full text, so the numbers below are the headline results.

A newer paper in 2024 looked at six published meta-analyses, searched up to June 2022. It found that hip protectors were effective at preventing hip fractures in people living in institutions (risk ratio 0.70, 95% CI 0.58 to 0.85) but not in people living in the community (risk ratio 1.12, 95% CI 0.94 to 1.34), and found no reduction in falls (risk ratio 1.01).² It is a summary of earlier analyses, not new trials, and again only the abstract was read.

The two reviews point the same way. Any benefit appears in institutions, and no clear benefit appears at home.

Reading “11 fewer per 1,000” in plain numbers

A risk ratio of 0.82 sounds like an 18% cut. The absolute figure is more useful, and it is smaller.

Worked example, care homes

Cochrane gives 11 fewer people per 1,000 with a hip fracture.¹ Eleven out of 1,000 is 1.1 in every 100, or 1.1 percentage points.

Turn it round: 1,000 divided by 11 is about 91. On the central estimate, around 91 people would need to wear protectors for one hip fracture to be avoided. The abstract does not give the follow-up period, so this is a rough guide, not a rate per year.

Now the edges. The range runs from 20 fewer to 0 fewer per 1,000.¹ At the favourable end, 1,000 divided by 20 is 50 people. At the other end, the result is compatible with no effect at all, so no number can be worked out.

None of this says hip protectors are worthless in a care home. It says the benefit is small, uncertain at the edges, and depends on the pads actually being worn.

Who might benefit, and who is unlikely to?

On the reviews read, the clearest signal is for people living in care homes and similar institutions.¹² For people living at home, both reviews found little or no effect.¹²

Two cautions apply. First, the Cochrane review searched for studies only up to December 2012,¹ and the 2024 paper reviews older meta-analyses rather than new trials. Second, the care home trials cannot simply be carried over to someone living in their own home, and the reviews do not say why the two settings differ.

Whether a particular person is at high risk of a hip fracture is a clinical question. The NHS says a GP can check for muscle weakness, osteoporosis and eyesight problems after falls, and can suggest strength and balance training.⁴ If you are weighing up hip protectors for yourself or someone you care for, that conversation comes first.

Nothing in the sources read covers hip protectors for men specifically, so this guide does not make a separate claim for them.

What NICE, the NHS and Age UK say about hip protectors

Here the evidence is quiet. The recommendations of NICE guideline NG249, published on 29 April 2025 for people aged 65 and over and people aged 50 to 64 at higher risk of falls, were searched for the words “protector”, “hip pad” and “protective”. None appears.⁶⁷ The guideline neither recommends nor advises against hip protectors.

The NHS pages on falls and on hip fracture read for this guide do not mention them either.³⁴ The Age UK falls prevention page does not mention them.⁹ That is a gap in what these pages cover, not a verdict on the pads.

What NG249 does recommend is worth knowing. For a person who has fallen in the last year and has a problem with gait or balance, it advises offering a falls prevention exercise programme and considering a home hazard assessment.⁷ For people who need comprehensive falls management in the community, it also advises offering a home hazard assessment and intervention using a validated tool, and considering having it done by an occupational therapist.⁷

Age UK suggests telling your doctor about any fall, or about feeling unsteady, even if you feel fine, so that they can check your balance and walking and point you to a falls assessment or a falls prevention service.⁹

The practical problem: wearing them

A protective pad only helps if it is on at the moment of the fall. Cochrane says poor acceptance and poor adherence by older people offered hip protectors is a barrier to their use, and that adherence was poor, particularly in the long term.¹

The same abstract reports adverse events during wear, including skin irritation, of 0% to 5%.¹

Beyond that, this guide has to be honest about what it did not find. No page read covers comfort, wearing the pads at night or in bed, wearing them with incontinence, sizing and fitting, or washing and care. No source read says whether the NHS supplies hip protectors. Without a source, none of those are written here. These are good questions for a GP or an occupational therapist.

Hip protectors, other protective equipment and falls prevention compared

People often mix up the different kinds of help. The table sets out what each does and what the sources read say about it. Cells with no source read are left out.

The difference between hip protectors and an airbag vest is passive versus active, and what each covers. For that comparison, read the airbag vest for elderly guide.

The NHS advice on reducing the chance of a fall is practical: shoes or slippers that fit well and grip, regular eyesight checks, and less clutter, with no trailing wires or loose rugs.⁴ Strength and balance work is covered in strength training for seniors, and the loss of muscle that comes with age in muscle loss after 50.

After a hip fracture

The NHS says that if you are over 50 and have broken a hip, a fracture liaison service can help prevent further broken bones, and that you can ask for it through your GP.³ NICE guideline CG124 covers the management of hip fracture and refers readers to the NICE falls guidance for a complete programme of care.⁸

The NHS also warns that a full return to previous strength and movement is not guaranteed.³ That is the reason for putting the effort into prevention, in whatever form suits the person.

Frequently asked questions