How to fall on black ice without getting hurt: winter tips from Ukraine

What's the problem?

In places where it snows, and temperatures drop below freezing, winter is a busy time for doctors specializing in bone and joint injuries. Ice and snow increase the chances of slipping and falling, which may lead to broken bones, sprains, dislocations, or bruises. Most injuries happen in the morning when people rush to work and in the evening when they come home.

What's the solution?

How can you avoid falling? What will help you feel confident walking on icy sidewalks? And, most importantly, what should you do if you do fall and hurt yourself? Ukrainians have had many cold winters and experienced many injuries from black ice, so Ukrainian doctors have plenty of advice to share.

Dr. Dmytro Mordovets, an orthopedic trauma doctor, explains the most common injuries and offers simple, effective tips for staying safe this winter.

How does it work?

"A typical day for a trauma doctor [in Ukraine] during the black ice season is extremely busy, stressful, and exhausting — both physically and emotionally," says Dr. Dmytro Mordovets. "During this time, the number of people coming to the hospital on their own doubles or triples. At the same time, more people are brought in by ambulances with serious injuries that require urgent surgery. This puts a lot of strain on trauma departments, making it harder to manage surgeries and both emergency and scheduled procedures."

People falling on ice often break bones, the most common injury being a forearm fracture. This injury happens when people instinctively put their hands out to break their fall, especially older people with fragile bones due to osteoporosis. Younger people (aged 25–50) are likelier to break their shinbones or ankles from unexpectedly twisting their feet. For those over 60, hip fractures or broken shoulders are common after falling onto their side or shoulder. Other frequent injuries include sprained ligaments, bruises, and head injuries from hitting the ice.

Older adults (60+) are the most vulnerable. They are at higher risk for several reasons: osteoporosis, coordination and balance issues, and slower reflexes.

However, younger people and even children aren't immune to falls. Active Ukrainians also often suffer other winter injuries caused by snow. Winter sports, for example, may lead to knee ligament tears, broken shinbones, or shoulder injuries. Accidents like falling off sleds can lead to spine fractures. The most dangerous injuries are head injuries, especially brain bleeds, which can cause neurological problems or even death.

Falls are perilous for older adults and children because of their physical characteristics: slower healing, higher risk of heart problems, and fractures due to osteoporosis. Children also face a higher risk of head injuries, dislocations, and hidden fractures since their bones are more flexible.

The doctor warns that both groups need special care after falling to prevent complications and ensure timely diagnosis.

The right way to fall can seriously reduce your chances of getting hurt. While you can't avoid injuries entirely, you can learn to fall correctly, especially if you're an athlete or tend to fall a lot. Sports that focus on balance and coordination can help you avoid injuries or at least make them less severe if you do fall.

"However, on icy sidewalks, falls often happen quickly and unexpectedly, so even fit people can get hurt," says Dr. Dmytro Mordovets.

He advises not to move after a fall if you suspect serious injuries, such as fractures or spine damage.

What to do if you're injured or witness someone falling:

• Check the person's condition (are they conscious or breathing?), and if necessary, perform first aid (CPR).
• If there's a fracture, try stabilizing the limb with whatever you have on hand and applying a bandage to any open bleeding wounds.
• Calm the injured person down and call for medical help if the injury seems serious.
• If the person has a head injury, keep them lying down with their head slightly raised and turned to the side until help arrives.
• For bruises, apply something cold (like frozen food wrapped in a towel) to the injured area to ease the pain and swelling.

"After a fall, people often make the mistake of trying to get up with the injured limb or moving when they shouldn't, not realizing this could make things worse, especially with serious injuries. Don't ignore symptoms like intense pain or swelling," Dr. Dmytro Mordovets adds.

Dr. Mordovets stresses that you should get medical help immediately if you experience:

• Intense pain,
• Limited movement in a joint,
• Crunching sounds (with pain),
• Unusual movement in the limb,
• Visible bone deformation,
• Loss of consciousness,
• Or head or spine injuries.

"Hip fractures in older patients usually require replacing the hip joint with an artificial one. However, most fractures heal well with surgery and reduce the risk of long-term complications. Delaying treatment or seeking inadequate care can make recovery harder, increase the chance of further issues, and might require additional surgeries or longer rehab," says Dr. Dmytro Mordovets.

How to reduce the risk of injury? Follow these tips:

• Plan your time so you're not rushing. Moving too fast in winter can make you more prone to falling.
• Wear shoes with solid tread and no heels. In severe ice, use ice grips. If you don't have them, you can make your own: just attach a piece of foam (cut to the size of your heel), sandpaper, or medical tape to your shoes before heading out.
• Move slowly, avoiding sudden movements.
• Keep your hands free to help with balance — don't keep them in your pockets. This will reduce the chance of serious injury if you fall.
• Keep your eyes on your feet and keep your knees slightly bent. Lean forward a bit as you walk.
• Avoid slippery spots, or take tiny steps if you must cross them.
• If you lose your balance, crouch down to minimize the height of your fall.
• If you do fall, try curling up and tense your muscles. When you hit the ground, try rolling so the impact spreads out and loses its force.
• Older people can benefit from using a cane or walking stick with a rubber tip or spike. Still, in icy conditions, it's best for them — and for pregnant women — not to go outside unless necessary.
• Be extra cautious when crossing the street or walking along the side of the road. Never run across the street during snow or black ice. Remember that cars take longer to stop on slippery roads, and falling in front of one can result in serious injury or even death.

Even more helpful solutions!

Trauma doctor Dmytro Mordovets points out that just because your fingers or joints can still move doesn't always mean there is no fracture. Some fractures, like cracks or microfractures, might not restrict movement, even if the bone is damaged. That's why getting an X-ray is so important for an accurate diagnosis.

Another common myth is that trauma doctors only treat injuries with casts. In reality, modern traumatology uses a variety of treatments depending on the injury. Along with casts, doctors might use metal plates, screws, or rods to stabilize fractures, as well as orthoses, bandages, and special splints to support damaged joints and tissues. For more serious injuries, they could perform surgery. Plus, treatment often includes physical therapy, rehab, and medication to manage pain and reduce inflammation. So, when it comes to treating injuries, traumatology is personalized, and the approach can vary based on the specific injury.