Fear of movement and fear of falling: what is it and how do you address it?

December 30, 2024

Now that it gets dark early and weather isn’t always cooperative, many people feel a higher threshold to move or go outside. Sometimes it also doesn’t feel safe to go out, for example when there is snow or ice and the pavement is slippery. Thankfully, winter doesn’t last forever and these situations are often temporary. But what if real anxiety around movement arises? Fear of falling and breaking something, or fear that movement itself will cause pain, fear of feeling stiff and wiped out the day after activity, or even feeling literally sick? We call this fear of movement or kinesiophobia. This is often linked to fear of falling.

How does fear of movement develop?

Fear of movement arises from negative experiences and thoughts the brain associates with movement. It is a complex interplay of mental, emotional and behavioural factors.
It can develop after earlier negative physical experiences (Tinetti et al. 1994), such as pain or a past stressful event, but it can also be purely psychological, people may think something bad will happen, even if it won’t (Delbaere et al. 2010). It can also arise because people lose trust in their own physical ability, they feel less mobile and confident (Bandura’s self‑efficacy theory 1998) about their balance and preventing a fall themselves. Moreover, some people may be predisposed generally more nervous or anxious (Zijlstra et al. 2007) regarding changes and trying new things.
Fear of movement can lead to avoidance behaviour and inactivity, which eventually severely limits mobility and quality of life. This can create a negative spiral that reinforces inactivity and it can increase fall risk on its own (Delbaere, Age and Ageing 2004).

Staying active despite fear

What can you do to overcome fear of movement? Take small steps and ask for help from healthcare professionals.

1. Fall-prevention movement intervention

A fall‑prevention movement intervention is a specialised programme with exercises and training to reduce fall risk. This form of physiotherapy aims to improve balance, coordination and strength. By doing specific exercises, muscles can strengthen and confidence in one’s own body can be restored (Savvakis, European Geriatric Medicine, 2024). An example of such a training programme is the Otago exercise programme (OEP), developed by the New Zealand Falls Prevention Research Group. This protocol can be performed at home in collaboration with a physiotherapist (Campbell, BMJ 1997; Campbell, Age and Ageing 1999).

2. Cognitive behavioural therapy

Cognitive behavioural therapy can increase confidence in one’s abilities, help set realistic goals, and support integrating exercises into daily life. It can also teach you to deal with fear of movement by reframing the brain’s negative associations with movement (Lenouvel, Cochrane Database Syst Rev. 2023).

3. Home modifications

At home, you can make changes to reduce fall risk—such as removing throw rugs that may cause tripping and installing grab bars to hold on to. Technical aids like a personal alarm, a GPS tracker or Bike Labyrinth can also help you move in a controlled way.

4. Support from loved ones

Support from friends, family and peers is also essential in overcoming fear of movement. Ask someone you trust to move with you for the first few times. A short walk, or a route on Bike Labyrinth: moving together builds connection, sparks conversation, and lowers the threshold to get moving.