You walk past it every day, but you probably didn’t know this is a common place where people sprain or fracture their ankle.

Published: March 14, 2019 | Updated: March 10, 2023

It can feel like a scary world out there, with potential danger lurking around every corner. You may be diligent and on guard for hazards when you leave your home, but you could be missing one of the worst offenders right in your own home.

The last step.

That’s right, the step just before your feet land safely on the ground is a common place where people injure themselves from falling or taking a misstep.

Injuries caused by falling from the last step

Andrew R. Harston, M.D., orthopedic surgeon with Norton Orthopedic Institute, sees patients with injuries from falling from the last step nearly every day.

“The patients I see who experience this type of injury vary in age from teenagers to older adults,” Dr. Harston said. “They are likely so used to going down the stairs that they take their attention off what they’re doing. Many patients tell me they thought they were on the last step or they were holding something that kept them a little off balance when they fell.”

Sprained ankles to fractured bones

According to Dr. Harston, the most common injuries he sees from this type of fall are sprained ankles and foot or ankle fractures that may or may not need surgery.

“Patients usually experience a twisting injury when they fall from the last step because their foot is turned when they step on the ground,” Dr. Harston said. “The person’s entire body weight plus gravity put pressure on the twisted joint.”

When to seek treatment after a fall

A minor injury after falling from the last step may be treated at home with rest, icing the area, compressing the area with a wrap or bandage and elevating the injured foot. But you may need to seek treatment from your health care provider if there is significant pain and you’re unable to put weight on your foot.

An urgent or immediate care center can take X-rays of the area to determine if there is a bone fracture. According to Dr. Harston, if there is a fracture, surgery may be needed if the ankle joint is unstable or the fracture would not heal correctly without it.

Preventing foot and ankle injuries from the last step

According to Dr. Harston, there are things you can do to prevent this common foot and ankle injury:

• Pay attention when you’re walking, even in familiar places where you walk every day.
• Reduce your risk factors for fractures by losing weight and talking to your primary care provider about taking steps to improve your bone health.

“As the weather warms, people tend to be more active and spend more time outdoors,” Dr. Harston said. “It’s important that we all limit distractions when we’re walking and keep our attention on what we’re doing. Beware of your last step every time so it doesn’t become the scene of an injury.”