Leash-related injuries: what 422,659 US emergency department visits reveal
Published by Planète Pets · managing editor: Clément Lacaille · how our guides are written
A leash protects the dog and bystanders, but it also regularly injures the person holding the other end. A study published in 2023 by Maxson, Leland, McFarland, Lu, Meshram and Jones in Medicine & Science in Sports & Exercise quantifies this risk across the United States over twenty years. Our other guidance is gathered in the dog travel and safety section.
Contents · 5 sections
A national hospital database, not a survey
The authors used NEISS, the US emergency-department injury surveillance system, to identify adults admitted between 2001 and 2020 for a leash-walking-related injury. Unlike a self-reported survey, these figures rest on real medical records — with the opposite limitation: an incident that never reached the emergency department is not counted.
422,659 adults in twenty years, a fourfold rise in incidence
Over the period studied, an estimated 422,659 adults presented to emergency departments for this reason, and annual incidence more than quadrupled, from 7,282 cases in 2001 to 32,306 in 2020. Women make up 75% of those injured, and 47% are aged 40 to 64 (mean age: 53). The dominant mechanism is a fall caused by the leash pulling or tripping the walker (55% of cases), with an upper-limb injury in 51% of cases. The three most common injuries are finger fracture (6.9%), traumatic brain injury (5.6%) and shoulder sprain/strain (5.1%). Fracture risk is significantly higher in people aged 65 or over (odds ratio 2.1) and in women (odds ratio 1.5).
Children too, with a different profile
A companion study published in 2024 by Maxson, Leland, Meshram, Goldfarb, Okeke and McFarland in the Journal of Pediatric Orthopaedics, built on the same NEISS database, puts the number of children aged 5 to 18 admitted to emergency departments for this reason over the same period at 35,611. Mean age is 11, 63% of those injured are girls, and 55% of injuries are orthopaedic. Notably, among children it is the youngest (ages 5-11) and boys who show the most serious injuries — fractures or traumatic brain injuries — a risk profile that is the reverse of what is seen in adults.
What these figures change in practice
Neither study tests a solution — they measure a risk, not its remedy. But the mechanism identified (a fall from a sudden pull) matches what a biomechanical study on the pulling force a dog exerts on a leash shows, which we detail in our article on leash pulling force and walker balance. Wrapping the leash around a wrist, holding it taut near a kerb, or letting a child walk a strong-pulling dog alone are situations that, on this evidence, visibly concentrate the risk.
Frequently asked questions
Does a retractable leash reduce this risk?
This study does not compare leash types against each other: it measures the overall volume of injuries across all models. The fall mechanism it documents remains relevant whatever type of leash is used.
Why are older people more at risk of fracture?
The study does not test the cause, but bone fragility becoming more common after age 65 makes an identical fall more likely to result in a fracture, which matches general data on fall risk in seniors.
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An accessory from our shop for this use: Adjustable dog car seat belt tether ($21.90, ships from the US) · the US shop
This guide is part of Planète Pets’s Dogs universe. Our advice is general in nature: for any health concern, your veterinarian remains the only reference.