Hip protectors are padded shorts designed to absorb impact force during a fall. The concept is straightforward. The evidence is more complicated — and so is getting Canadians to actually wear them.
Hip protectors are built into fitted undergarment shorts with padding over the greater trochanter — the bony prominence on the outer side of the hip. There are two mechanical designs:
The target is the trochanteric region. Most hip fractures in older adults are femoral neck or intertrochanteric fractures that initiate when the greater trochanter impacts a hard floor during a sideways fall. Redirecting or absorbing that force at the point of impact is the protective mechanism. Hip protectors don't prevent falls — they change what happens when you hit the floor.
The 2014 Cochrane review by Santesso et al. (PMID 24218376) pooled 14 randomized controlled trials covering 11,001 participants. In nursing home and long-term care residents, hip protectors reduced hip fracture risk with a relative risk of 0.82 (95% CI 0.72–0.94) — a statistically significant 18% relative risk reduction. The certainty of evidence was moderate.
In community-dwelling older adults, the same Cochrane review found no statistically significant reduction in hip fracture risk (RR 1.16, 95% CI 0.84–1.60). This is a striking difference from the institutional setting, and the explanation is largely adherence — community-dwellers simply wore the protectors far less consistently than residents with staff reminders and assistance.
Adherence studies in hip protector trials consistently show non-compliance rates of 40–60% in community settings. In some trials, over half of participants had stopped wearing their hip protectors by 6 months. The reasons are well-documented:
Institutional residents have a structural advantage: nursing staff can assist with donning the garment, provide consistent reminders, and monitor wear. Community-dwelling individuals — who may live alone or receive limited home care — lack that support structure. This is why the institutional benefit is real and the community benefit is largely theoretical in practice.
Hip protectors have the clearest benefit-to-cost ratio for:
For an independently mobile community-dwelling 68-year-old with a T-score of -2.3 and no fall history, hip protectors are a lower priority than fall prevention programs, medication review, and exercise. The adherence challenge makes them most useful for those at highest acute risk with support structures to encourage consistent wear.
Two brands dominate the evidence base and Canadian market:
| Brand | Type | Price (CAD) | Where to Buy |
|---|---|---|---|
| Safehip Active | Soft/energy-absorbing | ~$90–120 | Shoppers Home Health Care, Amazon.ca |
| Safehip Original | Hard-shell/energy-shunting | ~$120–160 | Shoppers Home Health Care, Amazon.ca |
| Tytex Safehip AirX | Soft/breathable foam | ~$80–100 | Amazon.ca, medical supply retailers |
| Tytex Suprima | Soft foam, multiple models | ~$70–110 | Home Depot (medical section), Amazon.ca |
Safehip (manufactured by Tytex, a Danish company) has the strongest evidence base — several of the positive Cochrane trials used Safehip devices specifically. The hard-shell design has more evidence than soft-foam designs for actual fracture prevention, though it's less comfortable for daytime wear.
Hip protectors are not covered by any provincial drug plan, including OHIP. They are not a listed benefit under the Ontario Assistive Devices Program (ADP). Some extended health benefit plans classify them as durable medical equipment (DME) and provide partial or full reimbursement — check your specific plan's DME coverage and whether a physician letter of medical necessity is required. This is variable across insurers.
The out-of-pocket cost of $80–160 CAD per garment is modest relative to the cost of a hip fracture — Ontario Health estimates the acute care cost of a hip fracture at over $30,000. The barrier is not price; it's adherence.
Research on adherence interventions points to a few strategies that actually work:
Hip protectors are a last line of defence — they intervene at the point of impact after a fall has already occurred. Preventing the fall itself has higher leverage. Osteoporosis Canada and the Canadian Falls Prevention Curriculum recommend a multifactorial approach that consistently outperforms any single intervention:
Fall-related hip fractures cost the Ontario health system an estimated $650 million annually in acute care, rehabilitation, and long-term care costs. Ontario Health Teams (formerly LHINs) fund fall prevention programs at no cost to patients in many regions — including group balance classes, home safety assessments, and physiotherapy referrals. Check with your Ontario Health Team or ask your family physician for a referral to a falls prevention program.
Some Ontario hospitals with designated fracture liaison services (FLS) — a nurse coordinator model for patients who've already had a fracture — automatically assess fall risk and can refer to community fall prevention programs as part of secondary fracture prevention. If you or a family member has had a fracture, ask the treating hospital whether they have an FLS.