Compass is still being developed and is effectively in beta. Some content and features may be incomplete, change, or not work as expected.

Content is anchored to trusted sources where available, but Compass has not yet been clinically reviewed. It provides general information rather than medical advice.

Feedback helps us identify gaps, errors, usability problems and opportunities to improve Compass over time.

How Compass is developedGive feedback

Movement and muscles

Falls and unsteadiness

Trips, stumbles and falls, often because a weakening leg or foot no longer clears the ground reliably.

Still being checked

What this is

A foot that no longer lifts cleanly, or a leg that gives way, catches on thresholds, rugs and stairs, and that is why so much of what helps is about changing the environment and getting the right aid slightly earlier than it feels necessary. Falls can have other causes too, including dizziness and medicines, so it is worth telling your team what happened rather than assuming it was the weakness.

What people often describe

  • Catching a toe on a threshold, a rug edge or the stairs
  • A knee that gives way without warning
  • Feeling less confident on uneven ground or in the dark
  • Near misses that did not become falls, which are the ones worth reporting

Important distinctions

  • Foot drop is the word for difficulty lifting the front of the foot, so the toes catch. It is behind many of these trips, and moving about safely covers more than that alone.

  • Stiffness changes how you walk and can contribute to falls, but it is a different problem with different management.

What may help

This page lists options that are used for this problem and says where each one comes from. It is not a ranking, it is not a recommendation, and it is not personalised to you. What suits you is a decision for you and your care team.

Practical and self-management

Things people do themselves, or with whoever is helping them.

  • Changing what trips you at home

    Loose rugs, clutter, poor lighting, thresholds and unsupportive footwear are the things people actually trip on, and all of them can be changed.

    Highlighted: shows the sources for this statement

    Discuss with

    Compass explains

Allied health

What a therapist can assess, teach or adjust.

  • A home assessment

    A physiotherapist or occupational therapist can look at your home and say what to change and in what order, which is quicker than working it out yourself.

    Discuss with

    Compass explains

  • Pacing and energy conservation

    Falls cluster when you are tired. Spreading activity through the day and taking transfers slowly is part of preventing them.

    Discuss with

    Compass explains

Equipment

Devices and physical aids.

  • Walking aids

    A stick, rail or rollator, and the timing matters: an aid brought in early is doing prevention rather than catching up.

    Highlighted: shows the sources for this statement

    Discuss with

    Compass explains

  • Ankle-foot orthosis

    A brace that holds the front of the foot up, so it clears the ground. Many people with ALS/MND need one at some point.

    Highlighted: shows the sources for this statement

    Discuss with

    Compass explains

When to get this looked at sooner

A fall, or a fall causing injury, is one of the changes worth raising between appointments rather than waiting for the next one.

Highlighted: shows the sources for this statement

Who may help

Where Compass explains this

Questions

Cards

Other problems

Words explained

About this page

This page lists options that are used for this problem and says where each one comes from. It is not a ranking, it is not a recommendation, and it is not personalised to you. What suits you is a decision for you and your care team.

Evidence for this page

The sources behind the statements on this page, and where to find them. Compass does not decide which option is right for anyone.

  1. Statement 1 of 4. Loose rugs, clutter, poor lighting, thresholds and unsupportive footwear are the things people actually trip on, and all of them can be changed.

    • Supports this. NEALS PT/OT guide — NEALS · Practical guide

      A physical and occupational therapy guide for ALS states plainly that preventing a fall is the best available treatment for one.

      In the case of falling, prevention is the best treatment.

      FALL PREVENTION

      Link checked August 2026

  2. Statement 2 of 4. A stick, rail or rollator, and the timing matters: an aid brought in early is doing prevention rather than catching up.

    • Supports this. Mobility and ALS — Your ALS Guide · Practical guide

      A practical guide on mobility in ALS makes the timing point directly: the right device at the right time helps prevent falls and the injuries that follow them.

      Getting the right device at the right time can help prevent falls and avoid injuries that could lead to additional complications.

      Mobility and ALS

      Link checked August 2026

  3. Statement 3 of 4. A brace that holds the front of the foot up, so it clears the ground. Many people with ALS/MND need one at some point.

    • Supports this. Guidelines for the physiotherapy management of MND — Irish Motor Neurone Disease Association · Clinical guideline · 2014

      An MND physiotherapy guideline states that many patients will require an ankle-foot orthosis.

      Many patients will require an ankle foot orthosis (AFO).

      Section 3.4b.1 Recommendations, item M

      Link checked August 2026

  4. Statement 4 of 4. A fall, or a fall causing injury, is one of the changes worth raising between appointments rather than waiting for the next one.

    • Supports this. NICE MND guideline — NICE · Clinical guideline

      Republished from the Compass answer "How do I know when to ask for help?", where this statement is already mapped to this source.

      Ensure arrangements are in place to trigger an earlier multidisciplinary team assessment if there is a significant change in symptoms identified by the person, family members and/or carers (as appropriate), or healthcare professionals.

      1.5.7

      Link checked August 2026