How to Get In and Out of the Shower Safely

To get in and out of the shower safely, hold a fixed grab rail (never a towel rail or soap holder), step in and out slowly with your stronger leg leading, and sit down for the jobs that make you balance on one leg, like washing your feet. This matters because, according to the Australian Institute of Health and Welfare's report on falls injuries in Australia, the home was the most common place of fall injury for people aged 65 and over, and same-level slips, trips and stumbles were the most common cause of their fall hospitalisations. Good technique, the right equipment and a few simple exercises can all help lower that risk.

Below you will find the risky moments in a shower, a step-by-step routine, five exercises that build the strength and balance you need, and when to get an exercise physiologist involved.

Why is the shower such a tricky place to stay steady?

The shower combines almost everything that challenges balance. The floor is wet and soapy, you step over a hob or bath edge, turn in a small space and close your eyes to rinse your hair. Steam can also leave you light-headed.

Falls among older people are common enough that the AIHW found people aged 65 and over were hospitalised for falls about 12 times as often as adults aged 25 to 44. The good news is that the risky moments in the shower are predictable, so you can plan for each one.

The risky moments in the shower, and what helps

Here are six points where people often lose their footing, and what targets each one.

Risk point	Why it is risky	Strategy or exercise that helps
Stepping over the shower hob or bath edge	You stand on one leg for a moment while lifting the other foot high	Hold a fixed grab rail; practise step-overs and single-leg stance
Wet or soapy floor	Less grip means a small slip can turn into a fall	Non-slip mat or treatment inside the shower; rinse soap away from your feet
Turning around	Small shuffling turns in a tight space can tangle your feet	Turn in small steps while holding the rail; practise side steps
Closing your eyes to wash your hair	Your balance relies heavily on vision, so closing your eyes removes a key cue	Sit on a shower chair, or tilt your head back with one hand on the rail
Reaching down to wash your feet	Bending forward on one leg shifts your weight past your base of support	Sit down and use a long-handled sponge; practise sit to stand
Stepping out onto a bath mat	Wet feet on a mat that can slide on tiles	Use a rubber-backed mat, step out slowly and hold the rail; practise heel raises for ankle strength

A step-by-step routine for getting in and out

Using the same routine every time means fewer decisions while you are wet. Try this order:

1. Get everything ready first: towel within reach, shampoo and soap on a shelf at waist height, non-slip mat in place.
2. Check the water temperature with your hand before you step in. Very hot water can make some people feel faint.
3. Hold a fixed grab rail with one hand. Never use a towel rail, soap holder, screen door or tap to take your weight. They can pull out of the wall.
4. Step in with your stronger leg first, then bring the other leg in. Lift your foot clearly over the hob or bath edge rather than sliding it.
5. If you have a shower chair, sit down once you are in. Wash your hair and feet while seated.
6. When you finish, turn the water off, wait a moment and let any light-headedness settle.
7. Hold the rail, step out with your stronger leg, and plant both feet on the mat before you reach for your towel.
8. Dry your feet while sitting on the chair, the closed toilet lid or a stable stool, not while standing on one leg.

If you shower over a bath, the step is much higher. A bath board or transfer bench (you sit, then swing your legs over) is often safer than stepping in standing up.

Equipment that makes the shower safer

Helpful equipment includes:

• Fixed grab rails where you step in, stand and step out, properly fixed into the wall.
• A shower chair or stool with non-slip feet for washing your hair and feet.
• A hand-held shower head for washing while seated.
• Non-slip mats or floor treatment inside the shower, and a rubber-backed mat outside it.
• A long-handled sponge so you do not bend to your feet.

An occupational therapist (OT) is the right person to advise where rails go and what equipment suits your bathroom, and your GP can help arrange this. An exercise physiologist complements that advice by building the strength and balance to use it well.

Five exercises for safer showering

These exercises target the movements the shower asks of you. Do them at your kitchen bench or a sturdy chair on most days. If you have a heart, lung, joint or bone condition, check with your GP or an exercise physiologist before starting. Stop if you feel dizzy, short of breath, have chest pain or feel unsteady, and sit down.

1. Side steps

These help you move and turn in a tight space.

1. Stand facing your kitchen bench, both hands resting on it.
2. Step one foot out to the side, then bring the other foot to meet it.
3. Take 5 steps one way, then 5 steps back.

Reps: 2 to 3 lengths each way.

Easier: take smaller steps and keep both hands on the bench.

Harder: use just your fingertips, or take bigger steps.

Safety tip: keep your toes pointing forward and do not cross your feet.

2. Single-leg stance at the bench

This builds the one-leg balance needed to step over the hob.

1. Stand side-on to the bench, holding it with one hand.
2. Lift the outside foot just off the floor.
3. Hold, stand tall and breathe normally.
4. Lower the foot, then turn around and do the other side.

Holds: 10 to 20 seconds, 3 times each leg.

Easier: hold with both hands, or just lighten one foot rather than lifting it.

Harder: rest only a fingertip on the bench, or hold for longer.

Safety tip: always keep the bench within easy reach, and stop before you get wobbly.

3. Heel raises

Strong ankles help you recover from a small slip.

1. Stand facing the bench with both hands on it, feet hip-width apart.
2. Rise slowly up onto your toes.
3. Pause at the top, then lower your heels slowly.

Reps: 10 to 15, 2 sets.

Easier: rise only a little way.

Harder: slow the lowering down to a count of three, or do them on one leg.

Safety tip: keep your weight over your big toes rather than rolling out to the little toes.

4. Step-overs

This rehearses stepping in and out of the shower.

1. Place a folded towel or a rolled-up yoga mat on the floor next to your bench.
2. Holding the bench, lift one foot clearly over the towel and place it down on the other side.
3. Bring the second foot over to join it.
4. Step back over, leading with the same leg, then swap the leading leg.

Reps: 5 to 8 step-overs leading with each leg.

Easier: use a flat towel so the obstacle is lower.

Harder: use a slightly higher obstacle, such as two folded towels.

Safety tip: use something soft that will not trip you if you clip it.

5. Sit to stand

This builds the leg strength to rise from a shower chair or toilet.

1. Sit near the front of a sturdy chair, feet flat and slightly back.
2. Lean forward a little, so your nose is over your toes.
3. Push through your heels and stand up tall.
4. Sit back down slowly and with control.

Reps: 8 to 12, 2 sets.

Easier: use your hands on the armrests or sit on a higher chair.

Harder: cross your arms over your chest, or lower more slowly.

Safety tip: make sure the chair cannot slide, for example by placing it against a wall.

For a broader program that builds on these, our falls prevention and balance training service tailors exercises to your own needs.

Tips for carers and family

If you help a parent or partner shower, let them do as much as they safely can, because doing it keeps them strong. Stand on their weaker side, and make sure a fixed rail, not you, is their main support.

Keep the bathroom door unlocked, or agree on a way to call for help. If your mum or dad starts skipping showers or seems anxious about the bathroom, a check-up is worthwhile.

When to see an exercise physiologist

It is worth getting help if you notice any of these:

• You have had a fall or a near miss, in the shower or anywhere else.
• You need to hold on to something to step over the hob or bath edge.
• You feel unsteady when you close your eyes or turn around.
• Getting up from a low chair or the toilet takes a few attempts.
• You have started avoiding the shower or worry about falling in it.

If you have a fall and hit your head, cannot get up, or feel sudden dizziness or weakness, seek medical help straight away and talk to your GP before returning to exercise.

At Summit Health Group, a falls risk and balance assessment looks at your strength, balance, walking and the movements you find hard. Your exercise physiologist then builds a program around them. You can see us at our Malvern and Blackburn clinics, or we can come to you. A home visit with an exercise physiologist means we can watch how you move in your own bathroom and practise the exact steps that feel risky, alongside any advice you get from your OT.

If getting in and out of the shower has started to feel uncertain for you or someone you care for, book an assessment with our team and we will help you feel steadier on your feet.