President Joe Biden took a leisurely bike ride in his home state of Delaware and as he came to a stop to greet supporters, he fell awkwardly on his right side. As an orthopedic surgeon, I know that this is the type of dangerous fall in which the elderly can easily break their hip.

Fortunately, President Biden appears to be okay as he indicated, "I’m good".

President Biden falls off bike

US President Joe Biden falls off his bicycle as he approaches well-wishers following a bike ride at Gordon's Pond State Park in Rehoboth Beach, Delaware, on June 18, 2022. - Biden took a tumble as he was riding his bicycle Saturday morning, but was unhurt. (Photo by SAUL LOEB/AFP via Getty Images)

As a sports medicine expert and orthopedic surgeon, I also analyze video for injuries at Sports Injury Central. Although this bike "accident" is not pure sports, the clear video is amenable to analysis.

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This type of spill could happen to anyone. Due to inertia, falling is certainly easier at slower speeds. Think back as you learned or taught your children how to ride a bike. It is hard to keep balance at very slow speeds. Biden places his left foot down for balance as he stops. As he shifts his weight to the right side, his foot gets caught in the toe cage attached to the pedal and he can’t get his right foot down in time. Thus, he tumbles onto his right side/hip. The video does not show how he lands. Perhaps he was able to react quickly enough to brace his fall and thus avoid hip fracture.

President Biden falls off bike

US President Joe Biden rides his bicycle at Gordon's Pond State Park in Rehoboth Beach, Delaware, on June 18, 2022. - Biden took a tumble as he was riding his bicycle Saturday morning, but was unhurt.  (Photo by SAUL LOEB / AFP) (Photo by SAUL LOEB/AFP via Getty Images)

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Biden does seem to have reasonably strong bones since he avoided a break. Hip fractures are more common in elderly women due to osteoporosis. He does seem to have age appropriate reaction time, but at age 79, no one is as facile as they once were.

President Biden falls off bike

US President Joe Biden falls off his bicycle as he approaches well-wishers following a bike ride at Gordon's Pond State Park in Rehoboth Beach, Delaware, on June 18, 2022. - Biden took a tumble as he was riding his bicycle Saturday morning, but was unhurt. (Photo by SAUL LOEB/AFP via Getty Images)

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This may come as a surprise, but the mortality rate in people over 50 in the first year after a hip fracture is approximately 1 in 3, even with surgical fixation and the latest medical advances. Of course with increased age and co-morbidities, that rate is even higher. Many of us have first-hand experience with our grandparents or parents.

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The bottom line is that Biden was lucky to have avoided a hip fracture, which is a very serious injury.