Walking your dog may help you reach your exercise goals, but it could also increase your risk of injury.

“In the past couple of years, we're seeing an exponential increase in people falling while walking their dogs,” Dr. Mark Cohen, an orthopedic surgeon at Rush University Medical Center in Chicago, said.

Common dog walking injuries include broken wrists, elbows and fractured hips.

“We frequently see these dog walking related injuries in the emergency room,” Dr. John Torres, NBC News medical correspondent and emergency room physician, said. “They involve them getting tangled in the leash or trying to avoid stepping on their dog and usually result in fractures to the wrist and forearm, but it’s not unusual to see someone with a hip fracture from falling during a dog walk.”

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A hip fracture can be a life-altering injury. At least 1 in 4 older adults dies within one year of breaking a hip, according to previous research.

People most at risk are women over the age of 65, according a University of Pennsylvania Medicine study published Wednesday in JAMA Surgery. The study looked at government data on emergency room visits and found hip fractures were the most common injury associated with dog walking, followed by wrist and upper arm fractures. The numbers nationwide jumped from almost 1,700 in 2004 to about 4,400 in 2017.

Almost 80 percent of the patients were women, who tend to have less dense bones than men. The rise in injuries is due to increased pet ownership and older people being more active.

Injuries typically happen when a dog pulls on a leash and walkers lose their balance.

At the same time, many people say walking their dogs has helped with weight loss, and walking can help save your life.

How to walk the dog safely

Don’t wrap the leash around your hand or wrist.

Use a retractable leash.

Take your dog to obedience school.

Pay attention. Don't text and walk.

People often don't perceive danger while with a dog, so it's important to pay attention, Cohen said.

“You can’t be on your cell phone,” he said. “You have to be careful, especially if there’s snow or ice.”

The Associated Press contributed to this report