Researchers from Johns Hopkins University found that traumatic brain injuries (TBIs) were the second most common injury among adults.

The other most common injuries were finger fractures and a shoulder sprain or strain.

The study revealed that those aged 65 and older were more likely to sustain serious injuries than others from different age groups - more than three times more likely to fall and more than twice as likely to have a fracture.

Researchers also found that women with injuries related to dog walking were 50% more likely to sustain a fracture than men.

Injuries that happened the most were down to the patient falling after being pulled, tangled in or tripped by the leash connected to a dog they were walking.

The 20-year study noted that injuries increased by a huge amount over the time period and researchers think this may be due to the rise of dog owners.

'We also strongly encourage people to leash their dogs'

The team hopes its findings will promote awareness among dog owners and encourage doctors to discuss the possible injuries linked to dog walking.

Senior author Edward McFarland said: "Clinicians should be aware of these risks and convey them to patients, especially women and older adults.

"We encourage clinicians to screen for pet ownership, assess fracture and fall risk, and discuss safe dog walking practices at regular health maintenance visits for these vulnerable groups.

"Despite our findings, we also strongly encourage people to leash their dogs wherever it is legally required."

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Ridge Maxson, the study's first author, added: "Dog ownership also increased significantly in recent years during the COVID-19 pandemic.

"Although dog walking is a common daily activity for many adults, few studies have characterised its injury burden. We saw a need for more comprehensive information about these kinds of incidents."

This study was published in the National Library of Medicine.