It's been a rough few months for Pat Robinson Schmidt.

Although she doesn't consider herself "a slip-and-fall person," Schmidt already has tumbled twice on the ice, including when she was on the way to buy nonslip shoes.

"I wouldn't say I'm terrified, but I'm always worried," said Schmidt, 59, of St. Louis Park.

That's understandable.

Over a five-year period ending in June, 89 percent of claims filed with the state for outdoor falls came between October and April. Nationally, falls are one of the leading causes of injuries treated in emergency rooms, according to the National Safety Council, with almost 9 million in 2012.

A winter such as this only makes things worse. After starting with an early-December storm that deposited an icy base, the season's treacherous thaw-and-refreeze cycle only promises to continue.

Falling is one thing. Recovering from the psychological effects is every bit as slippery.

Being wary of ice is "a healthy adaptive response," said Kent Smallwood, senior clinical psychologist at Hennepin County Medical Center. "I want to be scared if a grizzly bear is running at me, just as I want to be scared when I'm walking on slippery ice."

But sometimes, he added, that fear can overwhelm us, making us afraid to go outside, keeping us virtual prisoners in our homes until snowmelt.

It's important to "have a realistic appraisal of danger," said Chris Vye, chair of the University of St. Thomas' graduate school of professional psychology. After a tumble, worried walkers need to "return to a state where they are comfortable facing the risks that come with daily life," said Vye.

Pride goes with the fall

Don Darling, owner of Physical Therapy Orthopedic Specialist Inc., said he frequently has to repair brains as well as bones.

"If they've slipped and fallen one time, they are so nervous," Darling said. "It almost sets them up for another injury, because they're not relaxed, they're stiff. Or they just won't go outside."

In many cases, that's because the fall also wounded their pride.

Tracy Fausone-Hartjen 36, of Vadnais Heights has multiple sclerosis, but her apprehension "is more emotional than physical," especially after she tumbled into a parked vehicle outside her daughter's dance school last year.

"It was devastating to my daughter and embarrassing for me," said the mother of two. "Now falling on ice terrifies me. … When it gets extremely cold, snowy and/or icy, I stay home and my mother takes the kids to their activities. But if there's somewhere I have to go, I still go, like a dance performance for my daughter or a choir concert."

This dread seems to grow as we age. Our sense of balance starts slipping in our 20s, and can be quite shaky by the time we reach our "golden years."

"Older people have underlying balance problems and vision problems so they don't see the ice," said Dr. Jacqueline Geissler, an orthopedic and hand surgeon at Hennepin County Medical Center. "Also, as we age we tend to have less bone in our bone, so we're more at risk. All the bones are at risk."

Rx: 'a corrective experience'

That might help explain why an avid curler became "a real sissy."

Michelle Christianson, 63, of St. Paul, had both hips replaced last summer and spent November and December steering clear of her favorite pastime and avoiding all nonessential trips outside.

"I was a mess," Christianson said.

Many Minnesotans "gear up" and change how, where and when they walk.

Christianson said she "had to do what I used to call 'walking like a goat.' " Fausone-Hartjen's cane "has a device like an ice pick and I use that and just walk like a snail." Schmidt said "walking like a duck is helping," as are nonslip shoes.

The biggest key, Smallwood said, is to keep walking in winter — carefully.

And not to get complacent. Even when the weather starts to warm.

Last January, HCMC admitted 21 patients for injuries from falls. Two months later in March, that number doubled to 42.

Bill Ward • 612-673-7643