The risk of falling reportedly increases almost 2.5-times in those with lower extremity osteoarthritis (OALE) compared with age-matched controls. However, the mechanisms underlying the increased risk are not clear. The risk factors for falls in people with OALE found in the literature are mostly the same as the risk factors for people without OA LE. It is hypothesized that risk factors for falls are exacerbated by OALE, such that these individuals are more likely to become dynamically unstable and, once this has occurred, are less able to perform an appropriate compensatory stepping response compared with people without OA LE. To the extent that this is true, task-specific training targeting the compensatory step, which decreases falls in middle-aged and older women, should be effective for people with OALE. The purpose of the present review is to provide the rationale for the above hypothesis. Furthermore, the present authors present evidence that the fall risk of people with OA LE could be efficiently and effectively reduced using task-specific training previously shown to reduce falls in middle aged and older women. © 2012 Future Medicine Ltd.