Watch Fall Detection didn't work (all setting checked)

Fall detection can't detect all falls. Sometimes you might fall in a way your Apple Watch doesn't see the movements like a sudden hard stop which indicate a fall, for example your watch-wearing arm lands gently on top of you, or it grabbed some support on the way down and landed more gently. On other occasions it might get a false positive, for example while using a hammer or chopping wood where the motion mimics a fall.

The best you can say is that the fall detection increases the probability you will get help after a fall, but it is not possible to identify every event.

I took a hard fall on the hand my watch was on. Going to get X-rays for possible broken ribs. Very disappointed. I felt secure with it on. Sometimes if I hit the counter hard it asks if I fell. Not sure why it did not pick this up. All settings checked