Rehabify
In brief
- A walking aid can make walking safer and help you stay active, but the wrong aid, or one at the wrong height, can raise the risk of a fall.
- A cane suits mild unsteadiness or pain in one leg. A walker suits poorer balance or weakness in both legs.
- A cane is usually held in the hand opposite the weak or painful leg, with the handle at wrist height.
- At Rehabify in Bengaluru, Dr. Dharshan N A, a physiatrist, checks balance and walking and advises on the right aid, its height and how to use it.
Do you need a walking aid at all?
Many older adults buy a walking stick from a shop, or use one handed down in the family, without a check. Others avoid one because they feel it makes them look old. Both can be risky.
A walking aid may help if you:
- Hold walls or furniture to move around the house
- Feel unsteady when turning, on uneven ground or in crowds
- Have fallen, or nearly fallen, in the last year
- Have pain or weakness in one leg that makes you limp
- Are recovering from a stroke, a fracture or joint surgery
- Tire quickly and need to stop and rest when walking
You may not need one if you walk steadily, can turn and step over objects safely, and have had no falls. In that case, strength and balance exercise is often more useful than an aid. A walking aid is not a reason to stop exercising. Many people use an aid for a while, build strength and balance, and later need it less.
The main types
- Single-point cane (walking stick). For mild unsteadiness, or pain in one hip or knee. Light and easy to carry.
- Quad cane. A cane with four small feet at the base. It stands on its own and gives more support. Often used after a stroke, when only one hand can hold an aid.
- Walker (frame) without wheels. Gives much more support. You lift it, move it forward, then step into it. Suits poor balance or weakness in both legs, but walking is slower.
- Wheeled walker (rollator). Two or four wheels, so you do not need to lift it. A four-wheeled walker often has brakes and a seat. It suits people who need support but walk at a steadier pace, and needs good hand control for the brakes.
- Crutches. Usually used for a short time after an injury or surgery, when weight on one leg must be limited.
How a cane should be sized
A cane at the wrong height makes you stoop or lifts your shoulder, and can make you less steady.
- Wear your usual shoes and stand up straight.
- Let your arms hang loosely at your sides.
- The top of the cane handle should reach the crease of your wrist.
- When you hold the handle, your elbow should be slightly bent, about 15 to 30 degrees.
Adjustable canes have a push button to change the height. A wooden stick can be cut to length by a trained person. Check that the rubber tip is in good condition and replace it when worn, because a smooth tip can slip on wet floors. The same height rule applies to the handles of a walker.
Which hand holds the cane
Hold the cane in the hand opposite the weak or painful leg. If your right knee hurts, hold the cane in your left hand.
This matches the natural swing of the arms and takes weight off the painful side. Move the cane forward at the same time as the weak or painful leg, then step through with the stronger leg.
After a stroke, the cane is held in the stronger hand, which is also on the side opposite the weak leg.
Using stairs with a cane
A simple rule: up with the good, down with the bad.
- Going up: hold the handrail, step up with the stronger leg first, then bring up the weaker leg and the cane.
- Going down: put the cane down first, then the weaker leg, then the stronger leg.
Always use a handrail when there is one. Take one step at a time.
Walking aids after a stroke
After a stroke, the choice of aid changes as recovery progresses. Early on, a walker or quad cane may give the support needed to walk safely. Later, some people move to a single cane, or walk without an aid. An ankle splint may also help if the foot drags. A physiatrist and physiotherapist review this regularly, so the aid supports recovery and does not hold it back.
How Rehabify helps
Dr. Dharshan N A examines strength, balance, joints and walking, including how you get up from a chair and turn. If an aid would help, the doctor advises the type and height and how to use it at home, on stairs and outdoors. Bring your current stick or walker to the visit so it can be checked.
When to get help urgently
Common questions
Will using a walking stick make my legs weaker?
Not if you keep active. An aid helps you walk more, and walking more keeps legs stronger. Weakness is more likely if fear of falling keeps you at home. Combine the aid with a strength and balance programme, and the doctor will review whether you still need it over time.
Which hand should I hold my cane in?
Usually the hand opposite the weak or painful leg. If your left hip hurts, hold the cane in your right hand, and move it forward with the left leg. After a stroke, it is held in the stronger hand. A physiotherapist can watch you walk and correct the pattern.
How do I know if my cane is the right height?
Stand straight in your usual shoes with arms hanging down. The top of the cane should reach the crease of your wrist. When you hold it, your elbow should bend slightly. If you stoop forward or your shoulder rises, the height needs adjusting.
Should I choose a walker with wheels or without?
It depends on your balance, strength and how you walk. A walker without wheels gives the most stability but is slower. A wheeled walker suits a steadier walking pace and needs good hand control for the brakes. The doctor or therapist will advise after watching you walk.
Can I use a walking aid in the bathroom?
Walkers often do not fit in small Indian bathrooms, and a wet floor makes any aid less safe. Grab rails, a non-slip mat and a shower chair are usually safer there. Ask the doctor or therapist to plan how you move from the walker to the bathroom safely.
Sources
- [1]
American Academy of Orthopaedic Surgeons (AAOS). OrthoInfo patient information on how to use crutches, canes and walkers
- [2]
National Institute for Health and Care Excellence (NICE) guideline CG161. Falls in older people: assessing risk and prevention
- [3]
National Institute for Health and Care Excellence (NICE) guideline NG236. Stroke rehabilitation in adults, 2023
- [4]
World Health Organization (WHO). Step Safely: strategies for preventing and managing falls across the life-course, 2021
This guide is for general education and does not replace a consultation. Read how we write and review guides in our editorial policy.
