By Dr. Lisa Smith, PT, DPT
There are many reasons why someone may decide to reach for a walking aid. Maybe you are feeling a little off balance or unsteady when you are walking on uneven ground, maybe you have an injury to one of your legs and you are trying to decrease weight through that side, or maybe you don’t have the same walking endurance that you used to. Regardless of the reason, many walking aids are available over the counter which means someone may start incorporating one without consulting a medical professional.
At Optimal Physical Therapy, we believe education is key to preventing falls, minimizing strain, and promoting optimal recovery. Here’s what you need to know:
Single Point Cane
When it might be appropriate:
- Slight imbalance where light assistance is sufficient
- Discomfort in one leg that improves with slightly decreasing weight on that side
- Limp that resolves with light assistance
Proper use guidelines:
- For imbalance: usually better in your dominant hand but whichever feels more natural
- For off-loading: contrary to what you may think and what is shown on TV (e.g. the main character in the show, House), best off-loading occurs when you use the cane in the opposite side of your injury as your body will naturally lean toward the cane
Proper fit:
- With arm at your side, the top of the cane should hit at your wrist crease
Walking Poles
When it might be appropriate:
- Slight to moderate imbalance especially on uneven surfaces
- To improve upright posture with walking
- To improve walking speed and endurance
Proper use guidelines:
- For balance: Move the pole on the opposite side of your stepping foot, similar to a natural arm swing.
- For propulsion: Use a Nordic walking technique, planting the pole behind you and pushing off for forward momentum
Proper fit:
- Elbow should be at 90 degree angle when the pole tip touches the ground next to your foot, if using for imbalance
- Grip: slip your hands through the wrist straps and avoid gripping too tightly
Terrain awareness: Use rubber tips on pavement and remove them to reveal carbide tips on trails or snow for better grip.
Crutches
When it might be appropriate:
- Leg injuries or surgeries when you need to reduce or eliminate weight bearing on one leg
- Types
- Axillary (underarm) crutches: common for short-term use
- Forearm (Lofstrand) crutches: better for long-term users
Proper use guidelines:
- Non-weight bearing: move both crutches together and swing affected leg forward keeping it off the ground, push down through hand grips and swing good leg forward between crutches
- Partial weight bearing: advance both crutches and affected leg together, step through with good leg
- Always put weight through handgrips, not armpits to decrease risk of nerve damage
- Keep crutches close to your body to maintain balance
Proper fit:
- Top of the crutch should be about 1.5–2 inches (2–3 fingers) below your armpit
- Hand grips should allow for a 20–30 degree bend in your elbow when you hold them
Walker
When it might be appropriate:
- Offers the most support of these devices and are ideal for people recovering from lower limb surgery, those with balance issues, or generalized weakness
- Types
- Standard Walker – No wheels; must be lifted to move.
- Front-Wheeled Walker – Easier to push without lifting.
- Four-Wheeled Walker (Rollator) – Includes brakes and a seat; best for those with impaired endurance
Proper use guidelines:
- Standard Walker: Pick it up, place it a step ahead, then step in with your weaker leg in line with back leg of the walker followed by your stronger leg
- Wheeled Walker: Push it forward gently as you step in, making sure all legs are stable before shifting weight and keep body in line with back legs
- Standing up from a surface: Back up until your legs touch the chair, lock the walker (if present), reach back with one hand at a time to grab the chair arms, lower or raise yourself slowly without using the walker for leverage.
Proper fit:
- When standing inside the walker, the handles should be at wrist level
General Safety Tips for All Mobility Aids
- Check the rubber tips regularly for wear to prevent slipping.
- Clear your pathways at home—remove rugs, cords, and clutter.
- Wear supportive footwear to enhance stability.
- Practice in a safe environment, preferably with supervision at first.
- Consult your physical therapist if anything feels off
Why Fit Makes or Breaks Your Walking Aid
Walking aids can be life-changing tools when used correctly. But like any tool, improper use can lead to poor posture, muscle strain, or even falls. If you’ve been prescribed or advised to use walking poles, crutches, or a walker, don’t just grab them off the shelf—take time to get fitted properly, learn the technique, and check in with your physical therapist regularly.
At Optimal Physical Therapy, we offer one-on-one training to ensure you’re using your device safely and effectively. Whether you’re climbing mountains with poles or navigating your home with a walker, our goal is to keep you moving forward—safely and confidently.
Need help choosing or using a mobility aid? Contact us today at 920-648-2400 to schedule an evaluation with one of our expert doctors of physical therapy.
