Adapting to using a walking aid

THERE are many reasons why you might need a walking aid, and many types of aid to choose from, but whatever type you have you'll need to adapt to using it safely and correctly.

If you are injured in an accident or recovering from a medical procedure, you might be issued with a walking aid to help you get around while you recover, usually on a temporary basis. If this happens to you, then whoever issues the walking aid (usually a physiotherapist or other medic) should set it up to meet your specific needs and show you how to use it properly.

In most cases the walking aid will be crutches or a walking stick, but in some cases it could be a walking frame, either with or without wheels. If your recovery is lengthy you might go from one type of walking aid to another as you get better, for example, from a frame to crutches to a walking stick. At each stage, your physiotherapist should show you how to use each piece of equipment.

However, many people choose their own walking aid – typically beginning with some sort of walking stick – as they grow older, less mobile or just need a little extra help and reassurance in getting around. If this is the case, it’s important to get a few basics right. Let’s look first at walking sticks and canes, since this is the aid you’re most likely to ‘self-prescribe’:

Many people begin using a cane or stick occasionally, when they feel the need. For example, you might need one if you’re going out for the day, if you know you’ll be standing for a long period, if a condition such as arthritis is ‘flaring up’, or if you’re going to be walking ‘off the beaten track’. Some people who don’t normally need a cane will use ‘walking poles’ on a country walk.

If you’re choosing a cane, the most important thing is to make sure it’s the right length. There are many types of cane available, including handy folding versions, and lots of them are adjustable for height. If you choose a more traditional wooden cane, you may need to cut it to the right length. Remember you should use a cane on the opposite side to your injury or weakness, so if your left leg is affected, you should use the cane in your right hand, and vice versa. This helps to promote an upright posture and natural walking pattern (gait).

To adjust a walking stick to the right height, stand wearing your regular footwear with your arms hanging loosely at your sides, with a slight natural bend at the elbow. Now get someone to measure the distance between the floor and the crease of your wrist on the side that you’ll be using the stick; this measurement is the correct length for your stick.

If using an adjustable stick, choose the closest setting. If using a wooden stick, cut it to length but remember to account for any rubber ferrule you are fitting to the end. Another way with a wooden cane or stick is to stand as above then turn the stick upside down with the handle on the floor and mark the shaft where it meets the crease in your wrist. Again, don’t forget to account for the ferrule before cutting.

Another important feature to consider is the type of handle for your walking stick. There are many types and materials available, from a traditional curved ‘crook’ handle to a T-grip, ‘derby’ handle, or an anatomically contoured left or right-handed grip for maximum comfort and support. If you can, visit a store with a good selection of sticks and try several types to see which suits you. You might also be surprised at the attractive designs of many modern sticks, making them as much a fashion accessory as a walking aid. You could soon end up with several canes for different occasions!

If you need to use two walking sticks, even on a temporary basis, it is recommended to seek professional advice from a physiotherapist on the most suitable pattern of use to meet your needs. The same advice goes for using crutches, whether the shorter forearm (lofstrand) type or the full-length underarm (axillary) crutches. Both types should be adjustable in two ways; for the overall length and the position of the hand grip.

The way you use your crutches will depend on why you need them. For example, you might have an injury which means you can’t bear any weight at all on one leg, or you might be able to walk almost normally, just using the crutches for extra stability and reassurance. This is why it’s essential to get professional advice.

The same goes for a walking frame, both for the type of frame you need and the correct way to use it. If you’re choosing a ‘rollator’ type – with wheels, hand-operated brakes and often incorporating a seat to rest on – you should make sure it is correctly adjusted to your height and that you have a strong enough grip to operate the brakes. If you’re buying it from a mobility shop, the staff should help you, but many people now buy online. Make sure you read, understand and follow the instructions which should come with it.

A general rule for all types of walking frame is not to over-extend yourself. Move the frame only a short distance in front of you then, gripping the frame securely for support, step forward into it. Once you feel secure, repeat the process. You’ll soon find your confidence improving as the step-by-step pattern of movement becomes more familiar.

The National Health Service in Scotland has produced a series of helpful videos on using walking aids. Click on the highlighted text to link to videos on using a walking stick, using crutches, or using a walking frame. Remember though, particularly if using crutches or a frame, you should seek one-to-one advice, tailored to your individual needs, from a qualified physiotherapist.