Topic Overview

A walking aid—a walker, crutches, or a cane—helps substitute for a decrease in strength, range of motion, joint stability, coordination, or endurance. It can also decrease the stress on a painful joint or limb. Using a walking aid can help you be more safe and independent in your daily activities.

Almost everyone has used a walking aid at some time, even if it was just playing around with crutches that belonged to someone else. As a result, most people think they know how to use this equipment. But there are some simple principles that will make using your walking aid easier and safer.

General safety when using walking aids:

• Look straight ahead, not down at your feet.
• Clear away small rugs, cords, or anything else that could cause you to trip, slip, or fall.
• Be very careful around pets and small children. They can be unpredictable and get in your path when you least expect it.
• Be sure the rubber tips on your walking aid are clean and in good condition to help prevent slipping. You can buy replacement tips from medical supply stores and drugstores. Ice tips are also available to use outdoors in winter weather.
• Avoid slick conditions, such as wet floors and snowy or icy driveways. In bad weather, be especially careful on curbs and steps.
• Never use your walking aid to help you stand up or sit down. Even if you still have one hand on your walking aid, put the other hand on the surface you are sitting on or the arm of your chair. Use that hand to guide you as you sit down and to push with as you stand up. If you are less steady on your feet, rest your walking aid securely nearby, so it doesn't fall and you can reach it easily. And use both hands on the sitting surface to help you sit down or stand up.
• Always use your strong or uninjured leg to take the first step when you go up stairs or a curb (see instructions for curbs and stairs below). When you go back down, step with your weak or injured leg first. Remember "up with the good, and down with the bad" to help you lead with the correct leg. Ask for help if you feel unsure about going up and, especially, down stairs.

Using crutches

Crutches allow you to take some or all the weight off of one leg. They can also be used as an added support if you have some injury or condition of both legs. Your doctor will recommend crutches only if you have good balance, strength, and endurance.

Most people use axillary crutches, which go up under the arms. If you are going to use crutches for an extended period, your doctor may recommend crutches that clip around your forearms. The same walking instructions will work for either kind of crutches.

Note that when you are standing still with your crutches, they should be slightly in front of you, so the crutches and your feet form a triangle. Hold the crutches close enough to your body so you can push straight down on them, but leave room between the crutches for your body to pass through. Do not rest your underarms on the tops of your crutches, because you could damage a nerve that goes under your arm.

Be sure your crutches fit you. When you stand up in your normal posture, there should be space for two or three fingers between the top of the crutch and your underarm. When you let your hands hang down, the hand grips should be at your wrists. When you put your hands on the hand grips, your elbows should be slightly bent.

To walk using crutches:

1. Set the crutches at arm's length in front of you. Don't lean forward to reach farther.
2. If you can put any weight on your weak or injured leg, move it forward, almost even with the crutches.
3. Push straight down on the handles as you bring your good leg up, so it is even with the weak or injured leg. Keep all the weight on your hands and not on your underarms.
4. Repeat.

When you are confident using the crutches, you can move the crutches and your injured leg at the same time, then push straight down on the crutches as you step past the crutches with your strong leg, as you would in normal walking.

If you need to keep all the weight off the injured leg:

• Move your crutches forward, then push down on the hand grips and swing your strong leg forward almost up to the crutches. This is called "swing-to" gait because you swing your body up to the crutches. Remember it's best to form a triangle with the tips of the crutches and your foot. It's harder to balance if they all line up.
• When you are strong and your balance is good, you can swing your body between the crutches and land the strong leg in front of them, so you take a bigger step. This is called "swing-through" gait.

To go up or down a curb using crutches:

Try this first with another person nearby to steady you if needed.

1. Stand near the edge of the curb, and get your balance.
2. If you are going up, step up with your stronger leg first. Then bring the crutches and your weaker or injured leg up to meet it. If you are going down, move the crutches down first. Step down with your weaker leg first. Then bring your stronger leg down to meet it. Remember "up with the good, and down with the bad" to help you lead with the correct leg.
3. Push straight down on the crutches for balance and to take weight off your injured leg.
4. Get your balance again before you start walking.

To use your crutches on stairs:

Try this first with another person nearby to steady you if needed.

If the stairs have a good sturdy banister, you can hold the banister with one hand. Put both crutches together and use them with the other hand. If there is no banister or you do not think the banister is sturdy enough, use the crutches normally, holding one in each hand.

1. Stand near the edge of the stairs.
2. If you are going up, step up with your stronger leg first, then bring the crutches and your weaker or injured leg up to meet it. If you are going down, move the crutches down first. Step down with your weaker leg first, then bring your stronger leg down to meet it.
3. Repeat.
4. When you reach the level surface, get your balance again before you start walking.